Cross-Sectional Study: SDF Usage in Primary, Mixed, and Permanent Dentition.

Objectives: Silver-diamine fluoride (SDF) has been a crucial tool in caries-management in USA for the past decade. This study aims to assess its usage in pediatric and adult care clinics.
Methods: With IRB approval, data extracted from AXIUM electronic-health-record (EHR) database at Texas A&M University College of Dentistry, including all records with initial SDF-treatment codes on primary and/or permanent teeth from January2019 to February2024. Statistical analysis, cross-tabulation and Pearson Chi-square tests (p-value <0.05) evaluated associations between tooth location (anterior vs. posterior), SDF-treatment CDT-codes (D1354 vs. D1355), dentition stage (primary: ages2-5, mixed: ages6-13, permanent: ages>14), and SDF-reapplication (Yes/No).
Results: The study included 1,055 teeth (42.4% pediatric-patients and 56.5% adult-patients), with 1.1% missing data. Teeth were in the permanent-dentition stage (58.4%), mixed (26.1%) and primary (14.4%) stages. Majority of teeth (75.2%) were treated with D1354(SDF-arrest), while 23.7% treated with D1355(SDF-prevention). Posterior teeth accounted for 82.3% of the sample, and anterior teeth for 16.6%. 67.6% of teeth did not receive reapplication, 32.4% did, with 3.3% missing data. No significant difference was found in reapplication-rates between anterior(31.6%) and posterior teeth(32.5%) (P-value=0.818). Significant association was found between SDF-treatment codes and reapplication rates (P-value<0.001), with D1355 cases less likely to receive reapplication (21%) compared to D1354(35.9%). Dentition stage also influenced reapplication rates, with mixed(47.4%) and primary(49.7%) stages receiving more reapplications than the permanent stage(21.3%).
Conclusions: SDF is primarily used for arresting caries rather than prevention. Reapplication-rates are higher for D1354, indicating more frequent follow-ups for caries arrest. Teeth in mixed and primary dentition receive more reapplications than those in permanent stage, suggesting closer monitoring in younger-patients. No significant difference was found in reapplication rates between anterior and posterior teeth. These findings underscore the importance of SDF in caries-management across various age groups and highlight the need for tailored reapplication protocols in both main and pediatric clinics.