Effectiveness of chlorhexidine and xylitol varnish versus silver diamine fluoride in the control of initial dental caries lesions: a randomised clinical trial

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ABSTRACT

Aim

This study aims to compare the effectiveness of a chlorhexidine (2%) and xylitol (5%) varnish (VCX) versus a silver diamine fluoride (SDF) solution (30%) in controlling initial dental caries lesions in young children.

Methods

A randomised clinical trial was conducted with children aged 5 and 6 from public schools in Jequié, Bahia. Participants were randomly assigned to three groups: one treated with VCX, another with SDF, and a control group that received no intervention. Carious lesions were classified using ICDAS-II criteria, and interventions were applied following standardised clinical protocols. Blinding was applied to participants, though not to researchers due to physical differences in treatment materials.

Results

Of 105 children, 87 completed the study. In both intervention groups, a reduction in dental caries lesions classified as ICDAS-II Score 2 was observed. The reduction was statistically significant in the SDF group, which showed a notable decrease in lesion frequency compared to the VCX group and the control. However, SDF’s application led to aesthetic drawbacks, specifically tooth darkening, unlike the VCX varnish. Statistics The statistical analysis was performed using descriptive and inferential methods. Central tendency measures were calculated for continuous variables and frequency distributions for categorical variables. Differences in treatment effectiveness among the groups were assessed with repeated measures or Friedman tests, depending on data distribution. The significance level was set at 5%, and the analysis was conducted using JASP statistical software.

Conclusion

Both VCX and SDF were effective in reducing initial dental caries lesions, with SDF showing superior efficacy. However, VCX may serve as a viable alternative for patients concerned with aesthetics, though further studies are required to confirm its long-term effectiveness and optimise treatment protocols.

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