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Marcus HT Fung, May CM Wong, Edward CM Lo and CH Chu
Conventional restorative management of early childhood caries (ECC) is unlikely to tackle this prevalent disease, and arresting caries treatment using silver diamine fluoride (SDF) has become a pragmatic strategy, particularly for young and apprehensive children. Arrested caries is clinically characterized by its increase in hardness and a dark brown to black coloration. Subsequent restorative procedures can be carried out if necessary. This review article discusses the rationale of arresting caries treatment, mechanism of action of SDF, and safety and complications of SDF treatment. A literature search using PubMed was performed to review the clinical trials using SDF to manage ECC. Results found 6 clinical trials published in English since 1980. The studies suggested that one-off application of 12% SDF is not effective in arresting caries in children, but 38% SDF is. The main disadvantage of SDF treatment is black staining of the arrested lesion, but significant complications were not reported. In general, the studies concluded that topical application of SDF is a simple and low cost method to arrest ECC. This treatment strategy therefore increases access for children in developing countries to receive affordable dental treatment.