The Effect of Silver Diamine Fluoride, CPP-ACP/NaF, and Sodium Fluoride Varnish on Deciduous Enamel Erosion by Daily Snack ( Drink) in Children/ An In Vitro Study

Abstract

Objective: Most children consume carbonated soft drinks and fruit juices daily, inducing detrimental low pH and contributing to dental erosion. The current study aimed to assess and compare the efficacy of a single application of 38% Silver diamine fluoride (38% SDF), CPP-ACP/NaF varnish, and Sodium fluoride varnish (NaF) in the prevention of enamel demineralization in primary teeth against daily snack drink in children.  Methods: Forty primary anterior teeth (n=40) were divided into four groups and exposed to the following treatments (n=10): G1= 38%SDF (e- SDF TM); G2= CPP-ACP/NaF (MI VarnishTM); G3= NaF varnish (FluoroDose®); G4= Distilled water. The specimens were submitted for four days, with six pH cycles per day (10 minutes in orange juice) (SUNQUICK, IRAQ). Artificial saliva was used to remineralize the specimens after erosion challenges and as storage media between cycles. After four days of pH cycling, all the specimens were subjected to an atomic absorption spectrometer (AAS) to measure the amount of Calcium and phosphorus loss in each acidic solution. Scanning Electron Microscope evaluated the enamel topographic characteristics.       Results: All varnishes promoted better results for protecting enamel than the distilled water, with a difference. However, 38% of SDF demonstrated less Calcium and phosphorus loss than CPP-ACP/NaF, NaF varnish, and distilled water (p < 0.001).    Conclusions: Considering calcium and phosphorus loss values, a single application of each 38% SDF, MI varnish, and Naf effectively inhibited enamel erosion after four days of an erosive challenge, although the best protective effect was in favor of SDF.