A comparative cross-sectional study assessing aesthetic perceptions and acceptability of silver diamine fluoride staining between Spanish and Italian parents.

Abstract Background Assessing parental aesthetic acceptability of Silver Diamine Fluoride (SDF) staining is crucial for its potential implementation in paediatric dentistry in different regions. The aim of this study was to compare aesthetic perceptions and acceptance of SDF staining between Spanish and Italian parents, and assess weather acceptability is influenced by location, child’s cooperation, or demographic background. Methods A cross-sectional comparative study was conducted among Spanish and Italian parents at three university dental clinics, using a validated Italian version of the questionnaire “Parental perceptions of Silver Diamine Fluoride Dental Color Changes”. Results 264 Spanish and 234 Italian parents participated in the survey. 41.8% of Spanish parents, compared to 65.4% of Italians considered staining on posterior teeth acceptable (p < 0.001). 17.2% of Spaniards rated anterior teeth acceptable, versus 19.3% of Italians (p < 0.001). Italian parents showed clearly increased acceptability as child’s cooperation decreased. Acceptability levels in Spain remained more homogeneous, despite linear mixed model identifying a significant increase in acceptability scores from ‘collaboration’ to ‘non-collaboration’ scenario. Conclusions Spanish and Italian parents found SDF staining on posterior teeth more acceptable than in anterior regions. Level of acceptance increased with a child’s uncooperative behavior. Spanish parents generally demonstrated a lower acceptance of SDF pigmentation compared to Italians. Trial registration NCT06384326 (ClinicalTrials.gov ID)