Discussion
carious lesions, ’ behavior, caries arrest, caries, arrest, health behaviors
ARREST, CARIES
In 15–48-month-old Egyptian children living in rural areas, ECC arrest rates after 6 months did not differ significantly when one application of 38% SDF or 5% NaF combined with 2 MI sessions were used. Thus, the null hypothesis of the study was not rejected. There was a significant interaction between the intervention and baseline lesion severity with stronger effect of SDF than NaF/ MI in advanced than in moderate lesions. The study fills a knowledge gap by providing evidence on the effects of a potent caries arrest agent, SDF, and the traditional NaF varnish combined with MI targeting mothers’ behavior.The present study has some limitations. ECC was assessed clinically using visual-tactile examination without radiographs. Although this has the potential to miss some caries lesions, the outcome in the study was caries arrest which was assessed using visual-tactile sensation following the reported criteria. The same method was also used in previous studies assessing the effectiveness of fluoride agents [In the present study, there was no difference in ECC arrest rate between SDF and NaF/ MI in multivariable analysis. SDF had a significantly higher caries arrest rate in advanced lesions although this significance disappeared after adjusting for confounders. By contrast, SDF has been previously reported to be highly effective in arresting dentin carious lesions, [The study findings also show that there was a non-significant difference between SDF and NaF/ MI in arresting moderate lesions. This agrees with Duangthip et al. [There is scarce evidence on the effectiveness of SDF versus NaF supported by MI in arresting ECC. MI was reported to improve the oral health knowledge and attitudes of caregivers leading to improved oral health behaviors [Although black staining is a drawback of SDF, there was no significant difference in parental satisfaction between groups receiving SDF and those with NaF/ MI in the present study. It seems that the caregivers’ main concern was to stop caries progression regardless of the esthetics. These findings agree with previous studies [It is important to interpret the findings within the context of the study setting. Children in previous studies assessing the effect of SDF and NaF varnish on arresting caries had higher tooth brushing frequency [The current findings show that NaF/ MI can be an alternative to SDF for arresting ECC without staining the treated lesions. Behavior modification using MI combined with traditional NaF varnish may adequately arrest ECC in children with modest oral hygiene without the need to use SDF.