J Am Dent Assoc. 2017 Jul;148(7):510-518.e4. doi: 10.1016/j.adaj.2017.03.013. Epub 2017 Apr 27.
The caries arrest that can be achieved by using silver diamine fluoride (SDF) offers a minimally invasive and inexpensive alternative to traditional restorative caries treatment. The authors evaluated how the dentinal staining that is associated with SDF influences the acceptance of this treatment among parents of young children in the New York City metropolitan area.
The authors invited the parents of children who had experienced dental caries and who had appointments at the New York University Pediatric Dentistry Clinic and at several private clinics in New Jersey to participate in a Web-based survey designed to assess parents' demographics, perceptions of photographs of SDF-treated carious teeth, and acceptability of treatment in different behavior management scenarios.
Ninety-eight mothers and 22 fathers from diverse backgrounds participated. Most parents (67.5%) judged SDF staining on the posterior teeth to be esthetically tolerable, but only 29.7% of parents made this same judgment about anterior teeth (P < .001). In the absence of their child having behavioral barriers to conventional restorations, 53.6% of parents reported that they were likely to choose SDF to treat their child's posterior teeth, but only 26.9% of parents were likely to choose SDF to treat their child's anterior teeth. As the number of children's behavioral barriers increased, so did the parents' level of acceptance. In extreme cases, in which parents had to decide whether their children should undergo general anesthesia during treatment, parents' acceptance rate of SDF as a treatment method increased to 68.5% on posterior teeth and to 60.3% on anterior teeth. Parents' acceptance of the treatment also varied according to their socioeconomic status.
Staining on posterior teeth was more acceptable than staining on anterior teeth. Although staining on anterior teeth was undesirable, most parents preferred this option to advanced behavioral techniques such as sedation or general anesthesia.
Clinicians need to understand parental sensitivities regarding the staining effect of SDF to plan adequately for the use of SDF as a method of caries management in pediatric patients.
使用银胺氟化物 (SDF) 可以实现龋齿抑制，为传统的龋齿修复治疗提供了一种微创且经济实惠的替代方法。作者评估了与 SDF 相关的牙本质染色如何影响纽约市大都市区幼儿父母对这种治疗方法的接受程度。
作者邀请了在纽约大学儿童牙科诊所和新泽西州几家私人诊所就诊的患有龋齿的儿童的父母参加一项基于网络的调查，该调查旨在评估父母的人口统计学特征、对 SDF 治疗龋齿的照片的看法，以及在不同行为管理场景下治疗的可接受性。
来自不同背景的 98 位母亲和 22 位父亲参与了调查。大多数父母（67.5%）认为后牙的 SDF 染色在审美上是可以接受的，但只有 29.7%的父母对前牙做出了同样的判断（P<.001）。在没有孩子对常规修复存在行为障碍的情况下，53.6%的父母表示他们可能会选择 SDF 治疗孩子的后牙，但只有 26.9%的父母可能会选择 SDF 治疗孩子的前牙。随着孩子行为障碍数量的增加，父母的接受程度也随之增加。在极端情况下，即父母必须决定孩子在治疗过程中是否需要全身麻醉时，父母对 SDF 作为治疗方法的接受率在后牙增加到 68.5%，在前牙增加到 60.3%。父母对治疗的接受程度也因社会经济地位而异。
后牙染色比前牙染色更能被接受。尽管前牙染色不理想，但大多数父母宁愿选择这种方法，也不愿选择镇静或全身麻醉等先进的行为技术。
临床医生需要了解父母对 SDF 染色效果的敏感性，以便充分计划在儿科患者的龋齿管理中使用 SDF。
