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Silver diamine fluoride: a caries "silver-fluoride bullet"
A Rosenblatt1, T C M Stamford, R Niederman
1The Forsyth Institute, 140 The Fenway, Boston, MA 02115, USA. arosenblatt@forsyth.org
Journal of Dental Research
|March 13, 2009
Summary
Silver diamine fluoride (SDF) is a highly effective antimicrobial agent for preventing and arresting caries. This review found SDF significantly outperformed fluoride varnish in caries prevention and arrest, offering a valuable dental intervention.
Area of Science:
- Dentistry
- Microbiology
- Public Health
Background:
- Silver compounds have a long history of antimicrobial use, including in dental applications.
- Silver ions (Ag+) exhibit potent antimicrobial activity against pathogenic organisms.
- Current research explores silver diamine fluoride (SDF) for caries prevention.
Purpose of the Study:
- To systematically review and compare the effectiveness of silver diamine fluoride (SDF) versus fluoride varnish for caries prevention.
- To evaluate the best available evidence on SDF's efficacy in arresting and preventing dental caries.
- To assess SDF's potential as a caries-preventive intervention against established benchmarks.
Main Methods:
- A systematic review of human clinical trials published between 1966 and 2006 was conducted.
- Searches included five databases, reference reviews, and hand searches, identifying 99 trials.
- Dual review focused on controlled clinical trials with the patient as the unit of observation, excluding non-comparative or opinion-based studies.
Main Results:
- Silver diamine fluoride (SDF) demonstrated superior caries arrest (96.1%) and prevention (70.3%) compared to fluoride varnish (arrest 21.3%, prevention 55.7%).
- SDF required fewer applications (needed to treat 0.8-0.9) for caries arrest and prevention than fluoride varnish (needed to treat 3.7-1.1).
- No significant differences in adverse events were observed between SDF and control groups.
Conclusions:
- Silver diamine fluoride (SDF) is significantly more effective than fluoride varnish for both caries arrest and prevention.
- SDF represents a promising, safe, and efficient intervention for caries prevention, aligning with global health goals.
- The findings support SDF as a valuable tool to meet the criteria for 21st-century medical care and public health initiatives.
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