Comparing the anticaries effects of silver diamine fluoride and propolis tincture among community-dwelling older adults - a randomized controlled trial

Dental caries remains a major oral health burden among older adults, where conventional fluoride strategies may be less effective. The aim of this study was to compare the anticaries effects of 38% Silver Diamine Fluoride (SDF) with Propolis tincture in community-dwelling older adults. In a randomized trial, participants aged 55–65 years with active caries were allocated to receive either 38% SDF (Advantage Arrest®, Elevate Oral Care, USA) or Propolis tincture (Superbee®, Hi-Tech Natural Products (India) Ltd., India) at baseline, with follow-ups at 3 and 6 months. Caries progression and arrest were assessed using ICDAS and Root Caries Index (RCI). Primary outcome was caries arrest; secondary outcomes included progression, new lesions, and tolerability. Analyses followed the intention-to-treat principle. At the three-month follow-up, SDF achieved an 87% caries arrest rate versus 55% for Propolis tincture, indicating superior arrest and prevention with SDF (p<0.05). These findings persisted at six months, with SDF maintaining higher efficacy in arresting progression and preventing new lesions. Propolis showed some benefit for moderate lesions but was less effective in halting new caries. Safety data were not reported in the provided source. The 38% SDF formulation was more effective than Propolis tincture for caries arrest and prevention in geriatric dental care over six months. Propolis tincture may serve as an adjunct; however, its slower antibacterial action and lack of fluoride limit standalone effectiveness. Longer-term trials and combination approaches are warranted.