Silver diamine fluoride (SDF): its role in caries management

From Volume 46, Issue 11, December 2019 | Pages 1016-1022

Authors

Yasmi O Crystal

DMD, MSc, FAAPD, Clinical Professor of Paediatric Dentistry Department of Paediatric Dentistry, New York University College of Dentistry, New York, USA.

Articles by Yasmi O Crystal

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Abstract

Abstract

Silver diamine fluoride (SDF) combines the antibacterial properties of silver and the remineralizing actions of fluoride in an alkaline solution that creates an unfavourable environment for collagen degradation. Clinical trials have proven the efficacy of SDF as a caries-arresting agent in primary teeth and root caries in the elderly. It is minimally invasive, inexpensive, safe and easy to apply, but a sign of arrest is the dark discoloration of the lesions where it is applied. SDF provides clinicians with a valuable additional tool in their armamentarium for caries management that aims to stop the disease process at the tooth surface, when traditional restorative therapy is not the best option, and when aesthetic results are not a concern.

CPD/Clinical Relevance: Silver diamine fluoride (SDF) provides clinicians with an additional valuable option for arresting dental caries as part of a comprehensive caries management plan when traditional restorative therapy is not the best option.

Article

Despite advances in caries prevention and the reduction in caries prevalence as a result of the widespread use of fluoride in toothpastes and other delivery forms, dental caries continues to be a significant health problem for vulnerable populations worldwide. Increased consumption of sugar and processed carbohydrates are partly to blame for the persistent caries prevalence,1 and large numbers of individuals of all ages go untreated as they face barriers of cost and access to dental services. In addition, young children may also be unable to cope with undergoing conventional dental restorative treatment and are often treated with more risky procedures like sedation or general anaesthesia for the delivery of care. Special needs populations and the elderly may have additional co-morbidities that prevent them from receiving conventional dental treatment, which has a negative impact on their quality of life.2 Such circumstances highlight the need to find alternatives for caries control that are safe, effective, affordable and are easy to implement.

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