Silver diamine fluoride use for caries control is recommended as part of a comprehensive caries management program, according to a recent study published in the Pediatric Dental Journal
Dental caries continue to be a severe oral health problem despite a decrease in its prevalence over the past few decades. The contemporary philosophy of caries management has shifted from the traditional approach to a newer medical one, that frequently includes the utilization of fluoridated and antimicrobial agents.
Among these different agents, Silver Diamine Fluoride (SDF)∗ has gained significant recognition. Dr Nishino and Dr Yamaga in Japan pioneered its application to arrest caries.
The results of the study are:
38% SDF solution is more effective than lower concentrations
Twice a year application is more effective than yearly applications
Over longer periods (30 months), annual applications of SDF are more effective than 3 weekly applications at baseline
Application times ranging from 10 seconds to 3 minutes achieved various degrees of success that do not seem to be time-dependent;
Anterior teeth have higher rates of arrest than posterior teeth
Large lesions, occlusal lesions and those with visible plaque have fewer chances of arrest
It is an alkaline, colourless solution composed of diamine-silver and fluoride ions having silver's antibacterial and fluoride's remineralising properties.
It has been used successfully to arrest and prevent caries in deciduous and permanent teeth, prevent recurrence of secondary caries and treat dentinal hypersensitivity.
No adverse systemic effects due to SDF have been noted although black discolouration following its application has raised concerns.
When used wisely it is an effective, sustainable and inexpensive option for children with high caries risk, individuals who cannot endure conventional modalities of restorative treatment and those with special healthcare needs.
Thus, it can be concluded that Silver diamine fluoride use for caries control is recommended as part of a comprehensive caries management program, where individual needs and risks are considered.
Reference:
Silver Diamine Fluoride: Extending the spectrum of Preventive Dentistry, a literature review by Inshiya Alazhar Contractor et al. published in the Pediatric Dental Journal.
https://www.sciencedirect.com/science/article/abs/pii/S091723942030080X