Effectiveness of bi-annual application of 38% silver diamine fluoride and 5% sodium fluoride varnish on primary teeth of children, in a rural setting near Port Moresby, Papua New Guinea - A randomised clinical trial

Abstract

Aim: To assess the effectiveness of 38% silver diamine fluoride (SDF) solution and 5% sodium fluoride (NaF) varnish applied bi-annually in arresting carious lesions in primary teeth of children and to assess child and parent acceptability of the treatments. Methods: Children aged 2-5 years with at least one carious lesion were randomly allocated into 2 groups as follows: Group 1 received 38% SDF (Riva star SDI Ltd) solution and Group 2 received 5% NaF varnish (Duraphat®), applied at baseline and again at 6 months. Lesion progress or arrest was assessed by visual and tactile examination at 6 months and 12 months. Parental and child satisfaction were assessed with self-reports at 6 months and 12 months. Results: One hundred and four children were recruited. Baseline mean dmfs scores were 10.8 and 11.7 for Group 1 and 2 respectively. At 12 months, 86.5% (90) participants remained in the study. The caries arrest rate in SDF group, was higher than that of NaF group, 97.2% vs 71.5 % (p < 0.001). Logistic regression analysis showed that 38% SDF was more effective than the 5% NaF varnish (OR: 7.7, 95% CI=3.14 -19.09) in arresting carious lesions. There were no differences in parental and child satisfaction between the groups. Conclusion: At 12 months, both 38% SDF and 5% NaF were effective in arresting dental carious lesions, however 38% SDF was superior to 5% NaF. Parents and children were accepting of the treatment provided.