Salivary pH Levels at Three Different Time Intervals after Application of Silver Diamine Fluoride in Children with Severe Early Childhood Caries: A Quasi-experimental Study

Abstract

Introduction: Early Childhood Caries (ECC) is a major public health issue that negatively affects children’s physical and mental health. Silver Diamine Fluoride (SDF) is a novel material that has the potential to improve dentin hypersensitivity and enhance enamel remineralisation. This alkaline solution is known to be more resistant to acidic environments than hydroxyapatite. Aim: To measure the pH (Potential of Hydrogen) in saliva at three different intervals after the application of 38% SDF in children with ECC. Materials and Methods: This pre-post single-group quasi-experimental study was conducted in the Department of Paediatric and Preventive Dentistry at Rajarajeswari Dental College and Hospital in Bengaluru, Karnataka, India from September 2021 to February 2022. A total of 15 patients with ECC, aged 3-6 years, were selected for the application of 38% SDF. Saliva samples were collected before the application, immediately after the application, and one hour after the application of 38% SDF. pH analysis was then conducted. The data obtained were subjected to statistical analysis. Repeated measures of Analysis of Variance (ANOVA) and Bonferroni’s post-hoc test were used for multiple comparisons of salivary pH levels at different time intervals. Age and gender-wise comparisons of mean salivary pH levels at different time intervals were conducted using an independent Student’s t-test. Results: Among the 15 participants included in the study, the average age of the subjects was 4.60±1.06 years. Among the study participants, 9 (60.0%) were males and 6 (40.0%) were females. A comparison of mean salivary pH levels at different time intervals showed that the mean salivary pH levels before the SDF application were 6.45±0.22, immediately after the application were 6.95±0.18, and one hour after the application were 7.30±0.27. In the gender-wise comparison, a higher mean pH was recorded in males than in females. Conclusion: The change in mean pH was found to be statistically significant before and after the application of SDF, as well as at the one-hour time interval, showing an increasing trend. This indicates that the changes in salivary pH that occur after applying 38% SDF are clinically significant and can be used as an effective caries control and preventive strategy.

Keywords

• dental caries
• prevention
• remineralisation