Effectiveness of silver diamine fluoride and glass ionomer cement combined with fluoride varnish in arresting dental caries among intellectually disabled individuals: A randomized controlled trial

Spec Care Dentist. 2021 Sep;41(5):544-552. doi: 10.1111/scd.12607. Epub 2021 May 25.

Abstract

Aim: To assess the clinical effectiveness of 38% silver diamine fluoride (SDF) in arresting dental caries when compared to combination of fluoride-containing glass ionomer cement (GIC) and fluoride varnish(FV) (5%) among intellectually disabled (ID) individuals.

Methodology: A randomized controlled trial was conducted among ID (n = 82) individuals, in permanent posterior teeth with Nyvad score 2 and 3 (active caries) of dental caries, randomly allocated to experimental arm (38% SDF) (n = 41) and control arm (GIC along with FV) (n = 41). The caries arrest rate and caries preventive fraction was observed at 6-months among both groups.

Results: The caries arrest rate was 94.5% with SDF and 90.1% with GIC and FV (p = 0.405).The caries preventive fraction of SDF over GIC with FV was 45%, with hazard ratio (-0.588) at 6 months (p = 0.292). The binary logistic regression revealed that the Odds of arresting caries in SDF group is two times when compared to GIC group with p value = 0.218 which is not significant.

Conclusion: The present study concluded that the SDF is as clinically effective as combination of GIC and fluoride varnish in arresting caries. Further research and longer follow-up required for more conclusive results.

Keywords: Nyvad's criteria; glass ionomer cement; intellectually disabled; silver diamine fluoride, fluoride varnish.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Cariostatic Agents
  • Dental Caries* / prevention & control
  • Fluorides
  • Fluorides, Topical* / therapeutic use
  • Glass Ionomer Cements / therapeutic use
  • Humans
  • Quaternary Ammonium Compounds / therapeutic use
  • Silver Compounds

Substances

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