Dental Students' Silver Diamine Fluoride-Related Considerations: Does Program Year Matter?

Objectives: A significant percentage of the U.S. population has dental care needs, but faces challenges accessing dental care services due to financial constraints. The use of Silver Diamine Fluoride (SDF) for the treatment of caries could be one low cost way to provide care for some of these patients. The objectives were to assess pre-doctoral dental students' SDF-related education, knowledge and attitudes, and to explore if their considerations change over the course of their dental school education.




Methods: Anonymous survey data were collected from 609 pre-doctoral dental students at six different points in their dental education, namely at the beginning and end of the first year (D1), the beginning and end of the D2 year and in the Fall term of the D3 and D4 year.
Results: In 2018, first and second year dental students reported that they had been better educated in classroom-based settings than D3 and D4 students. While SDF had been introduced and used in the dental school clinics, students in all classes disagreed on average or were neutral in response to the question how well they had been educated about the use of SDF in clinical settings. However, all cohorts reported on average that they knew what SDF is used for in dentistry, how it is used to treeat dental caries in pediatric patients and which advantages it can have over traditional treatments. The more advanced the students were in their dental education, the less positive their attitudes were: D1 and D2 students agreed more strongly than D3 and D4 students that SDF is a good treatment to be used when treating lesions which are not in the esthetic zone on primary teeth and on permanent teeth. They also found the low cost for the patient, the decreased discomfort with the procedure and the level of evidence behinf SDF saftey and efficacy more appealing than D3 and D4 students.
Conclusions: SDF-related educational efforts about the proper use, benefits, and limitations of SDF are needed in both classroom-based and clinical settings. Beginning these efforts early on during the curriculum seems to be crucial. While SDF had been introduced for clinical use, it seemed that a lack of support by clinical faculty for the use of this new approach might have resulted in a lack of clinical exposure to SDF use.