The Great Debate: SDF vs NaF in Pediatric Dentistry
When it comes to arresting early childhood caries (ECC), the debate often centers around the effectiveness of different fluoride treatments. This recent study dives deep into this topic, comparing Silver Diamine Fluoride (SDF) with Sodium Fluoride (NaF) varnish, both supported by motivational interviewing (MI) sessions for mothers.
The Source Article Details
Effectiveness of silver diamine fluoride versus sodium fluoride varnish combined with mother's motivational interviewing for arresting early childhood caries: a randomized clinical trial by Randa Yassin et al. in 2023.
The Source Article's Abstract
Background
Silver Diamine Fluoride (SDF) has gained attention as one of the minimally invasive modalities to manage ECC although it causes black staining of treated carious lesions. A possible affordable alternative may be Sodium Fluoride (NaF) varnish combined with good oral hygiene promoted by parental Motivational Interviewing (MI). The study compared the effectiveness of 38% SDF solution and 5% NaF varnish supported by parental MI in arresting ECC.
Materials and Methods
Children aged ≤ 4 years old with at least one active carious lesion (ICDAS score ≥ 3) were randomly assigned to treatment by a single application of 38% SDF solution or a single application of 5% NaF varnish supported by two MI sessions for mothers at baseline and after three months.
Results
The study included 165 children with 949 active lesions. After 6 months, there were no significant differences between SDF and NaF/MI groups in overall caries arrest (63.7% and 58.1%, p = 0.08), and in moderate lesions (72.9% and 69.6%, p = 0.52). However, in advanced lesions, the arrest rate was significantly higher in the SDF than the NaF/ MI group (60.3% and 50.0%, P = 0.01).
Citing the Source Article (APA)
Yassin, R., Amer, H., Tantawi, M.E. (2023). Effectiveness of silver diamine fluoride versus sodium fluoride varnish combined with mother's motivational interviewing for arresting early childhood caries: a randomized clinical trial. BMC Oral Health, 23(1), 710-710. 10.1186/s12903-023-03456-3
The Power of Parental Involvement
The study takes a unique approach by incorporating motivational interviewing sessions for mothers. This is a significant step forward in acknowledging the role parents play in a child’s oral health.
MI is a patient-centered, collaborative counseling approach designed to strengthen an individual’s intrinsic motivation towards positive behavior. The study suggests that MI can be a game-changer in promoting good oral hygiene practices, which are crucial in managing ECC.
Key Findings: A Close Call with a Twist
- SDF and NaF were both effective in arresting ECC, with no significant differences in overall caries arrest.
- In moderate lesions, both treatments were almost equally effective.
- However, SDF had a higher arrest rate in advanced lesions compared to NaF.
PP-ICONS Analysis: A Closer Look
- Problem: The study focuses on Early Childhood Caries (ECC), a prevalent issue in pediatric dentistry.
- Patient or Population: Children aged ≤ 4 years old with at least one active carious lesion.
- Intervention: A single application of 38% SDF solution or a single application of 5% NaF varnish.
- Comparison: Both treatments were supported by two MI sessions for mothers.
- Outcome: The study measured the effectiveness of the interventions in arresting ECC.
- Number of Subjects: The study included 165 children.
- Statistics: Chi-Squared test and multilevel logistic regression analysis were used.
Implications for the Medical Profession
The study opens up new avenues for treatment strategies in pediatric dentistry. While SDF and NaF are both effective, the choice between them may depend on the severity of the lesions.
Moreover, the inclusion of MI sessions adds another layer to the treatment, emphasizing the importance of parental involvement in managing ECC.
What are your thoughts on the role of motivational interviewing in pediatric dentistry? Do you think SDF is a better option for advanced lesions? We’d love to hear your insights.