Limited data are available regarding the patient-based outcomes of SDF therapy in the kindergarten setting. This study aims to evaluate the dental fear and anxiety (DFA) of preschool children after participating in a school-based outreach service using SDF to arrest early childhood caries (ECC). The study recruited 3- to 5-year-old children with untreated ECC. A trained dentist performed a dental examination and applied SDF therapy to the carious lesions. ECC experience was measured using the dmft index. Questionnaires for parents were used to collect the children’s demographic information and their dental treatment experiences. The children’s DFA before and immediately after SDF therapy was assessed using the self-reported Facial Image Scale (FIS) on a Likert scale of 1 (very happy) to 5 (very distressed). The association between the children’s DFA after SDF therapy and the potentially related factors, including demographic background, caries experience, and DFA before SDF therapy, were analysed using bivariate analysis. Three hundred and forty children (187 boys, 55%) joined this study. Their mean (SD) age and dmft scores were 4.8 (0.9) and 4.6 (3.6), respectively. Most of them (269/340, 79%) never had a dental visit. After SDF therapy, 86% (294/340) of the children exhibited no or low DFA (FIS ≤ 3), whereas 14% (46/340) reported high DFA (FIS > 3). No factor was associated with children’s DFA after SDF therapy (p > 0.05). This study showed most preschool children with ECC exhibited no or low DFA after SDF therapy in a school setting.

In this 12-month randomized active-controlled clinical trial, we compare two post-treatment instructions for silver diamine fluoride (SDF) therapy in arresting dentine caries. The trial will include at least 254 kindergarten children with active dentine caries. The children will be randomized into two groups and receive a 38% SDF solution applied topically to their carious lesions. Children in Group A will rinse immediately, whereas those in Group B will refrain from rinsing, eating, and drinking for 30 min. One trained examiner will perform the dental examination at baseline and every six months. The primary outcome measurement will be the proportion of caries lesions that become arrested at the 12-month examination. Potential confounding factors and parents’ satisfaction with SDF therapy at baseline and after 12 months will be collected using parental questionnaires. This trial will provide evidence-based information for clinical practitioners to give post-treatment instructions for SDF therapy. This study is registered at ClinicalTrial.gov (USA) (registration number: NCT05655286).

Objectives: Silver diamine fluoride (SDF) has gained popularity in dentistry as an anti-hypersensitive and anti-caries agent. This study aims to review the postoperative instructions for SDF therapy and examine the evidence supporting these instructions in treating dentine hypersensitivity and caries control. Data and sources: Two independent reviewers searched three electronic databases (EMBASE, PubMed, and Web of Science) to identify clinical studies that used SDF to treat dentine hypersensitivity and dental caries. Additionally, they searched Google Chrome for information from manufacturers, the department of health, national dental organisations, authoritative dental organisations, and universities regarding SDF therapy for these conditions. Data on postoperative instructions were extracted, and their impact on the treatment of dentine hypersensitivity and caries control was investigated. Study selection: This review included 74 clinical studies, 11 sets of instructions from SDF manufacturers, and six recommendations from national dental organisations, departments of health and universities. Amongst the included records, 50 clinical studies, two manufacturers, and one department of health mentioned postoperative instructions for SDF therapy. The recommendations varied, from suggesting no specific instructions, immediate rinsing, refraining from eating or drinking for 30 to 60 min, and even avoiding brushing until the next day after SDF therapy. Notably, no clinical studies reported the effects of these postoperative instructions on the SDF treatment of dentine hypersensitivity or dental caries. Conclusions: This scoping review highlights the presence of inconsistent postoperative instructions for SDF therapy in the treatment of dentine hypersensitivity and caries control. Furthermore, there is a lack of evidence supporting the effectiveness of these instructions. Clinical significance No evidence supports the postoperative instructions for SDF therapy for managing dentine hypersensitivity and dental caries. Studies are necessary to provide guidance for clinicians using SDF in their clinical practice.

Objectives: This study aimed to characterize the age-related trends of caries experience among preschool children in Shenzhen, China. Methods: This cross-sectional study recruited 3- to 5-year-old preschool children in Shenzhen via a multistage random sampling method in 2024. Two calibrated examiners conducted oral examinations in kindergartens using disposable dental mirrors with LED illumination and ball-ended Community Periodontal Index probes. Caries experience was recorded using the dmft index, as recommended by the World Health Organization. Results: This study invited 4015 children from 27 selected kindergartens, and 3534 children (1886 boys, 53%) completed the survey. The response rate was 88%. The prevalence of caries experience was 31% at age 3, 49% at age 4, and 58% at age 5, representing a 27% higher prevalence in 5-year-olds than in 3-year-olds. The mean dmft scores (±SD) were 1.2 ± 2.5 for 3-year-olds, 2.2 ± 3.2 for 4-year-olds, and 2.8 ± 3.5 for 5-year-olds, indicating a 1.6 affected teeth higher mean dmft in 5-year-olds than in 3-year-olds. The upper central incisors were the most affected teeth (23%) in 3-year-olds and remained the most susceptible across all age groups, while the prevalence of caries in lower molars increased progressively from 7% at age 3 to 24% at age 5. Conclusions: Dental caries prevalence and severity among preschool children in Shenzhen increase significantly with age. These findings highlight the need for targeted preventive strategies focusing on high-risk teeth, including the upper central incisors and lower molars, to address the rising burden of early childhood caries in this population.

The objective of this prospective 12-month observational study is to examine the oral health-related quality of life (OHRQoL) among Hong Kong young children aged 3–4 years old receiving silver diamine fluoride (SDF) therapy for carious upper anterior primary teeth. A parental questionnaire was used to collect each child’s sociodemographic background and oral health habits at baseline. Data on parents’ satisfaction with their child’s dental aesthetics were collected at baseline and during a 12-month visit. The Chinese Early Childhood Oral Health Impact Scale (C-ECOHIS) was used to measure OHRQoL. A trained dentist performed examinations and recorded caries experience (dmft) and oral hygiene (visible plaque index) at baseline and 12 months. SDF was applied to the carious lesions. Out of 286 invited children, 248 (87%, 248/286) participated, and 211 (85%, 211/248) attended the 12-month examination. All SDF-treated carious lesions were discoloured at the 12-month examination. Regression analysis showed that the baseline C-ECOHIS score was associated with dmft (p < 0.001). The baseline and 12-month C-ECOHIS scores were 4.6 ± 5.5 and 5.0 ± 5.6, respectively (p = 0.42). The scores for parental satisfaction with dental aesthetics at baseline and 12 months were 59% to 46% (p < 0.001). Satisfaction was negatively associated with the number of discoloured upper anterior teeth (p < 0.001). In conclusion, SDF discoloured the carious upper anterior teeth of the Hong Kong kindergarten children. However, the discoloured lesions had no significant effects on the OHRQoL of these children. However, more parents became dissatisfied with their child’s dental aesthetics after SDF therapy. Hence, clinicians should inform parents well before they perform SDF therapy on children.

Background/Objectives: Traditional community oral health programs (COHPs) often remain reactive, clinic-based, and insufficiently integrated with medical, social, and aged-care systems. As a result, they may be poorly positioned to address the needs of older adults experiencing multimorbidity, mobility limitations, cognitive impairment, care dependency, and financial or geographic barriers. This paper proposes SPACES, an implementation-oriented conceptual framework for designing, delivering, and evaluating community oral health programs for older adults. Methods: SPACES was developed through a targeted interpretive synthesis of peer-reviewed literature, policy guidance, and implementation-oriented sources related to oral health, healthy aging, integrated care, access barriers, workforce development, and sustainable service delivery. Results: The framework comprises six interconnected domains: Scalable Prevention and Education, Partnerships Across Sectors, Adaptive Care Coordination, Community Access Solutions, Empowered Workforce Development, and Sustainable Service Models. It is intended primarily for adults aged 60 years and older, while allowing adaptation in jurisdictions that use 65 years and older as the eligibility threshold. The framework applies across community, home care, assisted living, and long-term care settings. SPACES organizes evidence-informed components for older-adult oral health, including routine screening, caregiver-supported daily mouth care, risk-stratified prevention, referral pathways, proximity-based service delivery, geriatric workforce competencies, task sharing, sustainable financing, governance, and quality improvement. Conclusions: SPACES is presented not as a tested intervention but as a conceptual and program-planning tool to help planners clarify responsibilities, identify equity gaps, align cross-sector resources, and select measurable implementation indicators. Future stakeholder refinement and empirical evaluation are needed through co-design, pragmatic implementation studies, and real-world assessment of feasibility, acceptability, cost, equity impact, and oral health outcomes.