Arrest of interproximal caries lesion in primary molars with 38% silver diamine fluoride solution and 5% sodium fluoride varnish: A randomized clinical trial

Abstract

Background: Dental caries is a global public health concern, with interproximal caries presenting a particular challenge due to their limited accessibility. Fluoride has long been employed in the prevention and management of early‑stage carious lesions. Aim: To evaluate and compare the effectiveness of 38% silver diamine fluoride (SDF) and 5% sodium fluoride varnish (NaF) in arresting interproximal caries in primary molars. Settings and Design: A split‑mouth randomized clinical trial was conducted following the CONSORT guidelines. Methods: Children aged 5–9 years with at least two noncavitated interproximal carious lesions (ICCMS stages RA1–RB4) were included. Teeth were randomly assigned to receive either 38% SDF (Group 1) or 5% NaF varnish (Group 2), applied biannually. Caries arrest was assessed radiographically as primary outcome at 6, 9, and 12 months. Statistical Analysis: Descriptive statistics summarized the data. Normality was confirmed through the Shapiro–Wilk test, permitting parametric analysis. Paired and unpaired t‑tests assessed intra‑ and inter‑group differences, respectively, and Chi‑square tests analyzed the categorical variables. A two‑tailed α =0.05 and power of 80% were applied. Results: At the 12‑month follow‑up, the caries arrest rate was 76.31% in Group 1 and 47.3% in Group 2, showing a statistically significant difference (P < 0.05). The arrest rates for 38% SDF at RA1, RA2, RA3, and RB4 were 90.9%, 88%, 80%, and 37.5%, respectively, compared to 80%, 60%, 22.2%, and 0% for 5% NaF varnish. Conclusion: SDF demonstrated greater effectiveness than NaF varnish in arresting interproximal caries in primary molars, particularly in lesions involving dentin.