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Evaluating the Knowledge and Opinions of Army Dentists Regarding Silver Diamine Fluoride - 2019
Evaluating the Knowledge and Opinions of Army Dentists Regarding Silver Diamine Fluoride - 2019.pdf
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Summary

Purpose

The study evaluated Army dentists’ knowledge, perceptions, and willingness to use Silver Diamine Fluoride (SDF), a cost-effective, noninvasive treatment that arrests dental caries. SDF, though FDA-approved for hypersensitivity, is widely used off-label for caries management.

Methods

  • Design: Cross-sectional online survey.
  • Participants: All active-duty Army dentists with AOC 63A (General), 63B (Comprehensive), and 63K (Pediatric).
  • Distribution: 747 invitations, 237 responses (31.7%).
  • Analysis: Descriptive statistics and Kruskal-Wallis test for group comparisons.

Key Findings

  • Awareness: 87.8% had heard of SDF.
  • Knowledge gap: Only 47.7% knew proper application.
  • Clinic availability: Just 14.7% reported having SDF available.
  • Interest: 73.3% wanted SDF in their clinic; 93.5% would consider using it.
  • Experience effect: Dentists with >10 years’ experience felt less comfortable applying SDF than newer practitioners.
  • Misconceptions: 5.5% misunderstood SDF’s caries-arresting role; some feared it weakened resin bonding (contradicted by studies).
  • Concerns: Dark staining of lesions, technique sensitivity, or preference for alternatives (e.g., fluoride varnish).

Military Relevance

SDF is well-suited for military and field use:

  • Portable, requires minimal equipment, inexpensive (~$160/250 applications).
  • Offers a quick way to stabilize caries during limited clinical access.
  • Especially useful for Soldiers with multiple caries or for pediatric dependents.

Conclusion

While most Army dentists are interested in SDF, lack of training and availability limit its use. Continuing education and streamlined procurement (e.g., adding SDF to the Defense Medical Logistics Standard Support system) are recommended.