Parental acceptance of silver Diamine fluoride application on primary dentition: a systematic review and meta-analysis

BACKGROUND: This systematic review of the literature was carried out to assess parental acceptance for silver diamine fluoride (SDF) application and esthetic outcome on their children primary dentition and evaluate factors that might influence their acceptance. METHODS: Our research protocol included a search strategy, inclusion/exclusion criteria, and a data extraction plan. The search engines we used were PubMed, Google Scholar, and Science Direct. Reviewers independently reviewed, determined and carried out quality assessment for included studies using CONSORT (for clinical-trials), and STROBE (for Observational studies). In addition, evidence and recommendation’s strength was conducted using Shekelle et al. system. Subsequently, a meta-analysis was performed to assess the association between parental acceptance for SDF treatment and teeth type, location and child’s cooperation. RESULTS: Eight studies fulfilled the inclusion criteria. There were statistically significant differences between parental acceptance for SDF usage on posterior teeth compared to anterior teeth (P < 0.001, OR: 0.23 and 95% CI: 0.15–0.34) and for SDF usage on anterior teeth of uncooperative compared to cooperative children (P < 0.001, OR: 0.27 and 95% CI: 0.17–0.44). Additionally, parent’s acceptance rate for SDF application increased after follow-up visits and education. CONCLUSION: Parental acceptance for SDF treatment was significantly related to tooth location, child cooperation and pre-operative instruction.