Use of Silver Diamine Fluoride in Active Carious Lesions in Primary Teeth: Case Series

Abstract

The management of caries in the primary dentition is an essential component of pediatric dentistry, particularly through minimally invasive strategies aimed at preserving tooth structure and maintaining oral health. This study describes two clinical cases involving pediatric patients aged 5 to 6 years who were treated at the Dental Clinic of Universidad San Gregorio de Portoviejo between November 2024 and March 2025 and presented extensive carious lesions in primary teeth. Clinical evaluation revealed multiple lesions associated with painful symptoms and esthetic impairment. Silver diamine fluoride (SDF) was selected as a therapeutic alternative because of its ability to arrest the progression of carious lesions. Treatment consisted of topical application of the agent and was complemented by parental education on oral hygiene, preventive measures, and periodic follow-up. During clinical monitoring, apparent arrest of the treated lesions and no evident clinical progression were observed, together with greater family adherence to oral hygiene recommendations. Given the descriptive nature of the study and the limited number of cases, these findings do not allow definitive conclusions regarding treatment efficacy. Nevertheless, SDF appears to be a conservative and minimally invasive alternative for managing caries in the primary dentition when integrated with preventive and educational strategies as part of a comprehensive contemporary pediatric dental approach.