SDF vs resin sealants in preventing caries among high-risk children: a 2-year randomized trial

This study was a parallel, double-blind, randomized clinical trial that aimed to evaluate the effect of silver diamine fluoride (SDF) on the prevention of dental caries in the first permanent molars of children. A total of 68 students aged 6 to 9 years from a public school in Diamantina, Brazil, participated. All children were classified as high caries risk and had at least one fully erupted molar without restorations or sealants. The participants were randomly divided in a 1:1 ratio to receive either SDF or resin sealant. The main outcome was the incidence of new carious lesions after 24 months. Secondary outcomes included plaque accumulation, gingival bleeding, oral health-related quality of life (OHRQoL, CPQ-8-10), caregiver satisfaction, and discomfort reported by the children using the Wong-Baker scale. Sociodemographic and health information were collected using questionnaires, dietary diaries, and clinical examinations in accordance with ICDAS-II criteria. Statistical analysis was performed using SPSS 22.0, employing Chi-square, Mann-Whitney, and Wilcoxon tests. Most families had low incomes, and mothers were usually responsible for the children's daily care. After 2 years, the SDF group showed a significant reduction in plaque compared with baseline, whereas the sealant group showed a small, non-significant increase. No significant difference in gingival bleeding was observed between groups. Both interventions were well tolerated, although the dark staining of the SDF-treated teeth was clearly visible. In conclusion, SDF demonstrated good preventive performance and acceptance among children at.