Comparison of the effectiveness of 38% silver diamine fluoride and atraumatic restorative treatment for treating dental caries in a school setting: A randomized clinical trial.

Background: Dental caries is an infectious microbial disease of the teeth, affecting mostly young children. It is caused by the interplay of numerous factors that are more common in susceptible and lower-income groups. Therefore, there is a dire need for a simple yet effective method of treating dental caries.

Objectives: The aim of the study was to compare the effectiveness of 38% silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) in the treatment of dental caries in a school setting.

Material And Methods: A randomized clinical trial (RCT) using a parallel-group design was conducted among schoolchildren aged 6-12 years. Oral hygiene practices and sugar exposure were recorded at baseline. In the schoolchildren, 190 dental caries lesions were restored using 38% SDF (group 1) or ART (group 2). The χ 2 test and the Kaplan-Meier survival analysis were done to assess the 2 treatment modalities. The RCT was carried out and reported in accordance with the CONSORT (Consolidated Standards of Reporting Trials) checklist.

Results: A total of 190 children fulfilled the inclusion criteria and the mean age of the study population was 9.3 ±1.3 years. The majority of the participants brushed their teeth once daily, using a toothbrush, rinsed their mouth after meals and had optimal sugar exposure. In measuring the outcome of the interventions after 9 months, 58.9% of the participants from group 1 had their restorations intact as compared to 47.8% in group 2, and this was found to be statistically significant (p = 0.004). The survival analysis using the log rank test showed 38% SDF to be better in comparison with ART.

Conclusions: This study indicated that SDF was better at arresting caries, and hence it can be considered a viable treatment option in areas with limited access to oral healthcare.