COMPARATIVE EFFECTIVENESS OF SILVER DIAMINE FLUORIDE AND RESIN INFILTRATION IN ARRESTING CARIES IN PEDIATRIC PRIMARY TEETH: A CLINICAL AND BEHAVIORAL STUDY
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Keywords
Silver diamine fluoride, Resin infiltration, Pediatric dentistry, Caries arrest, Behavioral acceptance, Minimally invasive dentistry
Abstract
Non-restorative treatment options such as silver diamine fluoride (SDF) and resin infiltration (RI) have gained increasing attention in pediatric dentistry for minimally invasive management of dental caries. While both modalities arrest lesion progression, their clinical effectiveness and behavioral acceptance remain areas of ongoing evaluation.
Objective: To compare the clinical and behavioral effectiveness of SDF and RI in the arrest of caries in pediatric primary teeth.
Methods: A systematic review of randomized controlled trials, clinical studies, and meta-analyses published up to 2025 was conducted. Clinical outcomes assessed included caries arrest, lesion progression, remineralization potential, treatment longevity, and recurrence. Behavioral outcomes included child discomfort, parental acceptance, and aesthetic satisfaction. Evidence was synthesized in narrative form and supported with a comparative analysis table.
Results: SDF demonstrated high arrest rates (25–99%) in cavitated dentin lesions, with enhanced efficacy observed for 38% solutions applied biannually. Its advantages included rapid, low-cost application and excellent child tolerance, though black staining significantly reduced parental acceptance, particularly for anterior teeth. RI effectively inhibited progression of non-cavitated proximal lesions, with long-term studies showing 70–90% lesion stability up to 4 years post-treatment. It provided superior esthetic outcomes and high parental satisfaction, but required rubber dam isolation, longer chairside time, and greater child cooperation. Both modalities were safe, with no significant adverse events reported.
Conclusions: Both SDF and RI are clinically effective but context-specific interventions. SDF is optimal for uncooperative children and cavitated lesions, offering ease and cost-effectiveness despite esthetic compromise. RI is better suited for cooperative patients with incipient lesions, providing excellent esthetic outcomes with durable lesion control. Treatment choice should be guided by lesion characteristics, patient cooperation, and parental preferences.
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Dr. Muhammad Zohaib Younus
FCPS Operative Dentistry, Assistant Professor & Head, Department of Paedodontics, Hamdard University Dental Hospital, Pakistan.
Dr. Saher Ahmed
Hamdard University Dental Hospital, Pakistan
Dr. Syeda Malika Haider
BDS, MBA (Healthcare & Hospital Management), CHPE, Jinnah Sindh Medical University, Pakistan.
Dr. Hafsa Tajwar
BDS, M.Phil (Physiology), Ziauddin University, Pakistan.
Dr. Amber Shams
MBBS, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan; Professional Diploma in Gynaecology & Obstetrics, Royal College of Physicians of Ireland (RCPI).
Dr. Rabiya Nadeem
BDS, RDS, Graduate, Jinnah Medical & Dental College, Pakistan.