Silver diamine fluoride therapy for dental care

Abstract

<p>Silver diamine fluoride (SDF) was developed in Japan in the 1960s. It is used to control early childhood caries, arrest root caries, prevent fissure caries and secondary caries, desensitise hypersensitive teeth, remineralise hypomineralised teeth, prevent <a href="https://www-sciencedirect-com.eproxy.lib.hku.hk/topics/medicine-and-dentistry/tooth-resorption" title="Learn more about dental erosion from ScienceDirect's AI-generated Topic Pages">dental erosion</a>, detect carious tissue during excavation and manage infected root canals. SDF is commonly available as a 38% solution containing 255,000 ppm silver and 44,800 ppm <a href="https://www-sciencedirect-com.eproxy.lib.hku.hk/topics/medicine-and-dentistry/fluoride-ion" title="Learn more about fluoride ions from ScienceDirect's AI-generated Topic Pages">fluoride ions</a>. Silver is an antimicrobial and inhibits cariogenic biofilm. Fluoride promotes remineralisation and inhibits the <a href="https://www-sciencedirect-com.eproxy.lib.hku.hk/topics/medicine-and-dentistry/demineralization" title="Learn more about demineralisation from ScienceDirect's AI-generated Topic Pages">demineralisation</a> of teeth. SDF also inactivates proteolytic <a href="https://www-sciencedirect-com.eproxy.lib.hku.hk/topics/medicine-and-dentistry/peptidase" title="Learn more about peptidases from ScienceDirect's AI-generated Topic Pages">peptidases</a> and inhibits dentine <a href="https://www-sciencedirect-com.eproxy.lib.hku.hk/topics/medicine-and-dentistry/collagen-degradation" title="Learn more about collagen degradation from ScienceDirect's AI-generated Topic Pages">collagen degradation</a>. It arrests caries without affecting <a href="https://www-sciencedirect-com.eproxy.lib.hku.hk/topics/medicine-and-dentistry/dental-pulp" title="Learn more about dental pulp from ScienceDirect's AI-generated Topic Pages">dental pulp</a> or causing <a href="https://www-sciencedirect-com.eproxy.lib.hku.hk/topics/medicine-and-dentistry/dental-fluorosis" title="Learn more about dental fluorosis from ScienceDirect's AI-generated Topic Pages">dental fluorosis</a>. Indirect <a href="https://www-sciencedirect-com.eproxy.lib.hku.hk/topics/medicine-and-dentistry/dental-pulp-capping" title="Learn more about pulp capping from ScienceDirect's AI-generated Topic Pages">pulp capping</a> with SDF causes no or mild inflammatory pulpal response. However, direct application of SDF to dental pulp causes <a href="https://www-sciencedirect-com.eproxy.lib.hku.hk/topics/medicine-and-dentistry/pulp-necrosis" title="Learn more about pulp necrosis from ScienceDirect's AI-generated Topic Pages">pulp necrosis</a>. Furthermore, SDF stains carious lesions black. Patients must be well informed before SDF <a href="https://www-sciencedirect-com.eproxy.lib.hku.hk/topics/medicine-and-dentistry/therapeutic-procedure" title="Learn more about treatment from ScienceDirect's AI-generated Topic Pages">treatment</a>. <a href="https://www-sciencedirect-com.eproxy.lib.hku.hk/topics/medicine-and-dentistry/fluoride-therapy" title="Learn more about SDF therapy from ScienceDirect's AI-generated Topic Pages">SDF therapy</a> is simple, painless, non-invasive, inexpensive, and requires a simple armamentarium and minimal support. Both clinicians and patients generally accept it well. In 2021, the World Health Organization included SDF as an essential medicine that is effective and safe for patients. Moreover, it can be used for caries control during the COVID-19 pandemic because it is non-aerosol-generating and has a low risk of cross-infection.<br></p>