Parents' satisfaction with aesthetic results of non-invasive Severe-Early Childhood Caries treatments

Activity: Talk or presentation typesOral presentation


Aims: The WHO recommends non-invasive methods including Silver Diammine Fluoride (SDF) in its Implementation Manual for ending Early Childhood Caries (ECC). SDF’s dark staining compromises aesthetics but other non-staining high-fluoride products are largely untested. This randomised clinical trial, evaluated; SDF, Tiefenfluorid and a placebo (each with 2 regimes). The trial’s primary aim was reduction in caries-related complications. The secondary objective reported here is parental satisfaction with aesthetics. Methods: The trial ran between: September 2020 and May 2022. Ethics approval was obtained (Ethics Committee Nr.6-1/06/20) as was informed written parental consent. At 12-month follow-up parents rated their satisfaction with aesthetics (Likert scale, 1-5) and whether they felt it acceptable to continue with the same treatment. Data analysis involved use of the R statistics programme (R Core Team, 2013). Results: Four hundred and twenty eight children; (248 (58%) boys, 180 (42%) girls; median (IQR) age, 45 (35;55) months) with S-ECC enrolled in the study, of whom 373 (87%) were followed-up at 12-months. Overall, 166 (44.5%) children experienced major complications. Parents of 144 (69%) children were satisfied with the aesthetic outcomes of treatment (4 or 5 on 5-point Likert scale). For SDF groups: the satisfaction levels were 37 (58%) and 47 (72%); for Tiefenfluorid: 36 (65%) and 51 (77%) and for the placebo: 39 (75%) and 38 (65%). There was no evidence of a statistically significant difference between groups , but parents were more likely to be satisfied with treatment if their children had no visible plaque OR (95%CI) values of 1.91 (1.14;3.24) and no emergencies 1.99 (1.01;4.00). Parents of 359 (96%) children would definitely continue using non-invasive caries treatment. Conclusions: SDF discolouration did not negatively impact parental satisfaction compared to non-staining treatments. Clean teeth and avoidance of emergencies were important for parental satisfaction.
Acknowledgements: Supported by European Regional Development Fund
Period9 Sept 2022
Event title26th European Association of Dental Public Health (EADPH) Congress: Non-communicable diseases: time for action
Event typeCongress
Conference number26
LocationMontpellier, FranceShow on map
Degree of RecognitionInternational


  • early childhood caries
  • noninvasive caries management
  • silver diamine fluoride

Field of Science

  • 3.2 Clinical medicine