The success of silver diamine fluoride in arresting dentine caries: what's behind it?

Abstract

Objectives: This paper reviews and discusses the mechanism of silver diamine fluoride (SDF) in arresting dentine caries. Methods: Studies have shown that SDF can arrest dental root caries and cavitated coronal caries involving dentine. Caries is a biofilm-mediated oral disease that involves bacteria and dentine, is composed of mineral and organic contents. The effects of silver and fluoride on bacteria and those on dentine were included in this review. Papers published in Chinese and English were reviewed.Studies on the mechanism of silver fluoride were included. Results: Silver ion is a broad-spectrum antimicrobial agent that inhibits bacterial growth. Fluoride enhances mineral formation by forming fluorohydroxyapatite with reduced solubility. The alkaline property of SDF may provide an unfavourable environment for collagen enzyme activation. The combination of silver and fluoride in an alkaline solution has a synergistic effect in arresting dentine caries. Conclusions: Understanding the mechanisms of SDF in arresting dentine caries helps clinicians to develop appropriate protocol for the use of SDF in clinical care.