Investigating the effect of a silver fluoride intervention on the life journeys of young Indigenous peoples and the arresting of dental caries across the life course

INTERVENTION: The silver diamine fluoride intervention involves the application of AgF(NH3)2 38% (Riva Star) to sites of active dental caries lesions in the primary and permanent dentition. After cleaning teeth with dry gauze, dentally‐qualified research officers will apply the product on decayed teeth for approximately 1 minute and allow to air dry, followed by the application of a Potassium Iodide (KI) solution to prevent staining. The application of the procedures will take approximately 5 minutes in total. Application of the product to the teeth of participants in the immediate intervention clusters will occur at the baseline visits. No strategies to monitor adherence to the intervention will be necessary. CONDITION: Dental caries;Early childhood caries; ; Dental caries ; Early childhood caries Oral and Gastrointestinal ‐ Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon PRIMARY OUTCOME: Arrest of carious lesions in the dentition, with arrested caries defined as non‐penetration by dental probe.[12 months (primary timepoint) and 24 months after intervention] SECONDARY OUTCOME: Dental anxiety will be assessed using the Child Dental Anxiety and Scale modified to capture anxiety from adolescent participants.[12 months and 24 months after the intervention.] Dental behaviours: consumption of sugar‐sweetened beverages and foods, assessed using items from the 2012‐14 National Child Oral Health Survey.[12 months and 24 months after intervention.] Dental behaviours: tooth brushing frequency, assessed using items from the 2012‐14 National Child Oral Health Survey.[12 months and 24 months after the intervention.] Dental behaviours: use of fluoride toothpaste, assessed using items from the 2012‐14 National Child Oral Health Survey.[12 months and 24 months after the intervention.] Dental behaviours: usual reason for participant to visit oral health care provider, assessed using items from the 2012‐14 National Child Oral Health Survey.[12 months and 24 months after the intervention.] Effectiveness measures for economic evaluation: changes in SEWB measured using the questionnaires General Child Health Utility Scale, Child Health Utility 9D Inde X(CHU_9D), and the proxy reporting of the EQ‐5D‐Y tool.[12 months and 24 months after intervention.] Effectiveness measures for economic evaluation: number of children and young people managed in primary oral health care without need for specialist referral. This will be determined based on self‐reported information on utilisation of dental services and clinical evaluation of need for specialist referral.[12 months and 24 months after intervention.] Effectiveness measures for economic evaluation: the numbers and types of treatments provided, and caries increments. This will be determined based on clinical evaluation.[12 months and 24 months after intervention.] Socio and Emotional Wellbeing (SEWB) will be measured using the Strengths and Difficulties Questionnaire (SDQ).[12 months and 24 months after intervention] INCLUSION CRITERIA: Indigenous children and young adults aged 2 to 18 years with active carious lesions in the primary and/or permanent dentition residing in selected study clusters will be eligible.