Silver Diamine Fluoride for Caries Management in Primary Teeth – A Literature Review

Abstract

Global research interest in the efficacy of silver diamine fluoride (SDF) for caries management has rapidly increased in recent years. According to several clinical trials, SDF has had more efficacy for arresting cavitated dentin caries in primary teeth than any comparators. The arresting mechanisms could relate to the unique properties of silver ions and the high concentration of fluoride, including antimicrobial effects, inhibition of demineralization, promotion of remineralization, and inhibition of dentin collagen degradation. Insufficient evidence exists to draw conclusions on the caries prevention effect and non-cavitated caries arrest in primary teeth or the caries prevention and arresting effects in permanent teeth. The presence of plaque is the most reported factor in reducing caries arrest. Therefore, SDF treatment should be done in conjunction with comprehensive caries preventive measures to achieve maximum efficacy. The black staining from SDF is a barrier to parental acceptance, but the key factors affecting acceptance were the location of the teeth and the child’s cooperation. Due to its efficacy and simplicity, SDF is recommended as a potential measure for caries management. This article highlights the beneficial effects and considerations of SDF treatment in primary teeth based on recent evidence.