Silver diamine fluoride versus sodium fluoride varnish in the treatment of proximal caries in primary molars: A randomized clinical trial

The present randomized clinical trial with a split-mouth design investigated the effectiveness of 30% silver diamine fluoride (SDF) compared to 5% sodium flouride varnish (NaD) in arresting proximal caries in the primary molars of preschool-aged children. Forty-three children with contralateral initial proximal carious lesions on primary molars were included. Caries status at the baseline was recorded using clinical and radiographic indices. Lesions restricted to the enamel or the exterior third of dentin were included. A sufficient space was created between the contacts using elastic separators. Then, 5% NaF varnish and 30% SDF were randomly applied to either side of the mouth. Six months later, bitewing radiographs were obtained, and the post-intervention caries scores were compared with the baseline radiographs. Children's oral hygiene was recorded via a questionnaire. The findings indicated that the baseline and post-intervention caries status were comparable between the groups. The success rate of the SDF treatment (74.4%) and the NaF varnish (67.5%) was comparable. Baseline radiographic caries status was significantly related to the treatment result in the NaF group (p = 0.047). Dental flossing was significantly associated with the treatment result when SDF was used (p = 0.027). In conclusion, both fluoride-containing materials exhibited comparable efficacy in arresting early proximal caries lesions in primary molars. SDF 30% showed a higher but insignificant success rate in arresting initial proximal lesions of the primary molar compared to NaF 5% varnish.Trial registration: IRCT, IRCT20220425054647N1. Registered on 24 September 2022, https://en.irct.ir/trial/63168 .