Department of Pediatric Dentistry, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain.
Hospital Dentistry, Clinical Orthodontics and Periodontal Medicine Research Group (HDCORPEMrg), Institut de Recerca Sant Joan de Déu (IRSJD), Barcelona, Spain.
Clin Exp Dent Res. 2022 Oct;8(5):1175-1184. doi: 10.1002/cre2.611. Epub 2022 Jul 22.
The present critical analysis aims to propose an action protocol for the use of silver diamine fluoride (SDF) in pediatric patients in a hospital setting, especially for those who are currently awaiting hospital dental treatment under general anesthesia.
A literature search was performed in the PubMed/MEDLINE from 2009 to 2021 using the search terms "silver diamine fluoride", "pediatrics silver diamine fluoride", "application silver diamine fluoride", and "AND" - combined with terms: "potassium iodide", "properties", "adverse effects", "early childhood caries", "patient with disability", "management", "special health care needs patient". Articles that recorded the type of teeth, application protocol, the concentration of the product, and possible complications of the treatment were selected.
Four hundred and sixteen related articles were obtained, of which 13 were finally chosen on the basis of the search criteria. The age at which the use of SDF was recommended ranged from the first year of life to 12 years, in most cases in primary teeth. The study populations varied in size from 53 to 799 patients. An analysis of the characteristics of SDF and its use in pediatric patients with dental caries was performed. The recommended concentration was 38% SDF, applied twice yearly. The main complication reported was staining. A decision algorithm was designed including SDF as an agent for caries control in patients attending the specific population of our hospital (divided into two groups: healthy children aged 0-4 years and patients with special health care needs (SHCNs) aged 0-18 years).
SDF therapy appears to be effective in the control of caries in pediatric patients. We propose an action protocol for patients with early childhood caries to reduce risk, complications, and the progression of lesions. The protocol is aimed especially at pediatric patients who also have some systemic pathology, disability, SHCNs, and/or behavioral difficulties.
本批判性分析旨在为医院环境中儿科患者使用氟化银（SDF）提出行动方案，特别是对于那些正在全麻下等待医院牙科治疗的患者。
在 2009 年至 2021 年期间，使用搜索词“silver diamine fluoride”、“pediatrics silver diamine fluoride”、“application silver diamine fluoride”和“AND”在 PubMed/MEDLINE 中进行文献检索，与术语结合：“potassium iodide”、“properties”、“adverse effects”、“early childhood caries”、“patient with disability”、“management”、“special health care needs patient”。选择记录牙齿类型、应用方案、产品浓度和治疗可能并发症的文章。
共获得 416 篇相关文章，其中根据搜索标准最终选择了 13 篇。建议使用 SDF 的年龄从出生后第一年到 12 岁不等，大多数情况下是在乳牙。研究人群的规模从 53 到 799 名患者不等。对 SDF 的特性及其在患有龋齿的儿科患者中的应用进行了分析。建议的浓度为 38%的 SDF，每年应用两次。报告的主要并发症是染色。设计了一个决策算法，将 SDF 作为我们医院特定人群（分为两组：0-4 岁健康儿童和 0-18 岁有特殊医疗需求的患者（SHCNs））中控制龋齿的药物。
SDF 治疗似乎对控制儿科患者的龋齿有效。我们提出了一项针对早期儿童龋齿患者的行动方案，以降低风险、并发症和病变进展。该方案特别针对那些也患有一些系统性疾病、残疾、SHCNs 和/或行为困难的儿科患者。
