Background The sustainability of school-based caries prevention programs depends on the utilization of effective, efficient treatments and the availability of trained clinicians. The objective of this study was to determine whether registered nurses are non-inferior to dental hygienists in the application and effectiveness of silver diamine fluoride (SDF) for dental caries.

Methods CariedAway was a school-based cluster-randomized trial of SDF versus dental sealants and atraumatic restorations. Within the SDF arm, subjects were treated by either a licensed dental hygienist or a registered nurse, both under the supervision of a pediatric dentist. The proportion of children who remained caries free after two years was analyzed using two-group proportion tests, adjusting for the clustering effect of schools.

Results 417 children were analyzed including 298 treated by hygienists and 119 by nurses. The proportion of caries-free individuals was 0.812 and 0.798 for hygienists and nurses, respectively, for a difference of 0.014 (95% CI = -0.07, 0.098) and within the pre-determined non-inferiority margin.

Conclusions Results support silver diamine fluo-ride and fluoride varnish delivery by both dental hygienists and nurses in school-based oral health programs.

The authors have declared no competing interest.

NCT03442309

https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-018-2891-1

Research reported in this publication was funded through a Patient-Centered Outcomes Research Institute (PCORI) award (PCS-1609-36824). The content is solely the responsibility of the authors and does not necessarily reflect the official views of the funding organization, New York University, or the NYU College of Dentistry.

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CariedAway is a registered study at www.clinicaltrials.gov (#NCT03442309) and received ethical approval from the New York University School of Medicine IRB (#i17-00578).

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