Silver Diamine Fluoride to Arrest Dentine Caries of Permanent Teeth in People with Intellectual Disability

Abstract

Background: This study aimed to compare the effectiveness of 38% silver diamine fluoride (SDF) with different application frequencies in arresting dentine caries of permanent teeth in people with intellectual disabilities (ID) and evaluated their treatment cooperation. Methods: Forty-six people with ID (aged 6-30 years) with at least one permanent dentine caries were assigned to two groups: Group 1 (N = 23, 51 teeth) received semiannual applications, while Group 2 (N = 23, 61 teeth) received once a week for 3 consecutive weeks, followed by one application semiannually. Caries activity and Frankl behaviour rating scales were assessed at baseline, 6, and 12 months. Chi-squared, Fisher's exact, and multilevel logistic regression analyses were performed. Results: At 6 months, the between-group difference in caries-arresting rate was not statistically significant (14.0%, 95% CI: –0.7%, 28.7%). At 12 months, unadjusted analysis showed significantly higher caries-arresting rates in Group 2 compared to Group 1 (difference: 18.9%, 95% CI: 2.5%,35.3%). However, multilevel logistic regression revealed no significant differences between groups at both time points. No subjects showed behaviour deterioration; behaviour improvement was observed in 37.5% of Group 1 and 57.1% of Group 2 at 12 months. Conclusion: Overall, 38% SDF is effective in arresting dentine caries in people with ID without a significant difference in application frequency. Applying 38% SDF does not negatively impact behaviour in people with ID and may promote positive behavioural changes.