Clinical Trial Details
— Status: Completed
Administrative data
NCT number |
NCT06316323 |
Other study ID # |
REC/09/2021 (FB/51) |
Secondary ID |
|
Status |
Completed |
Phase |
Phase 1
|
First received |
|
Last updated |
|
Start date |
February 1, 2023 |
Est. completion date |
January 26, 2024 |
Study information
Verified date |
March 2024 |
Source |
Universiti Teknologi Mara |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Interventional
|
Clinical Trial Summary
Sodium Fluoride (NAF) varnish was considered as the treatment of Early Childhood Caries
(ECC). However, the emergence of Silver Diamine Fluoride (SDF) has become more popular to
tackle dental caries among children. SDF has silver ions that harbor antibacterial properties
that play a crucial role in arresting active, cavitated carious lesions and has fluoride ions
that are important in remineralizing enamel and dentin. This randomized control trial aims to
compare the effect of SDF and NaF varnish on the salivary pH and density of Streptococcus
mutans and Lactobacillus. 49 subjects below 6 years old, attending dental treatment at the
Faculty of Dentistry, Universiti Teknologi MARA (UiTM) were recruited and were divided into
two groups of treatment: 38% SDF or 5% SDF. Saliva samples of each subject were collected to
test for salivary pH and density of S. mutans and Lactobacillus before the treatment and
after 3 months of treatment. The salivary pH were tested using a calibrated pH meter. Saliva
samples were subjected to microbiological analysis using Colony Forming Unit (CFU) and
quantitative Polymerase Chain Reaction (qPCR) technique. The findings of this study will be
used to support the use of SDF as an alternative to NaF varnish and to develop a
recommendation guideline on the clinical use of SDF in ECC management.
Description:
ECC continues to become a significant oral health concern owing to its high prevalence
worldwide despite the preventive measures taken, including excessive oral health promotion.
While conventional tooth restoration has been widely accepted as a standard intervention in
managing ECC, the traumatic effects it causes may lead to dental fear, which prevents
children from receiving dental treatment and subsequently leads to caries sequelae and
complications. There is well-established evidence-based research proving the benefits of
fluoride-based products in preventing dental caries. Previously, caries prevention in ECC was
widely considered to be due to sodium fluoride (NaF) varnish. However, a systematic review
found that treating dental caries with 5% NaF varnish is insufficient, urging the need to
find another solution that is effective in halting caries progression.
In recent years, there has been great interest in the use of Silver Diamine Fluoride (SDF) as
a new method for caries prevention because of its superior effects. The utilisation of SDF
eliminates the necessity for tooth drilling, and it possesses anticariogenic properties that
are essential for curbing active and cavitated carious lesions by rebuilding enamel and
dentin. Existing data indicate that employing a non-invasive method of applying SDF with a
38% concentration twice a year can effectively manage ECC by up to 76.3% after a 30-month
follow-up period. The application of 38% SDF has been demonstrated to significantly reduce
the occurrence of new caries in treated children by approximately 77% compared with
non-treated children.
Although various mechanisms underlying the antibacterial effects of SDF have been elucidated,
data on its effects on salivary pH and cariogenic bacteria, particularly S. mutans and
Lactobacillus, are lacking. Although several in vivo studies have explored the effect of SDF
on S. mutans and Lactobacillus, the scarcity of clinical investigations remains a challenge.
This study provides a better understanding of the effects of SDF on the modulation of
salivary pH and S. mutans and Lactobacillus and provides scientific evidence on the mechanism
of action of SDF in the oral environment. Therefore, this study is crucial to support the use
of SDF in clinical settings as an alternative to the conventional method of treatment in
managing ECC. To date, there is no clinical data regarding the use of SDF in Malaysia or the
investigation of cariogenic bacterial profiling following SDF treatment among the Malaysian
population. therefore the general research objective is to compare the effects of 38% SDF and
5% NaF on salivary pH, S. mutans, and Lactobacillus counts in children with ECC.