Effect of silver diamine fluoride and nano silver fluoride on oral health-related quality of life of children with early childhood caries: A randomized clinical trial

J Dent. 2024 Mar:142:104878. doi: 10.1016/j.jdent.2024.104878. Epub 2024 Feb 2.

Abstract

Objectives: Untreated caries in primary teeth is one of the most prevalent health problems in children worldwide. Silver diamine fluoride (SDF) non-invasively arrests caries but causes staining unlike Nano Silver Fluoride (NSF) which causes no stains. This study compared the effect of NSF and 38 % SDF on the oral health related quality of life (OHRQoL) of preschool children after 6 months.

Methods: Children were included if they were younger than 4 years, with at least one active lesion, ICDAS score ≥3, attending nurseries in a rural area in Alexandria, Egypt. They were randomly assigned to receive NSF once at baseline, or SDF at baseline and after 6 months. The Arabic version of the Early Childhood Oral Health Impact Scale (A-ECOHIS) was used to assess the OHRQoL. The groups were compared using chi-square test and the effect of the intervention on OHRQoL was assessed using multiple linear regression.

Results: 360 children were included, mean (SD) age = 42.3 (8.2) months. After 6 months, NSF had significantly lower A-ECOHIS scores than SDF in bivariate analysis (p< 0.05) and in regression analysis (B= -5.02, p = 0.001) after adjusting for confounders. There were significant reductions in the A-ECOHIS total and domains' scores in both study groups, except for the social interaction domain in the SDF group.

Conclusion: After 6-month, both agents significantly improved children's OHRQoL although NSF had a significantly better impact on OHRQoL than SDF.

Clinical significance: Patient-reported outcomes support the inclusion of the two agents among the options for ECC management with better effect on quality of life after NSF.

Trial registration: The trial was registered in the clinicaltrials.gov registry (#NCT05255913).

Keywords: Early childhood caries; Nano silver fluoride; Oral health related quality of life; Preschool children; Silver diamine fluoride.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Cariostatic Agents / therapeutic use
  • Child, Preschool
  • Dental Caries Susceptibility
  • Dental Caries* / drug therapy
  • Dental Caries* / prevention & control
  • Fluorides* / therapeutic use
  • Fluorides, Topical / therapeutic use
  • Humans
  • Quality of Life
  • Quaternary Ammonium Compounds / pharmacology
  • Quaternary Ammonium Compounds / therapeutic use
  • Silver Compounds / therapeutic use

Substances

  • Cariostatic Agents
  • Fluorides
  • Fluorides, Topical
  • Quaternary Ammonium Compounds
  • Silver Compounds
  • silver diamine fluoride
  • silver fluoride

Associated data

  • ClinicalTrials.gov/NCT05255913