Silver diamine fluoride: recent evidence on its effectiveness in arresting dental caries

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Odontólogo aplicando fluoruro diamino de plata sobre una lesión de caries en un entorno clínico

Silver diamine fluoride (SDF) has become one of the most studied minimally invasive approaches for controlling dental caries, particularly in pediatric dentistry and in patients with limited access to restorative treatments.

A recent systematic review with meta-analysis evaluated the effectiveness of SDF in arresting carious lesions compared with other treatment strategies used in clinical practice.

The results show that 38 % SDF is effective in stopping the progression of dental caries, both in primary and permanent teeth.

Caries arrest rates

Several clinical studies indicate that SDF application can arrest approximately 65 % to 80 % of treated carious lesions, depending on the application protocol and the type of lesion.

This effect is explained by several mechanisms:

  • antibacterial action of silver ions
  • remineralization promoted by fluoride
  • inhibition of dentinal collagen degradation

These mechanisms help stabilize the lesion and slow down the progression of caries.

Comparison with other treatments

Some studies have also compared SDF with minimally invasive restorative approaches such as atraumatic restorative treatment (ART).

The findings suggest that SDF may be an effective alternative for caries control, particularly in situations where conventional restorative treatment is difficult to perform.

In addition, its application is quick and does not require anesthesia or rotary instruments.

Clinical limitations

The most well-known side effect of SDF is the permanent black staining of the treated carious lesion, which can limit its use in aesthetic areas.

Despite this limitation, numerous scientific reviews conclude that SDF represents an effective and low-cost tool for caries management, particularly within minimally invasive dentistry strategies.

Source:
https://pmc.ncbi.nlm.nih.gov/articles/PMC12930589/