Delivery Methods of Silver Diammine Fluoride to Contacting Proximal Tooth Surfaces and History of Silver in Dentistry

Silver has a long history of use in medicine and dentistry, as its powerful antimicrobial properties have benefited mankind immensely. Silver formulations can be traced back to Hippocrates, and silver nitrate has centuries of use in medicine, including being utilized intraorally since at least the early 1800s. In the past roughly 40 years, silver diammine fluoride (SDF) has been used in many parts of the world to treat tooth sensitivity and for chemical attenuation of dental caries lesions. SDF was more recently introduced in North America for treatment of dental sensitivity with widespread off-label use as a dental caries infection inhibitor. Accordingly, SDF has been the subject of much dental research and many published articles in dentistry. In addition to providing significant chemical interference of progression of caries infections, SDF has the ability to prevent initiation of the caries process. This article gives a brief history of silver use in medicine and dentistry and documents a simplified procedure to saturate contacting proximal surfaces of teeth with 38% SDF solution, followed by fluoride varnish coverage, to prevent caries lesions and intercept progression of existing caries infections.