Abstract
BACKGROUND: Children from marginalized backgrounds show higher susceptibility to early childhood caries which can have serious repercussions. Determining the ideal application frequency of 38% silver diamine fluoride (SDF) is crucial for those with limited access to dental care. OBJECTIVES: This study aimed to evaluate the effectiveness of different frequencies of 38% SDF application in halting the progression of active dentin coronal carious lesions in primary teeth of children aged 2-6 years. METHODS: A randomized controlled trial with parallel arms was conducted at Amrita Kripa Hospital, Kalpetta, Wayanad, a region with a significant tribal population. Children with cavitated carious lesions were randomly assigned to three groups: (1) annual group (one application per year), (2) biannual group (two applications per year), and (3) four applications per year (at baseline, 2, 4, and 8 weeks). Carrie's arrest was assessed at 6 and 12 months. RESULTS: The study included 80 children and 440 teeth. The four-application group showed the highest caries arrest rate (80.5%), followed by the biannual group (78.2%) and the annual group (58.4%). Statistical analysis revealed significant differences between the groups (χ2 = 21.873, P < 0.001). CONCLUSIONS: More frequent SDF applications (four times per year) were significantly more effective in halting caries progression compared to biannual or annual applications, particularly evident in tribal children; a high-risk population with limited access to dental care. The study supports the use of SDF as a noninvasive, cost-effective preventive treatment for young children, especially in resource-limited settings, and emphasizes the need for frequent SDF applications in community-based oral health programs with limited dental care access.