Efficacy of Silver Diamine Fluoride and Nanosilver Fluoride in Preventing Caries: A Comparative Study.

Background: Dental caries remains a prevalent global health issue, particularly among children. Silver diamine fluoride (SDF) is a well-established caries-arresting agent, while nanosilver fluoride (NSF), a newer formulation combining silver nanoparticles and fluoride, offers potential antibacterial and remineralizing benefits. However, comparative evidence on their caries-preventive efficacy remains limited. Methods: A randomized, double-blind, controlled clinical trial was conducted involving 90 caries-active children aged 6 to 9 years. Participants were randomly assigned to three groups (n = 30 each): Group A received 38% SDF, Group B received NSF, and Group C received distilled water (control). Baseline caries experience was recorded using the DMFS index. Treatments were applied at baseline and after six months. Follow-up examinations were conducted at six and 12 months. Data were analyzed using ANOVA and post hoc Tukey's test with significance set at P < 0.05. Results: After 12 months, Group A (SDF) showed a mean increment of 0.8 ± 1.2 in DMFS, Group B (NSF) showed 1.1 ± 1.3, and Group C (control) showed 2.7 ± 1.5. The differences between Group A and Group C (P < 0.001) and between Group B and Group C (P = 0.003) were statistically significant, while the difference between Group A and Group B was not (P = 0.217). Conclusion: Both silver diamine fluoride and nanosilver fluoride were effective in preventing caries progression in high-risk children, with SDF showing marginally better efficacy. NSF appears to be a promising alternative with comparable outcomes.