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CTRI Number  CTRI/2025/12/098940 [Registered on: 11/12/2025] Trial Registered Prospectively
Last Modified On: 20/07/2026
Post Graduate Thesis  Yes 
Type of Trial  Interventional 
Type of Study   Dentistry 
Study Design  Randomized, Parallel Group, Active Controlled Trial 
Public Title of Study   Comparison Of Three Fluoride Agents For Preventing Tooth Decay In Children 
Scientific Title of Study   Comparative Evaluation Of Cariostatic Efficacy Of 5% Nano silver Fluoride,38% Silver Diamine Fluoride,5% Sodium Fluoride Varnish On Primary Teeth In Children Of Age Group 4 To 8 Years With Incipient Carious Lesions – An In-Vivo Randomized Clinical Trial 
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  BHEEMA PRAVALIKA 
Designation  POST GRADUATE 
Affiliation  MNR DENTAL COLLEGE AND HOSPITAL 
Address  Room No 8 Department of pedodontics and preventive dentistry MNR DENTAL COLLEGE MNR NAGAR FASALWADI MOHD SHAHPUR

Medak
TELANGANA
502294
India 
Phone  9059875550  
Fax    
Email  pappulapravalika12@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr SRIDHAR MUKTINENI 
Designation  PROFESSOR  
Affiliation  MNR DENTAL COLLEGE AND HOSPITAL 
Address  Room No 8 Department of pedodontics and preventive dentistry MNR DENTAL COLLEGE MNR NAGAR FASALWADI,MOHD SHAHPUR

Medak
TELANGANA
502294
India 
Phone  9393812081  
Fax    
Email  sridharneni@gmail.com  
 
Details of Contact Person
Public Query
 
Name  Dr NASEEMOON SHAIK 
Designation  ASSOCIATE PROFESSOR 
Affiliation  MNR DENTAL COLLEGE AND HOSPITAL 
Address  Room No 8 Department of pedodontics and preventive dentistry MNR DENTAL COLLEGE MNR NAGAR FASALWADI MOHD SHAHPUR

Medak
TELANGANA
502294
India 
Phone  8105935678  
Fax    
Email  dr.naseemoonshaik@gmail.com  
 
Source of Monetary or Material Support  
MNR DENTAL COLLEGE AND HOSPITAL Room No 8 Department of pedodontics and preventive dentistry MNR NAGAR FASALWADI MOHD SHAHPUR 
 
Primary Sponsor  
Name  BHEEMA PRAVALIKA 
Address  Room No 8 Department of pedodontics and preventive dentistry MNR DENTAL COLLEGE MNR NAGAR FASALWADI MOHD SHAHPUR 
Type of Sponsor  Other [SELF] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
BHEEMA PRAVALIKA  GOVERNMENT HIGH SCHOOL  GHS SHAIKPET, room no 1,500008
Hyderabad
TELANGANA 
9059875550

pappulapravalika12@gmail.com 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
MNR DENTAL COLLEGE AND HOSPITAL INSTITUTIONAL ETHICAL COMMITEE  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: B949||Sequelae of unspecified infectiousand parasitic disease, (2) ICD-10 Condition: B999||Unspecified infectious disease,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  38% Silver Diamine Fluoride (SDF)  The comparator material, 38% Silver Diamine Fluoride (SDF), is a chemical complex composed of silver, ammonia, and fluoride. It is applied to the affected tooth surface using a cotton pellet or micro brush for about 10 seconds, following the same protocol as the other agents. The silver component provides a strong antimicrobial effect, while fluoride aids in remineralization, effectively arresting the progression of dental caries. However, a notable drawback of SDF application is the black discoloration of the treated carious lesion, which may affect the esthetics, especially in anterior teeth. Despite this, it remains one of the most effective agents for non-invasive caries management. 
Intervention  5% Nano Silver Fluoride (NSF)  In this study, the intervention involves the application of 5% Nano Silver Fluoride (NSF), which consists of nano-sized silver particles combined with 5% fluoride. The material is applied to the tooth surface using a cotton pellet or micro brush for approximately 10 seconds on a clean air-dried surface. The nano silver particles exert a potent antimicrobial effect against cariogenic bacteria such as Streptococcus mutans, while the fluoride component promotes remineralization of incipient enamel lesions. This combination is designed to arrest the progression of dental caries effectively without causing discoloration of the treated tooth surface, making it a promising minimally invasive approach for managing early carious lesions in children. 
Comparator Agent  5% Sodium Fluoride (NaF) Varnish  The comparator material, 5% Sodium Fluoride (NaF) varnish, is a conventional fluoride formulation widely used in preventive dentistry. It is applied directly onto the tooth surface using a cotton pellet or micro brush for approximately 10 seconds on a clean, dry surface. The varnish acts as a sustained-release source of fluoride, enhancing enamel remineralization and inhibiting demineralization. Through this mechanism, it helps in preventing the initiation and progression of dental caries, making it a standard and well-established agent in caries control protocols for children. 
 
Inclusion Criteria  
Age From  4.00 Year(s)
Age To  8.00 Year(s)
Gender  Both 
Details  Subject who is willing to participate in the study and has
given written consent.
Children aged 4 to 8 years with incipient lesions or dental
caries in primary teeth
Absence of pulp involvement, pain, mobility, abscess,
sinus, or fistula.
Participants should be free of any systemic diseases. 
 
ExclusionCriteria 
Details  Children whose parents refused to give consent
Primary teeth with irreversible pulpitis
Primary teeth which are close to exfoliation
Children with fluorosis 
 
Method of Generating Random Sequence   Coin toss, Lottery, toss of dice, shuffling cards etc 
Method of Concealment   Other 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
Caries arrest rate measured by change in lesion hardness and color   Caries arrest rate measured by change in lesion hardness and color at 1 week 3 months
6 months 9months 12months 
 
Secondary Outcome  
Outcome  TimePoints 
Parental satisfaction and child acceptance of treatment  Immediately post intervention 
 
Target Sample Size   Total Sample Size="140"
Sample Size from India="140" 
Final Enrollment numbers achieved (Total)= "0"
Final Enrollment numbers achieved (India)="140" 
Phase of Trial   N/A 
Date of First Enrollment (India)   22/12/2025 
Date of Study Completion (India) 22/12/2025 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Date Missing 
Estimated Duration of Trial   Years="1"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)   Not Yet Recruiting 
Recruitment Status of Trial (India)  Completed 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary
Modification(s)  
Background: Untreated dental caries in children adversely affects their general
health, social well-being, and educational prospects, largely because of poor access
to basic oral healthcare. Arresting caries treatment (ACT) has been proposed to
manage untreated dental caries in children.

Aims and objectives: The purpose of the present clinical study is to investigate the
effectiveness of a new anticaries agent, Nano silver fluoride (NSF), in preventing and
arresting caries in children compared with silver diamine fluoride, sodium fluoride
varnish, and saline as a control group.

Materials and methods: A total of 120 primary teeth, both maxillary and
mandibular, were randomly selected from 100 children aged 4–8 years, which were
randomly divided into the NSF experimental group, Silver Diamine Fluoride (SDF),
Sodium Fluoride Varnish (SFV) test groups, and Saline control group with 30 in each
group. Teeth were clinically assessed, treated, and followed up at 7 days, 1, 3, and
12 months. Caries activity was evaluated using ICDAS II criteria. Pearson’s Chi-
square test was used to compare groups across follow-ups.

Results: 66.6% of teeth showed arrested caries within 1week follow up, 90% of
decayed teeth showed hard arrested dentine at 3 month to 12 month analysis in the
NSF group where as it was 100% in 3 month to 12 month follow up in SDF group
and 73.3% in 3 month to 12 month follow up in SFV group, where as saline group
proved to be in effective.

Conclusion: The present study proves that SDF emerged as the most effective
anticaries agent, followed closely by NSF and presents a non-invasive option for
caries arrest and treatment when applied directly to caries lesions.
Keywords: Caries arrest, Dental caries, Nano silver fluoride, silver diamine fluoride,
sodium fluoride varnish.
 
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