Silver diamine fluoride parental acceptance, a systematic review & meta-analysis

Abstract

Introduction: This systematic review of the literature was carried out to assess the level of parental acceptance for SDF treatment, this in turn, will affect the dentist judgement in including silver diamine fluoride as a treatment option for pediatric patients. Material& methods: Our research protocol included a search strategy, inclusion/exclusion criteria, and a data extraction plan. The search engines used were PubMed, Google Scholar, and Science Direct. Study selection was performed independently by six reviewers. Articles published from 2000 to 2017 were reviewed based on inclusion and exclusion criteria. Meta-analysis was performed to compare the parental acceptance between anterior and posterior teeth also between the cooperative and uncooperative children. Results: Five studies fulfilled the inclusion criteria. Primary posterior teeth had a higher parental acceptance compared to anterior teeth, there was a significant effect of children cooperation only on parental acceptance of SDF on anterior teeth, parents of uncooperative children were accepting SDF statically significantly higher than those with cooperative children and the parental acceptance rate for SDF use increased after follow-ups visits. Conclusions: The parental acceptance of SDF discoloration ranged from 29.66% to 95.4%. Therefore, there is a huge variation in the parental acceptance between the included studies, which promote the selection of cases before choosing the SDF as a treatment option to know which of the cases are suitable for SDF application. The parental acceptance was significantly higher in posterior teeth compared to anterior teeth, and uncooperative children compared to cooperative children. Many parents accepted SDF treatment to avoid alternative treatment under general anesthesia.