Dental Caries Management in Children Using Silver Diamine Fluoride: A Comprehensive Contemporary Review
Keywords:
Silver diamine fluoride, dental caries, Early childhood caries, remineralization, pediatricAbstract
Dental caries remains a widespread chronic disease in children, posing significant challenges in both clinical and public health domains. Silver Diamine Fluoride (SDF), a topical agent with dual antibacterial and remineralizing properties, has gained recognition as an effective, non-invasive solution for caries arrest in pediatric populations. This review offers a comprehensive evaluation of SDF, detailing its composition, physicochemical properties, mechanisms of action including antimicrobial and anti-enzymatic effects, clinical indications, application protocols, and safety profile. Special attention is given to its utility in children with early childhood caries (ECC), special health care needs, or limited access to conventional dental services. Additionally, the review discusses SDF’s interactions with restorative materials such as glass ionomer cements and resin composites, and summarizes relevant research findings. By synthesizing current evidence, this review underscores the potential of SDF as a frontline agent in pediatric dental caries management within the framework of minimally invasive dentistry.
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Martins MT, Sardenberg F, Bendo CB, Abreu MH, Vale MP, Paiva SM, et al. Dental caries remains as the main oral condition with the greatest impact on children’s quality of life. Pentapati KC, editor. PLOS ONE. 2017 Oct 5;12(10): e0185365.
Frencken JE, Peters MC, Manton DJ, Leal SC, Gordan VV, Eden E. Minimal intervention dentistry for managing dental caries – a review. Int Dent J. 2012 Oct;62(5):223–43.
Nuvvula S, Mallineni SK. Silver Diamine Fluoride in Pediatric Dentistry. J South Asian Assoc Pediatr Dent. 2019 Dec 1;2(2):73–80.
Zheng FM, Yan IG, Duangthip D, Gao SS, Lo ECM, Chu CH. Silver diamine fluoride therapy for dental care. Jpn Dent Sci Rev. 2022 Nov; 58:249–57.
World Health Organization; 2021. WHO-MHP-HPS-EML-2021.01 eng.pdf [Internet]. Available from: The Selection and Use of Essential Medicines 2021. Report of the 23rd WHO Expert Committee on the Selection and Use of Essential Medicines, virtual meeting, 21 June–2 July 2021. Geneva: World Health Organization; 2021 (WHO/MHP/HPS/EML/2021.01). Licence: CC BY-NC-SA 3.0 IGO.
Bhadule S, Kalaskar R. Role of silver diamine fluoride in caries prevention: A narrative review. SRM J Res Dent Sci. 2021;12(4):210.
Surendranath P, Krishnappa S, Srinath S. Silver Diamine Fluoride in Preventing Caries: A Review of Current Trends. Int J Clin Pediatr Dent. 2022 Mar 16;15(S2): S247–51.
Goel P, R V, M S A, M E S. Silver Diamine Fluoride – A “Silver fluoride Bullet” for Dental Caries. RGUHS J Dent Sci. 2021;13(4):279–82.
Wakshlak RBK, Pedahzur R, Avnir D. Antibacterial activity of silver killed bacteria: the “zombies” effect. Sci Rep. 2015 Apr 23;5(1):9555.
Davis MR, Johnson EL, Meyer BD. Comparing Dental Treatment between Children Receiving and not Receiving Silver Diamine Fluoride. J Clin Pediatr Dent. 2020 Dec 1;44(6):400–6.
Young DA, Quock RL, Horst J, Kaur R, MacLean JK, Frachella JC, et al. Clinical Instructions for Using Silver Diamine Fluoride (SDF) in Dental Caries Management.
Croll TP, Berg J. Delivery Methods of Silver Diammine Fluoride to Contacting Proximal Tooth Surfaces and History of Silver in Dentistry. Compendium of Continuing Education in Dentistry (Jamesburg, N.J.: 1995). 2020 Feb;41(2):84-89; quiz 90. PMID: 32017586.
Crystal YO, Marghalani AA, Ureles SD, Wright JT, Sulyanto R, Divaris K, et al. Use of Silver Diamine Fluoride for Dental Caries Management in Children and Adolescents, Including Those with Special Health Care Needs. 39(5).
Greenwall-Cohen J, Greenwall L, Barry S. Silver diamine fluoride - an overview of the literature and current clinical techniques. Br Dent J. 2020 Jun;228(11):831–8.
Crystal YO, Niederman R. Silver Diamine Fluoride Treatment Considerations in Children’s Caries Communication and Commentary. 2017.
Mei ML, Lo EC, Chu CH. Clinical use of silver diamine fluoride in dental treatment. Compend Contin Educ Dent. 2016 Feb 1;37(2):93-8.
Yamaga M, Hieda T. Adhesiveness of Glass Ionomer Cement Containing Tannin-Fluoride Preparation (HY agent) to Dentin - An Evaluation of Adding Various Ratios of HY agent and Combination with Application Diammine Silver Fluoride.
C.H. Chu, E.C.M. Lo*, and H.C. Lin. Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Arresting Dentin Caries in Chinese Pre-school Children. 2002.
Knight G, McIntyre J, Craig G, Mulyani, Zilm P, Gully N. An in vitro model to measure the effect of a silver fluoride and potassium iodide treatment on the permeability of demineralized dentine to Streptococcus mutans. Aust Dent J. 2005 Dec;50(4):242–5.
Chu CH, Mei L, Seneviratne CJ, Lo ECM. Effects of silver diamine fluoride on dentine carious lesions induced by Streptococcus mutans and Actinomyces naeslundii biofilms: Effects of silver diamine fluoride. Int J Paediatr Dent. 2012 Jan;22(1):2–10.
Mei Ml, Chu Ch, Low Kh, Che Cm, Lo Ecm. Caries arresting effect of silver diamine fluoride on dentine carious lesion with S. mutans and L. acidophilus dual-species cariogenic biofilm. Med Oral Patol Oral Cirugia Bucal. 2013; e824–31.
Gluzman R, Katz RV, Frey BJ, McGowan R. Prevention of root caries: a literature review of primary and secondary preventive agents: PREVENTION OF ROOT CARIES IN OLDER ADULTS: A SUMMARY. Spec Care Dentist. 2013 May;33(3):133–40.
Horst JA. Silver Fluoride as a Treatment for Dental Caries. Adv Dent Res. 2018 Feb;29(1):135–40.
Mei ML, Nudelman F, Marzec B, Walker JM, Lo ECM, Walls AW, et al. Formation of Fluorohydroxyapatite with Silver Diamine Fluoride. J Dent Res. 2017 Sep;96(10):1122–8.
Iovan A, Benchea M, Stoleriu S, Tărăboanță I, Cimpoeșu N, Nica I, et al. Effects of Acidic Challenge on Demineralized Root Surface Treated with Silver Diamine Fluoride and Potassium Iodide. Diagnostics. 2023 Feb 1;13(3):530.
Almuqrin A, Kaur IP, Walsh LJ, Seneviratne CJ, Zafar S. Amelioration Strategies for Silver Diamine Fluoride: Moving from Black to White. Antibiotics. 2023 Feb 2;12(2):298.
Muntean A, Mzoughi SM, Pacurar M, Candrea S, Inchingolo AD, Inchingolo AM, Ferrante L, Dipalma G, Inchingolo F, Palermo A, Bordea IR. Silver diamine fluoride in pediatric dentistry: effectiveness in preventing and arresting dental caries—a systematic review. Children. 2024 Apr 22;11(4):499.
Elshenawy EA, Alawy SB, Alghonemy WY, El Dosoky AI. Preventing white spot lesions around orthodontic brackets: efficacy of pre-reacted glass-ionomer barrier coat versus silver diamine fluoride: an in vitro study. BDJ open. 2025 May 5;11(1):45.
Duangthip D, Fung MHT, Wong MCM, Chu CH, Lo ECM. Adverse Effects of Silver Diamine Fluoride Treatment among Preschool Children. J Dent Res. 2018 Apr;97(4):395–401.
Patel J, Foster D, Smirk M, Turton B, Anthonappa R. Acidity, fluoride, and silver ion concentrations in silver diamine fluoride solutions: a pilot study. Aust Dent J. 2021 Jun;66(2):188–93.
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