Effectiveness of Silver Diamine Fluoride vs. Fluoride Varnish for Arresting Dental Caries in School-Aged Children in Gilgit-Baltistan

Abstract

Background:
Dental caries remains a prevalent chronic disease among children, particularly in underserved regions such as Gilgit-Baltistan, where access to restorative dental care is limited. Minimally invasive, cost-effective interventions are vital for effective caries management. Silver Diamine Fluoride (SDF) has recently gained global attention for its dual antibacterial and remineralizing properties, offering a simple, affordable, and efficient method to arrest carious lesions.

Objective:
To evaluate and compare the effectiveness of 38 % Silver Diamine Fluoride and 5 % Fluoride Varnish in arresting active dentinal caries among school-aged children in Gilgit-Baltistan.

Methods:
A randomized controlled trial was conducted among 180 children aged 6–12 years attending private hospitals in Gilgit-Baltistan. Participants were randomly assigned to receive either 38 % SDF or 5 % Fluoride Varnish. Lesion activity was assessed at baseline, 6 months, and 12 months using standardized clinical criteria. The primary outcome was the proportion of arrested carious lesions. Data were analyzed using chi-square tests and logistic regression, with significance set at p < 0.05.

Results:
At 12 months, 82.1 % of lesions in the SDF group were arrested compared to 50.0 % in the Fluoride Varnish group (p < 0.001). The mean number of arrested lesions per child was higher in the SDF group (1.87 ± 0.82) than in the FV group (1.02 ± 0.76). No serious adverse effects were reported, apart from expected black discoloration of arrested lesions.

Conclusion:
SDF demonstrated superior caries-arrest effectiveness compared to Fluoride Varnish, confirming its value as a safe, efficient, and feasible caries management option for school-aged children in resource-limited settings.

Keywords:
Caries Arrest, Children, Dental Caries, Fluoride Varnish, Gilgit-Baltistan, Randomized Controlled Trial, Silver Diamine Fluoride