{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T16:47:23Z","timestamp":1775666843999,"version":"3.50.1"},"reference-count":39,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T00:00:00Z","timestamp":1703116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Silver diamine fluoride (SDF) has been incorporated into the treatment of dental caries in children, mainly in countries with high caries prevalence. In Europe, however, SDF started to gain popularity during the COVID-19 pandemic. This study aimed to investigate the efficacy of SDF and to evaluate dentists\u2019\/parents\u2019 acceptance of SDF use in paediatric patients treated in a German university setting. Materials and Methods: A retrospective analysis of all patients treated with SDF between 2017 and 2020 was carried out. Only teeth with no reported clinical\/radiographic evidence of irreversible pulpal inflammation were included. The outcome measures were success, minor failures (caries progression, reversible pulpitis) and major failures (irreversible pulpitis, abscess). The treatment acceptance by dentists and the parents of SDF-treated children was cross-sectionally evaluated using questionnaires. Descriptive statistics and Kaplan\u2013Meier survival analysis were performed. Results: A total of 93 patients (mean age 5.3 \u00b1 2.9 years) with 455 treated teeth (418 primary\/91.9%; 37 permanent\/8.1%) were included and followed up for up to 24 months (19.9 \u00b1 10.5 months). SDF was used for dental caries (98.2%) and hypersensitivity relief on MIH teeth (1.8%). Most teeth did not show any failure (total success 84.2%). A total of 5 teeth (1.1%) showed minor failures, and 67 teeth (14.7%) showed major failures (p = 0.001). Success\/failure rates were not affected by patient compliance, gender, dentition, or operator (p &gt; 0.05). In total, 30 questionnaires were collected from parents (mean age 36.8 \u00b1 6.4 years). SDF was applied on anterior (n = 2\/6.7%), posterior (n = 15\/50%) and anterior\/posterior teeth (n = 13\/43.3%). At the 1-week follow-up, 80% of parents noticed black teeth discoloration. Treatment satisfaction was higher for posterior (95.2%) than for anterior teeth (36.4%; p &lt; 0.001). In the 27 responses from clinicians, SDF was generally considered a viable option in paediatric dentistry (n = 23; 85%). Conclusions: SDF was found to be effective and well-accepted by parents and dentists for caries inactivation in a paediatric dentistry German university setting.<\/jats:p>","DOI":"10.3390\/medicina60010016","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T05:36:12Z","timestamp":1703136972000},"page":"16","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Silver Diamine Fluoride Renaissance in Paediatric Dentistry: A 24-Month Retrospective and Cross-Sectional Analysis"],"prefix":"10.3390","volume":"60","author":[{"given":"Ruba","family":"Abdulrahim","sequence":"first","affiliation":[{"name":"Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian H.","family":"Splieth","sequence":"additional","affiliation":[{"name":"Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mhd Said","family":"Mourad","sequence":"additional","affiliation":[{"name":"Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany"},{"name":"Department of Orthodontics, University of Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annina","family":"Vielhauer","sequence":"additional","affiliation":[{"name":"Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manasi R.","family":"Khole","sequence":"additional","affiliation":[{"name":"Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1322-6351","authenticated-orcid":false,"given":"Ruth M.","family":"Santamar\u00eda","sequence":"additional","affiliation":[{"name":"Department of Preventive and Pediatric Dentistry, University of Greifswald, 17475 Greifswald, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Butera, A., Maiorani, C., Morandini, A., Simonini, M., Morittu, S., Trombini, J., and Scribante, A. (2022). Evaluation of Children Caries Risk Factors: A Narrative Review of Nutritional Aspects, Oral Hygiene Habits, and Bacterial Alterations. Children, 9.","DOI":"10.3390\/children9020262"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Qasim, S.S.B., Ali, D., Khan, A.S., Rehman, S.U., Iqbal, A., and Baskaradoss, J.K. (2021). Evidence-Based Bibliometric Analysis of Research on Silver Diamine Fluoride Use in Dentistry. BioMed Res. Int., 2021.","DOI":"10.1155\/2021\/9917408"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1159\/000504335","article-title":"How to Intervene in the Caries Process: Early Childhood Caries\u2014A Systematic Review","volume":"54","author":"Schmoeckel","year":"2020","journal-title":"Caries Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1007\/s40368-021-00675-6","article-title":"Minimal intervention dentistry for managing carious lesions into dentine in primary teeth: An umbrella review","volume":"23","author":"BaniHani","year":"2022","journal-title":"Eur. Arch. Paediatr. Dent."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1159\/000508899","article-title":"How to Intervene in the Caries Process: Dentin Caries in Primary Teeth","volume":"54","author":"Abudrya","year":"2020","journal-title":"Caries Res."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"World Health Organization (2021). WHO Model List of Essential Medicines-22nd List, 2021, World Health Organization. Technical Document.","DOI":"10.1530\/ey.19.13.1"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1177\/0810767","article-title":"Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children","volume":"81","author":"Chu","year":"2002","journal-title":"J. Dent. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1111\/j.1875-595X.2011.00088.x","article-title":"Paradigm shift in the effective treatment of caries in schoolchildren at risk","volume":"62","author":"Ribeiro","year":"2012","journal-title":"Int. Dent. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"147","DOI":"10.15236\/ijcpd.2017.13.3.147","article-title":"Caries Arresting Effect of Silver Diamine Fluoride in Vietnamese Preschool Children","volume":"13","author":"Nguyen","year":"2017","journal-title":"Int. J. Clin. Prev. Dent."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"685557","DOI":"10.3389\/froh.2021.685557","article-title":"Global Oral Health Policies and Guidelines: Using Silver Diamine Fluoride for Caries Control","volume":"2","author":"Gao","year":"2021","journal-title":"Front. Oral Heal."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1159\/000507692","article-title":"How to Intervene in the Caries Process in Children: A Joint ORCA and EFCD Expert Delphi Consensus Statement","volume":"54","author":"Splieth","year":"2020","journal-title":"Caries Res."},{"key":"ref_12","first-page":"788","article-title":"How did the COVID-19 pandemic lockdown affect dental emergency care in children? Retrospective study in a specialized pedodontic center","volume":"52","author":"Splieth","year":"2021","journal-title":"Quintessence Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1038\/sj.bdj.4813466","article-title":"A novel technique using preformed metal crowns for managing carious primary molars in general practice\u2014A retrospective analysis","volume":"200","author":"Innes","year":"2006","journal-title":"Br. Dent. J."},{"key":"ref_14","unstructured":"Basner, R., Santamaria, R.M., Schmoeckel, J., Sch\u00fcler, E., and Splieth, C.H. (2018). Epidemiologische Begleituntersuchungen zur Gruppenprophylaxe 2016, DAJ-Deutsche Arbeitsgemeinschaft F\u00fcr Jugendzahnpflege e. V."},{"key":"ref_15","first-page":"181","article-title":"Outcomes of dental procedures performed on children under general anesthesia","volume":"27","author":"Herman","year":"2003","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"144","DOI":"10.2344\/anpr-64-04-05","article-title":"Office-Based Anesthesia: Safety and Outcomes in Pediatric Dental Patients","volume":"64","author":"Spera","year":"2017","journal-title":"Anesth. Prog."},{"key":"ref_17","unstructured":"(2023, September 11). FDA Drug Safety Communication: FDA Review Results in New Warnings about Using General Anesthetics and Sedation Drugs in Young Children and Pregnant Women, Available online: https:\/\/www.fda.gov\/drugs\/drug-safety-and-availability\/fda-drug-safety-communication-fda-review-results-new-warnings-about-using-general-anesthetics-and."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1111\/cdoe.12362","article-title":"WHO Global Consultation on Public Health Intervention against Early Childhood Caries","volume":"46","author":"Phantumvanit","year":"2018","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_19","first-page":"E135","article-title":"Use of silver diamine fluoride for dental caries management in children and adolescents, including those with special health care needs","volume":"39","author":"Crystal","year":"2017","journal-title":"Pediatr. Dent."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Zaffarano, L., Salerno, C., Campus, G., Cirio, S., Balian, A., Karanxha, L., and Cagetti, M.G. (2022). Silver Diamine Fluoride (SDF) Efficacy in Arresting Cavitated Caries Lesions in Primary Molars: A Systematic Review and Metanalysis. Int. J. Environ. Res. Public. Health, 19.","DOI":"10.3390\/ijerph191912917"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Seifo, N., Cassie, H., Radford, J.R., and Innes, N.P.T. (2019). Silver diamine fluoride for managing carious lesions: An umbrella review. BMC Oral. Health, 19.","DOI":"10.1186\/s12903-019-0830-5"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1159\/000478668","article-title":"Silver Diamine Fluoride Has Efficacy in Controlling Caries Progression in Primary Teeth: A Systematic Review and Meta-Analysis","volume":"51","author":"Chibinski","year":"2017","journal-title":"Caries Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1177\/2380084416661474","article-title":"Clinical trials of silver diamine fluoride in arresting caries among children: A systematic review","volume":"1","author":"Gao","year":"2016","journal-title":"JDR Clin. Transl. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.cden.2018.08.011","article-title":"Evidence-Based Dentistry Update on Silver Diamine Fluoride","volume":"63","author":"Crystal","year":"2019","journal-title":"Dent. Clin. N. Am."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1038\/s41415-020-1203-9","article-title":"The use of silver diamine fluoride (SDF) in dental practice","volume":"228","author":"Seifo","year":"2020","journal-title":"Br. Dent. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2197","DOI":"10.1007\/s00784-021-04236-5","article-title":"Management of initial carious lesions of hypomineralized molars (MIH) with silver diamine fluoride or silver-modified atraumatic restorative treatment (SMART): 1-year results of a prospective, randomized clinical trial","volume":"26","author":"Ballikaya","year":"2022","journal-title":"Clin. Oral Investig."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"104066","DOI":"10.1016\/j.jdent.2022.104066","article-title":"Effect of silver diamine fluoride on vital dental pulp: A systematic review","volume":"119","author":"Zaeneldin","year":"2022","journal-title":"J. Dent."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Seifo, N., Cassie, H., Radford, J., and Innes, N. (2020). \u201cIt\u2019s really no more difficult than putting on fluoride varnish\u201d: A qualitative exploration of dental professionals\u2019 views of silver diamine fluoride for the management of carious lesions in children. BMC Oral. Health, 20.","DOI":"10.1186\/s12903-020-01243-y"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"173","DOI":"10.21815\/JDE.019.020","article-title":"Pediatric Dentists\u2019 Silver Diamine Fluoride Education, Knowledge, Attitudes, and Professional Behavior: A National Survey","volume":"83","author":"Antonioni","year":"2019","journal-title":"J. Dent. Educ."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1111\/ipd.12097","article-title":"Acceptability of different caries management methods for primary molars in a RCT","volume":"25","author":"Santamaria","year":"2015","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"399","DOI":"10.2147\/CCIDE.S270562","article-title":"Knowledge on and attitude toward silver diamine fluoride among Saudi dental practitioners in Riyadh public hospitals","volume":"12","author":"Alajlan","year":"2020","journal-title":"Clin. Cosmet. Investig. Dent."},{"key":"ref_32","first-page":"1","article-title":"Survey of knowledge, attitudes and practices of brazilian dentists regarding silver diamine fluoride","volume":"20","author":"Moreira","year":"2019","journal-title":"Pesqui. Bras. Odontopediatria Clin. Integr."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/ipd.12465","article-title":"Aesthetic perception, acceptability and satisfaction in the treatment of caries lesions with silver diamine fluoride: A scoping review","volume":"29","author":"Magno","year":"2019","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1111\/jphd.12241","article-title":"Effect and acceptance of silver diamine fluoride treatment on dental caries in primary teeth","volume":"78","author":"Clemens","year":"2018","journal-title":"J. Public Health Dent."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1111\/jphd.12338","article-title":"Caregiver satisfaction with interim silver diamine fluoride applications for their children with caries prior to operating room treatment or sedation","volume":"79","author":"Cernigliaro","year":"2019","journal-title":"J. Public Health Dent."},{"key":"ref_36","first-page":"25","article-title":"Parental perceptions and acceptance of silver diamine fluoride treatment in Kingdom of Saudi Arabia","volume":"13","author":"Alshammari","year":"2019","journal-title":"Int. J. Health Sci."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/0300-5712(95)00079-8","article-title":"Dental aesthetics\u2014A survey of attitudes in different groups of patients","volume":"24","author":"Vallittu","year":"1996","journal-title":"J. Dent."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.adaj.2017.03.013","article-title":"Parental perceptions and acceptance of silver diamine fluoride staining","volume":"148","author":"Crystal","year":"2017","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Butera, A., Gallo, S., Pascadopoli, M., Montasser, M.A., El Latief, M.H.A., Modica, G.G., and Scribante, A. (2022). Home Oral Care with Biomimetic Hydroxyapatite vs. Conventional Fluoridated Toothpaste for the Remineralization and Desensitizing of White Spot Lesions: Randomized Clinical Trial. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19148676"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/1\/16\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:39:36Z","timestamp":1760132376000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/1\/16"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,21]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["medicina60010016"],"URL":"https:\/\/doi.org\/10.3390\/medicina60010016","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,21]]}}}