Restorative treatment with sedation or general anesthesia (GA) is often the traditional strategy for managing severe early childhood caries (S-ECC). These methods of advanced behavior management are costly and invasive
Researchers have found in a retrospective cohort study that silver diamine fluoride (SDF) could be used effectively in managing and arrest caries in paediatrics and hence can delay the need of dental rehabilitation under General Anaesthesia. Further Children treated with SDF had a longer time to procedural sedation or exposure to GA.

The study entitled “Silver diamine fluoride–associated delays in procedural sedation in young children” has been published in JADA, The Journal of the American Dental Association.
They quantified the time from first diagnosis to first sedation encounter for children from birth through age 71 months.
The differences were compared between those treated with or without SDF.
The study results could be summarised as follows:
There were 175,824 children included in this research.
Using SDF, there was an increase in the time to first sedation or GA encounter by 63 days when treated by different dentists and by 91 days when treated by the same dentist.
The Practical Implication focussed on the advantages of using silver diamine fluoride (SDF).
The study addressed that increasing the time to first sedation or GA encounter at a usual source of care has numerous advantages:
Before treatment, children get more developmental time.
It provides dental offices more flexibility in delivering care.
Supports delivery of person-centred care.
We found that children receiving silver diamine fluoride (SDF) had delayed their first sedation by three months. The delay was three months for those who visited the same dentist and two months for those who saw different dentists at diagnostic and sedation or GA encounters.
We also recorded age perspective finding with the delay longest for 3-year-olds (3 months) compared with 1-year-olds or 5-year-olds (1 month). Among 1-year-olds, parental esthetic preferences and emotions dictate the timing of the first sedation or GA encounter.
Further reading:
Silver diamine fluoride–associated delays in procedural sedation in young children. February 03, 2023DOI:https://doi.org/10.1016/j.adaj.2022.12.008