Effect of Silver Diamine Fluoride on Local Anesthesia in Hypomineralized Molars

Inclusion Criteria: * At least one hypomineralized first permanent molar with a primary cavitated caries lesion(s) or a cavitated tooth defect requiring restorative dental care with local anesthesia * American Society of Anesthesiologists (ASA) Physical Status Classification I or II (healthy children or those with mild systemic disease) * English speaking * Subjects for which basic behavior guidance (non-pharmacological or nitrous oxide/oxygen) is indicated Exclusion Criteria: * Teeth with irreversible pulpitis and pulp necrosis * Patients requiring advanced behavior management such as moderate sedation, general anesthesia, and/or active or passive restraint * Inability of the child to cooperate due to special needs or other conditions * Allergy to SDF, local anesthetic or other material component * Subjects with ulcerative gingivitis or stomatitis * Subjects with known sensitivity to silver or other heavy-metal ions * Subjects showing abnormal skin sensitization in daily circumstances