Knowledge, attitude and practice of paediatric dentists towards silver diammine fluoride in Egypt: a national survey

The primary aim was to assess the educational experience, knowledge, attitude, behaviour, and perceived barriers regarding silver diammine fluoride (SDF) use by Egyptian paediatric dentists. A secondary aim was to analyse how these domains are related.

This cross-sectional survey used a pre-validated questionnaire, distributed electronically to all registered Egyptian paediatric dentists (n = 745) between March and May 2025. Data were analysed using SPSS version 23.0, with statistical significance set at p < 0.05.

A total of 546 paediatric dentists completed the survey (73% response rate). Most respondents (96.7%) were familiar with SDF, mainly through dental school (53.8%), and reported greater exposure during postgraduate training. Overall, 84.1% demonstrated moderate-good knowledge and positive attitudes towards SDF use, particularly for non-aesthetic primary teeth (88.7%) and patients with behavioural (85.6%) or medical (85%) challenges. However, clinical application remained limited, mainly for arresting caries lesions in primary teeth (32.4%), with patient or caregiver non-acceptance (89.1%) being the main barrier. Knowledge, attitude, and practice were positively correlated, and higher academic qualifications were significantly associated with greater knowledge and more frequent SDF use.

Although Egyptian paediatric dentists showed good awareness and positive attitudes towards SDF, its clinical use remained limited by parental reluctance and aesthetic concerns. Broader adoption may be supported by integrating SDF into undergraduate curricula, enhancing postgraduate training, and promoting targeted education campaigns.

Improved education and training on SDF can enhance its clinical use for managing caries in uncooperative or high caries-risk children. Addressing aesthetic concerns and caregiver acceptance may further support its wider adoption in paediatric practice. Individualised caries-risk assessment, integrated within a holistic caries-management plan, is essential for achieving successful SDF outcomes.