SDF vs Fluoride Varnish for Streptococcus Mutans Reduction in Children

Evaluation of Streptococcus Mutans Reduction by Silver Diamine Fluoride vs. Fluoride Varnish: A Split-Mouth Study in Children

This randomized split-mouth clinical trial will compare the effectiveness of 38% silver diamine fluoride (SDF) versus 5% sodium fluoride varnish (FV) in reducing salivary Streptococcus mutans levels in children with bilateral caries. Each participant will receive SDF on one side of the mouth and FV on the contralateral side. The primary outcome is change in Dentocult SM Strip Mutans scores in plaque over 3 months. Secondary outcomes include plaque index, bleeding on probing, and adverse events.

Inclusion Criteria:

• Age 3-8 years; cooperative (Frankl ≥2).
• ≥2 contralateral primary molars with active dentin caries (ICDAS 3-5) of comparable severity.
• Parent/guardian consent; child assent when appropriate.

Exclusion Criteria:

• Silver allergy; ulcerative gingivitis/stomatitis.
• Systemic antibiotics within 4 weeks.
• Fixed appliances interfering with plaque assessment.
• Conditions precluding safe participation per clinician judgment.