Comparative Evaluation of Salivary Fluoride Concentration after Topical Application of Silver Diamine Fluoride and Sodium Fluoride: A Randomized Controlled Trial

Abstract

Background: The topical fluoride acts on the tooth in many ways and their most important action is inhibition of demineralization and enhancement of enamel remineralization. Aim: The purpose of this clinical trial was to assess the fluoride concentration in saliva before and after 38% silver diamine fluoride (SDF) and 5% sodium fluoride (NaF) application on enamel and duration of its availability at different time intervals. Methodology: A randomized clinical trial was conducted among 40 healthy children aged between 6 and 12 years. The participants were then randomly allocated into two different groups in which the first group (group I) was given 30% SDF and the second group (group II) were topically applied with 5% NaF solution. The fluoride concentration was measured in the salivary samples, which were collected at three time intervals, that is, at baseline (S1), 2 hours (S2), and 24 hours (S3) after application. Analysis of variance (ANOVA) test was used for evaluation and independent paired t-test was conducted for comparison between groups. Results: When using an ANOVA with repeated measures with a Greenhouse–Geisser correction, the mean scores of fluoride concentration were statistically significantly different at different time intervals for both NaF (F = 20.854, p < 0.0005) and SDF (F = 22.746, p < 0.0005). Conclusion: The present trial concluded that topical fluoride application increases fluoride bioavailability in saliva thereby increasing tooth remineralization. A steep rise in fluoride concentration was observed shortly post-SDF application at 2 hours and 24 hours time interval emerging a need for further research into the field of fluoridation with SDF.