Incorporating the Use of Silver Diamine Fluoride
Silver diamine fluoride (SDF) has been used internationally for years to treat dentinal hypersensitivity and caries lesions.1–3 In 2014, it was cleared for use in the United States by the Food and Drug Administration (FDA) for treating sensitivity, and was granted the FDA’s breakthrough therapy designation for the arrest of dental caries in 2016.4,5 SDF is a cost effective, minimally invasive, and clinically simple treatment option for all patients. Moreover, it has the potential to more easily treat vulnerable populations, such as adults with special health-care needs.1 This article will provide an overview of its use in clinical practice.In its 38% formulation, SDF is composed of 25% silver ions (Ag+1) and 5% fluoride ions (F-1) dissolved in 8% amine (2NH3).1,2 Similar in structure to silver nitrate, plus fluoride,1 SDF’s biochemical interaction with tooth structure and cariogenic bacteria is also similar (Figure 1).1,2 Oral health professionals are knowledgeable about the major interaction of fluoride with tooth structure to form fluorapatite, but may be less aware of the antimicrobial role of silver.1,2,6–11 Silver reacts with thiol groups in the amino acids and nucleic acids to prevent the formation of disulfide bonds. These bonds are essential in forming and maintaining proper structure and function of proteins and nucleic acids. Improper structure and function of these molecules lead to bacterial cell death.1,2,6,7,8–10
* References can be found in the original article via the link below.
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