silver-diammine and Dental-Caries

To evaluate the efficacy of silver diamine fluoride (SDF) in arresting dental caries in cavitated caries lesions in primary molars.. A systematic search was carried out in PubMed, Scopus, and Embase. Furthermore, cross-referencing was performed using the references lists of full-text articles and grey literature was also retrieved for eligible studies. Two independent reviewers were responsible for study selection and data extraction.. Randomized and non-randomized clinical studies that evaluated the caries arrest rate of SDF compared to no treatment or any other type of non-invasive or minimally-invasive treatment were included. Only publications in the English, Italian and French language and with a minimum follow-up of 6 months were considered for study eligibility.. The characteristics of the included studies-age, sex, type of study, sample size, caries at baseline, setting, operator, blinding, intervention, outcomes and assessment of any confounders-were extracted from the included papers. The quality assessment was carried out using the Cochrane risk of bias tool. The success rate and odds ratios were chosen to calculate the effect size for the meta-analysis.. A total of nine publications were included for qualitative review and five of them were included in the meta-analysis. Around half of lesions that received annual or biannual application SDF ≥ 38% were arrested.. SDF 38% application was found to be effective in arresting dental caries progression in cavitated primary molars.

Topics: Cariostatic Agents; Dental Caries; Fluorides; Fluorides, Topical; Humans; Molar

This in vitro study evaluated the microshear bond strength (μSBS) of a universal adhesive after silver diammine fluoride (SDF) application at different concentrations on carious dentinal lesions in primary teeth.. The application of 38% SDF resulted in higher μSBS mean than control and use of 12% SDF (p = 0.006). No significant differences were observed among control, 12% SDF, and 30% SDF. All specimens tested showed adhesive/mixed failure.. The use of SDF does not jeopardise the bonding of a universal adhesive applied in the etch-and-rinse mode to carious dentinal lesions in primary teeth, irrespective of the product concentration.

Topics: Composite Resins; Dental Bonding; Dental Caries; Dental Cements; Dentin; Fluorides; Humans; Materials Testing; Resin Cements; Tensile Strength; Tooth, Deciduous

Silver Diammine Fluoride (SDF) is a topical medication used to arrest cavitated carious lesions non-invasively. The primary aim was to investigate, and analyse the relationships between; knowledge, attitudes and practises (including barriers and facilitators) for SDF use in the management of dental caries by general dental practitioners (GDPs) and paediatric dentists (PDs) in the Netherlands. A secondary aim was to explore any differences in these, between these groups.. A randomly selected sample of 600 Dutch GDPs (out of 9,502 respectively) and all 57 registered Dutch PDs were invited to participate in this cross-sectional survey, consisting of four sections: (1) participant characteristics, (2) knowledge (through responses to summative questions), (3) attitudes (through statement agreement using 5-point Likert scale), and (4) practises, use, barriers and facilitators (through multiple choice questions).. The response rates were: GDPs 23% (n = 140) and PDs 47% (n = 27). Knowledge: out of 15 questions to test understanding of SDF, the mean number of correct answers were GDPs 6.7; standard deviation (SD) 2.6 and PDs 7.4, SD 2.2 with no significant difference. The mean overall attitude score showed positive attitudes towards SDF use for both groups. Compared to GDPs, PDs were more likely to use SDF (p < 0.001) and expected to increase their use (p = 0.037). The main barrier for users was parental acceptance (47%) and for non-users it was lack of knowledge (60%). The main facilitator for both users and non-users was gaining knowledge through courses and workshops, followed by written information leaflets about SDF for parents.. Less than half of the knowledge questions about SDF were answered correctly. Despite low knowledge, attitude towards SDF use was positive. Practitioners believed that its use would be facilitated by professionals having more accessible information and training and by the availability of parent information leaflets. Furthermore, SDF is used more frequently by PDs than GDPs.

Topics: Cariostatic Agents; Child; Cross-Sectional Studies; Dental Caries; Dentists; Fluorides; Fluorides, Topical; Health Knowledge, Attitudes, Practice; Humans; Netherlands; Professional Role; Quaternary Ammonium Compounds; Silver Compounds

Silver diammine fluoride (SDF) is a caries-arresting agent for dentine lesions. This study investigated the effect of application frequency of SDF when used with glass ionomer cement (GI) for remineralising carious dentine.. Freshly extracted human posterior teeth with advanced caries were used. After superficial removal of infected dentine, single (G3), double (G4), triple (G5) applications of SDF (Advantage Arrest SDF 38 %) followed by a layer of GI (GC Fuji IX GP) were compared to no treatment (negative control-G2), and GI only (G1). All teeth were stored in artificial saliva between treatments and for 2-weeks after final treatment. Micro-computed X-ray tomography (NSI) scans were obtained at each stage and analysed to plot mineral density-depth profile, lesion depth (LD) and mineral loss (ΔZ). Data was statistically analysed at a significance level of 0.05.. Mean LD values were 837 μm, 735 μm, 841 μm, 1008 μm, 707 μm at baseline and 785 μm, 727 μm, 712 μm, 855 μm, 639 μm after treatment for groups G1 to G5, respectively. Mean ΔZ values were 6327 vol%μm, 5995 vol%μm, 10014 vol%μm, 7192 vol%μm, 5649 vol%μm at baseline and 3686 vol%μm, 5126 vol%μm, 5539 vol%μm, 2327 vol%μm, 3218 vol%μm after treatment for groups G1 to G5, respectively. Paired t-test showed that LD and ΔZ changed significantly within all groups from baseline to treatment weeks following storage (p < 0.05) except LD in the control (p > 0.05). ANCOVA showed significant difference among groups in net lesion depth recovery and net mineral gain (p < 0.05), and G3 and G4 showed the highest mineral gains.. One or two applications of SDF prior to placement of GI, were effective in remineralising advanced dentine lesions, while additional applications, when combined with GI, did not demonstrate additional benefit in this study.. This short-term laboratory research study showed that one or two applications of SDF followed by GI coverage could remineralise advanced dentine caries in the presence of artificial saliva. This procedure carries potential in the treatment of difficult lesions where conventional restorations would require significant tooth structure removal through traumatic procedures.

Topics: Acrylic Resins; Ammonia; Dental Caries; Dental Caries Susceptibility; Dentin; Fluorides; Fluorides, Topical; Glass Ionomer Cements; Humans; Quaternary Ammonium Compounds; Silicon Dioxide; Silver Compounds

This study aimed to examine whether discoloration of carious dentin after silver-diammine-fluoride (SDF) application might be used as a mean to detect demineralized-dentin. Fourty specimens were obtained from 20 human permanent teeth. Teeth were sectioned through the center of carious lesions to create 2-halves in which each half was assigned to a treatment group. Specimens were divided into two groups (n=20) (each half was assigned to one group) according to solution, namely Caries Check (CC), or SDF. SDF group was subdivided into 2 groups: light-cured and 2-day storage groups. The specimens were tested using light-microscope, microhardness test and SEM/EDS analysis. Repeated-measures ANOVA was used for statistical analysis. The light-microscope showed superficial discoloration in the CC-group while SDF (2-day storage) group showed deeper discoloration for the lesion area. SDF showed significant increase in the hardness compared with the CC-group. SDF showed potentiality to be used as an assisting-tool for caries detection.

Topics: Ammonia; Dental Caries; Dentin; Fluorides; Fluorides, Topical; Humans; Silver Compounds

Parents of children with autism spectrum disorder (ASD) may have concerns with fluoride/silver content in silver diammine fluoride (SDF).. To compare parental acceptance of SDF and dental fear between children with and without ASD.. Three hundred parents were enrolled. Demographics, dental history, and dental fear were recorded. Subjects viewed an educational video and completed survey about SDF acceptance including the following: (a) overall acceptance, (b) aesthetic concerns by tooth location, (c) fluoride/silver concerns, and (d) its use as a general anaesthesia (GA) alternative. Descriptive, bivariate, and multivariate analyses were used.. Significantly, more children with ASD had dental fear (ASD: 56% vs neurotypical: 26%). No differences in acceptance existed between the two groups overall or with respect to aesthetics, fluoride/silver content, or as an alternative to GA. Overall acceptance is >60%. Regardless of group, parents of older children were less likely to accept SDF as an alternative to GA (OR = 0.67 [95% CI: 0.50-0.90]).. Parents of children with ASD had similar acceptance of SDF use compared to parents of neurotypical children. Children with ASD had higher levels of dental fear. Parents of younger children are more likely to accept SDF as an alternative to GA in both groups.

Topics: Ammonia; Autism Spectrum Disorder; Cariostatic Agents; Child; Dental Caries; Fluorides; Fluorides, Topical; Humans; Parents; Quaternary Ammonium Compounds; Silver Compounds

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.

Topics: Ammonia; Cariostatic Agents; Dental Caries; Dentistry; Fluorides; Fluorides, Topical; Humans; North America; Quaternary Ammonium Compounds; Silver Compounds

The mechanism of action of silver diammine fluoride (SDF) on plaque micro-ecology is seldom studied. This study investigated micro-ecological changes in dental plaque on extensive caries of deciduous teeth after topical SDF treatment.. Deciduous teeth with extensive caries freshly removed from school children were collected in clinic. Unstimulated saliva collection and initial plaque sampling were done before tooth extraction, then each caries was topically treated with 38% SDF in vitro. After intervention, each tooth was stored respectively in artificial saliva at 37 °C. Repeated plaque collections were done at 24 h and 1 week post-intervention. Post-intervention micro-ecological changes including microbial diversity, microbial metabolism function as well as species correlations were analyzed and compared after pyrosequencing of the DNA from the plaque sample using Illumina MiSeq platform.. After SDF application, microbial diversity decreased (P > 0.05), although not statistically significant. Microbial community composition post-intervention was noticeably different from that of supragingival and pre-intervention plaque as well as saliva. At 1 week post-intervention, the relative content of Pseudomonas, Fusobacterium and Pseudoramibacter were higher than before, while most of the other bacteria were reduced, although the changes were not statistically significant (P > 0.05). The inter-microbial associations became more complex, much more positive associations among survived bacteria were observed than negative ones. COG function classification diagram showed carbohydrate transportation and metabolic functions in the plaque were significantly reduced at 24 h and 1 week post-intervention.. SDF has extensive antimicrobial effect on dental plaque, which may reduce carbohydrate metabolism in dental plaque and help promote new balance of the plaque flora.

Topics: Ammonia; Child; Dental Caries; Dental Plaque; Fluorides, Topical; Humans; Quaternary Ammonium Compounds; Silver Compounds; Tooth, Deciduous

Silver diammine fluoride (SDF) is an anticaries agent that binds to tooth tissue. The aim of the present study was investigate the dose-response effect of SDF on demineralized dentine in basal medium mucin (BMM) saliva substitute and human saliva.. Dentine discs stored in saliva substitute, BMM, and human unstimulated whole saliva (UWS) were chemically demineralized, and 10 μL of 10 wt%, 24 wt%, or 38 wt% SDF was applied and then stored in its respective saliva (BMM or UWS) for 5 days. Dentine disc samples were digested in 70% HNO. For both the BMM and UWS groups, the presence of silver increased proportionally with increasing concentrations of SDF (P < 0.05). For the 38 wt% SDF application, the mean absorption percentage of silver in dentine was 3.90% for the UWS group and 6.61% for the BMM group. The BMM group was found to yield a significantly higher amount of silver compared to UWS at 10 wt% and 38 wt% SDF application (α = 0.05); 38 wt% SDF interacts more with BMM with higher silver deposition than UWS.. The amount of silver found in dentine was in proportion to the concentration of SDF. Extrapolation of in vitro investigations using artificial saliva for SDF tooth interactions should be interpreted with caution.

Topics: Administration, Topical; Ammonia; Cariostatic Agents; Dental Caries; Dentin; Dose-Response Relationship, Drug; Fluorides; Fluorides, Topical; Humans; In Vitro Techniques; Quaternary Ammonium Compounds; Saliva; Silver; Silver Compounds; Surface Properties; Tooth Demineralization

Minimally invasive treatment protocols may leave a residual layer of carious dentin, which requires treatment for the inhibition of bacterial growth beneath restorations. We aimed to examine the in vivo effect of silver diammine fluoride (SDF) and SDF + potassium iodide (KI) application on bacteria present in deep carious lesions. We studied the in vivo efficacy in five patients, each of which had five carious lesions. Dentin samples taken before and after treatment were subjected to microbial analyses. Following treatment with SDF, the median colony-forming unit (CFU) counts per mg of dentin reduced from 9 × 10

Topics: Ammonia; Anti-Bacterial Agents; Colony Count, Microbial; Dental Caries; Dentin; Fluorides; Humans; Silver Compounds; Streptococcus mutans