Parental perception and acceptance of silver diamine fluoride treatment among Syrian refugees

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  • Nesreen A. Salim
  • Lyn A. El-Smadi
  • Faleh A. Sawair
  • Julian D. Satterthwaite


Objective: Silver diamine fluoride (SDF) is an effective cariostatic agent, although staining associated with treatment is a significant impediment to its acceptability. Basic Research Design: A cross-sectional study of Syrian refugees to identify acceptance of SDF treatment.
Methods: Information was collected on: sociodemographics, medical/dental child history, dental status (dmft/DMFT), andperceptions of
photographs of SDF-treated teeth. Associations between clinical findings and the acceptability were assessed. Results: Of 258 parents or
guardians, 37.8% accepted SDF treatment for their children. Acceptance was related to the location and type of teeth, being higher for
primary than permanent teeth, and posterior than anterior teeth in both dentitions. Uncooperative behavior during previous dental treatment, the presence of dental discoloration, history of child dental pain, and number of filled teeth were all associated with better parental
acceptance. Acceptance was also related to parental age, level of education, and their relation to the child. Conclusion: Parents’ acceptance
of SDF treatment is low. However, staining on posterior teeth was more acceptable than staining on anterior teeth and on primary more
than permanent teeth.
Keywords: Oral health, caries, refugees, Silver diamine fluoride, cariostatic

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