Evaluation of school-based oral health program using silver diamine fluoride

Abstract

Objectives: The study aimed to evaluate a school-based oral health program using silver diamine fluoride (SDF) treatment in preschool children in Hong Kong. Methods: A large-scale school-based oral health program using SDF for caries control has been implemented in preschool children in Hong Kong since 2010. Written parental consent for participation was obtained. The program comprised of three main activities as follows; 1) clinical examination to identify children who had cavitated dentine caries using visual inspection and apply SDF on these lesions for caries arrest, 2) provide oral health education for parents, 3) train kindergarten teachers to promote child oral health in their schools. Information on the acceptability of SDF treatment, the prevalence of dentine caries, and adverse effects were collected. Results: A total of 169,382 preschool children enrolled in the program from 2010 to 2019. Among them, parents of 144,091 (85%) children accepted that their child should receive SDF treatment if needed. In total, 159,793 children received the dental examination, and 60,936 (38%) children were diagnosed having dentine caries. Out of these, 53,497 children (88%) received SDF treatment. The prevalence of dentine caries gradually declined from 43% in 2010 to 34% in 2019. No major adverse effect and acute systematic illness were reported. Conclusions: A school-based oral health program using SDF is effective for caries control in preschool children. SDF treatment is safe, feasible, and well accepted by preschool children and their parents.