International Journal of Clinical Pediatric Dentistry

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VOLUME 15 , ISSUE S2 ( Special Issue-2 (Cariology), 2022 ) > List of Articles


Silver Diamine Fluoride in Preventing Caries: A Review of Current Trends

Padmapriya Surendranath, Srinath Krishnappa

Keywords : Silver diamine fluoride, Caries, Primary dentition, Minimal invasive dentistry

Citation Information :

DOI: 10.5005/jp-journals-10005-2167

License: CC BY-NC 4.0

Published Online: 16-03-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Aim and objective: To evaluate whether silver diamine fluoride (SDF) is effective in the management of dental caries. Background: Dental caries is most common chronic disease and conventional treatment method could not tackle the problem completely. The use of silver compounds in dentistry is over a 100 years. Silver diamine fluoride has become a newer trend in handling the caries especially in young and apprehensive children. It is a noninvasive method of arresting caries which is painless, safe, and cost effective. This article describes the trends in silver diamine fluoride in arresting caries. The combined effects of remineralizing and antibacterial property make SDF an effective cariostatic agent. Review results: Articles were searched in electronic data bases for literature. In vivo studies, in vitro studies, systematic reviews and case reports were included. Conclusion: Silver diamine fluoride is effective in the management of caries in primary dentition. There is a little effect of silver diamine fluoride in permanent molars. Clinical importance: In the current scenario of raising importance of minimal invasive dentistry and preventive dentistry, silver diamine fluoride is an efficient tool in the management of caries.

  1. Pitts NB, Zero DT, Marsh PD, et al. Dental caries. Nat Rev Dis Primers 2017;3(1):1–6. DOI: 10.1038/nrdp.2017.30
  2. Mehta A. Trends in dental caries in Indian children for the past 25 years. Indian J Dent Res 2018;29(3):323–328. DOI: 10.4103/ijdr.IJDR_615_17
  3. Costa SM, Martins CC, Bonfim MD, et al. A systematic review of socioeconomic indicators and dental caries in adults. Inte J Environ Res Public Health 2012;9(10):3540–3574. DOI: 10.3390/ijerph9103540
  4. Chu CH, Lo EC. Promoting caries arrest in children with silver diamine fluoride: a review. Oral Health Prev Dent 2008;6(4): 315–321. PMID: 19178097
  5. Peng JY, Botelho MG, Matinlinna JP. Silver compounds used in dentistry for caries management: a review. J Dent 2012;40(7):531–541. DOI: 10.1016/j.jdent.2012.03.009
  6. Fung HT, Wong MC, Lo EC, et al. Arresting early childhood caries with silver diamine fluoride-a literature review. Oral Hyg Health 2013; 1(3):1–5. DOI: 10.4172/2332-0702.1000117
  7. Crystal YO, Niederman R. Evidence-based dentistry update on silver diamine fluoride. Dent Clin North Am 2019;63(1):45–68. DOI: 10.1016/j.cden.2018.08.011
  8. Alexander JW. History of the medical use of silver. Surg Infect 2009;10(3):289–292. DOI: 10.1089/sur.2008.9941
  9. Demling RH, Desanti L. Effects of silver on wound management. Wounds 2001;13(1):4–15.
  10. Feng QL, Wu J, Chen GQ, et al. A mechanistic study of the antibacterial effect of silver ions on Escherichia coli and Staphylococcus aureus. J Biomed Mater Res 2000;52(4):662–668. DOI: 10.1002/1097-4636(20001215)52:4<662::aid-jbm10>;2-3
  11. Shah S, Bhaskar V, Venkatraghavan K, et al. Silver diamine fluoride: a review and current applications. J Adv Oral Res 2014;5(1):25–35. DOI: 10.1177/2229411220140106
  12. Hamama HH, Yiu CK, Burrow MF. Effect of silver diamine fluoride and potassium iodide on residual bacteria in dentinal tubules. Aust Dent J 2015;60(1):80–87. DOI: 10.1111/adj.12276
  13. Mei ML, Li QL, Chu CH, et al. The inhibitory effects of silver diamine fluoride at different concentrations on matrix metalloproteinases. Dent Mater 2012;28(8):903–908. DOI: 10.1016/
  14. Mei ML, Nudelman F, Marzec B, et al. Formation of fluorohydroxyapatite with silver diamine fluoride. J Dent Res 2017;96(10):1122–118. DOI: 10.1177/0022034517709738
  15. Chu CH, Mei LE, Seneviratne CJ, et al. Effects of silver diamine fluoride on dentine carious lesions induced by Streptococcus mutans and Actinomyces naeslundii biofilms. Int J Paediatr Dent 2012;22(1):2–10. DOI: 10.1111/j.1365-263x.2011.01149.x
  16. Mei ML, Li QL, Chu CH, et al. Antibacterial effects of silver diamine fluoride on multi-species cariogenic biofilm on caries. Ann Clinical Microbiol Antimicrob 2013;12(1):4. DOI: 10.1186/1476-0711-12-4
  17. Mei ML, Ito L, Cao Y, et al. An ex vivo study of arrested primary teeth caries with silver diamine fluoride therapy. J Dent 2014;42(4):395–402. DOI: 10.1016/j.jdent.2013.12.007
  18. Shah S, Bhaskar V, Venkataraghavan K, et al. Efficacy of silver diamine fluoride as an antibacterial as well as antiplaque agent compared to fluoride varnish and acidulated phosphate fluoride gel: an in vivo study. Indian J Dent Res 2013;24(5):575. DOI: 10.4103/0970-9290.123374
  19. Fakhruddin KS, Egusa H, Ngo HC, et al. Silver diamine fluoride (SDF) used in childhood caries management has potent antifungal activity against oral Candida species. BMC Microbiol 2020;20(1):95. DOI: 10.1186/s12866-020-01776-w
  20. Ishiguro T, Mayanagi G, Azumi M, et al. Sodium fluoride and silver diamine fluoride–coated tooth surfaces inhibit bacterial acid production at the bacteria/tooth interface. J Dent 2019;84:30–35 DOI: 10.1016/j.jdent.2018.12.017
  21. Milgrom P, Horst JA, Ludwig S, et al. Topical silver diamine fluoride for dental caries arrest in preschool children: a randomized controlled trial and microbiological analysis of caries associated microbes and resistance gene expression. J Dent 2018;68:72–78. DOI: 10.1016/j.jdent.2017.08.015
  22. Wakshlak RB, Pedahzur R, Avnir D. Antibacterial activity of silver-killed bacteria: the “zombies” effect. Sci Rep 2015;5:9555. DOI: 10.1038/srep09555
  23. Fung MHT, Duangthip D, Wong MCM, et al. Arresting dentine caries with different concentration and periodicity of silver diamine fluoride. JDR Clin Trans Res 2016;1(2):143–152. DOI: 10.1177/2380084416649150
  24. Zhi QH, Lo EC, Lin HC. Randomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children. J Dent 2012;40(11):962–967. DOI: 10.13039/501100003803
  25. Hammersmith KJ, DePalo JR, Casamassimo PS, et al. Silver diamine fluoride and fluoride varnish may halt interproximal caries progression in the primary dentition. J Clin Pediatr Dent 2020;44(2):79–83. DOI: 10.17796/1053-4625-44.2.2
  26. Caroline J, Maharani DA, Adiatman M, et al. Effect and impact of silver diamine fluoride application in primary teeth caries on children's quality of life. J Phy Conf Ser 2018;1073(4):042001. DOI: 10.1088/1742-6596/1073/4/042001
  27. Caglar. Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial. J Dent Res 2007;86(1):95; author reply 95. DOI: 10.1177/154405910708600116
  28. Chu CH, Lo EC, Lin HC. Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children. J Dent Res 2002;81(11):767–770. DOI: 10.1177/0810767
  29. Clemens J, Gold J, Chaffin J. Effect and acceptance of silver diamine fluoride treatment on dental caries in primary teeth. J Public Health Dent 2018;78(1):63–8. DOI: 10.1111/jphd.12241
  30. Burgess JO, Vaghela PM. Silver diamine fluoride: a successful anticarious solution with limits. Adv Dent Res 2018;29(1):131–14. DOI: 10.1177/0022034517740123
  31. Chibinski AC, Wambier LM, Feltrin J, et al. Silver diamine fluoride has efficacy in controlling caries progression in primary teeth: a systematic review and meta-analysis. Caries Res 2017;51(5):527–541. DOI: 10.1159/000478668
  32. Garrastazua MD, Mathias-Santamariab IF, Rochac RS, et al. Three-month effect of silver diamine fluoride (SDF) in salivary levels of streptococcus mutans in children. An exploratory trial. Oral Health Prev Dent 2020;18(1):325–330. DOI: 10.3290/j.ohpd.a43360
  33. Lou YL, Botelho MG, Darvell BW. Reaction of silver diamine fluoride with hydroxyapatite and protein. J Dent 2011;39(9):612–618. DOI: 10.1016/j.jdent.2011.06.008
  34. Bimstein E, Damm D. Human primary tooth histology six months after treatment with silver diamine fluoride. J Clin Pediatr Dent.42(6):442–444. DOI: 10.17796/1053-4625-42.6.6
  35. Rossi G, Squassi A, Mandalunis P, et al. Effect of silver diamine fluoride (SDF) on the dentin-pulp complex: ex vivo histological analysis on human primary teeth and rat molars. Acta Odontol Latinoam 2017;30(1):5–12. PMID: 28688180
  36. Li Y, Liu Y, Psoter WJ, et al. Assessment of the silver penetration and distribution in carious lesions of deciduous teeth treated with silver diamine fluoride. Caries Res 2019;53(4):431–440. DOI: 10.1159/000496210
  37. Duangthip D, Fung MH, Wong MC, et al. Adverse effects of silver diamine fluoride treatment among preschool children. J Dent Res2018;97(4):395–401. DOI: 10.1177/0022034517746678
  38. Crystal YO, Janal MN, Hamilton DS, et al. Parental perceptions and acceptance of silver diamine fluoride staining. J Am Dent Assoc 2017;148(7):510–518. DOI: 10.1016/j.adaj.2017.03.013
  39. Gordon. Silver diamine fluoride staining is acceptable for posterior primary teeth and is preferred over advanced pharmacologic behavior management by many parents. J Evid Based Dent Pract 2018;18(1):94–97. DOI: 10.1016/j.jebdp.2018.01.001
  40. Kumar A, Cernigliaro D, Northridge ME, et al. A survey of caregiver acculturation and acceptance of silver diamine fluoride treatment for childhood caries. BMC oral health 2019;19(1):228. DOI: 10.1186/s12903-019-0915-1
  41. Kyoon-Achan G, Schroth RJ, Martin H, et al. Parents’ views on silver diamine fluoride to manage early childhood caries. JDR Clin Trans Res 2020;1:2380084420930690. DOI: 10.1177/2380084420930690
  42. Markham MD, Tsujimoto A, Barkmeier WW, et al. Influence of 38% silver diamine fluoride application on bond stability to enamel and dentin using universal adhesives in self-etch mode. Eur J Oral Sci 2020; 128(4):354–360 DOI: 10.1111/eos.12701.
  43. de Siqueiraa FS, Moralesb LA, Granjac MC, et al. Effect of silver diamine fluoride on the bonding properties to caries-affected dentin. J Adhes Dent 2020;22:161–172. DOI: 10.3290/j.jad.a44281
  44. Firouzmandi M, Mohaghegh M, Jafarpisheh M. Effect of silver diamine fluoride on the bond durability of normal and carious dentin. J Clin Exp Dent 2020;12(5):e468 –e473. DOI: 10.4317/jced.56303
  45. Garg S, Sadr A, Chan DC. Potassium iodide reversal of silver diamine fluoride staining: a case report. Oper Dent 2019;44(3):221–226. DOI: 10.2341/17-266-s
  46. Zhao IS, Mei ML, Burrow MF, et al. Effect of silver diamine fluoride and potassium iodide treatment on secondary caries prevention and tooth discolouration in cervical glass ionomer cement restoration. Int J Mol Sci 2017;18(2):340. DOI: 10.3390/ijms18020340
  47. Roberts A, Bradley J, Merkley S, et al. Does potassium iodide application following silver diamine fluoride reduce staining of tooth? A systematic review. Aust Dent J 2020;65(2):109–117. DOI: 10.1111/adj.12743
  48. Alvear Fa B, Jew JA, Wong A, et al. Silver modified atraumatic restorative technique (SMART): an alternative caries prevention tool. Stoma Edu J 2016;3(2):18–24.
  49. Jiang M, Wong MCM, Chu CH, et al. A 24-month randomized controlled trial on the success rates of restoring untreated and SDF-treated dentine caries lesions in primary teeth with the ART approach. J Dent 2020;100:103435. DOI: 10.1016/j.jdent.2020.103435
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