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Objectives: This study investigated the ability of SDF, and its individual components, silver (Ag + ) and fluoride (F - ) ions, in preventing enamel demineralization under pH-cycling conditions in the presence or absence of twice-daily fluoride application., Design: Polished human enamel specimens were assigned to five treatment groups (n = 36 per group): SDF (38 %); SDF followed by application of a saturated solution of potassium iodide (SDF + KI); silver nitrate (AgNO 3 ; silver control, 253,900 ppm Ag); potassium fluoride (KF; fluoride control, 44,800 ppm F); deionized water. Treatments were applied once. Specimens in each treatment group were divided into two subgroups (n = 18). During the subsequent 7-day pH-cycling phase, specimens were treated twice daily with either 275 ppm fluoride as sodium fluoride or deionized water, immediately before and after a 3-h cariogenic challenge with exposure to artificial saliva at all other times. Changes in color, Vickers surface microhardness (SMH), transverse microradiography (TMR) was calculated. Data were analyzed using two-way ANOVA., Results: In both models, SDF, SDF + KI and KF were superior in inhibiting demineralization compared to AgNO 3 and deionized water (p < 0.0001). There was no statistically significant difference between SDF, SDF + KI and KF with twice daily fluoride treatments (p > 0.8). However, KF was more effective in preventing demineralization than SDF and SDF + KI in the absence of fluoride treatments (p = 0.0002). KI did not affect the ability of SDF to prevent demineralization (p > 0.4)., Conclusion: SDF and SDF + KI appears to be an effective option in preventing primary coronal caries., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

This article reviews current evidence on the effectiveness of silver diamine fluoride (SDF) as a caries arresting and preventive agent. It provides clinical recommendations around SDF's appropriate use as part of a comprehensive caries management program. Systematic reviews confirm that SDF is effective for caries arrest on cavitated lesions in primary teeth and root caries in the elderly. It may also prevent new lesions. Application is easy, noninvasive, affordable, and safe. Although it stains the lesions dark as it arrests them, it provides clinicians with an additional tool for caries management when esthetics are not a primary concern., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Background: The caries arrest that can be achieved by using silver diamine fluoride (SDF) offers a minimally invasive and inexpensive alternative to traditional restorative caries treatment. The authors evaluated how the dentinal staining that is associated with SDF influences the acceptance of this treatment among parents of young children in the New York City metropolitan area., Methods: The authors invited the parents of children who had experienced dental caries and who had appointments at the New York University Pediatric Dentistry Clinic and at several private clinics in New Jersey to participate in a Web-based survey designed to assess parents' demographics, perceptions of photographs of SDF-treated carious teeth, and acceptability of treatment in different behavior management scenarios., Results: Ninety-eight mothers and 22 fathers from diverse backgrounds participated. Most parents (67.5%) judged SDF staining on the posterior teeth to be esthetically tolerable, but only 29.7% of parents made this same judgment about anterior teeth (P < .001). In the absence of their child having behavioral barriers to conventional restorations, 53.6% of parents reported that they were likely to choose SDF to treat their child's posterior teeth, but only 26.9% of parents were likely to choose SDF to treat their child's anterior teeth. As the number of children's behavioral barriers increased, so did the parents' level of acceptance. In extreme cases, in which parents had to decide whether their children should undergo general anesthesia during treatment, parents' acceptance rate of SDF as a treatment method increased to 68.5% on posterior teeth and to 60.3% on anterior teeth. Parents' acceptance of the treatment also varied according to their socioeconomic status., Conclusions: Staining on posterior teeth was more acceptable than staining on anterior teeth. Although staining on anterior teeth was undesirable, most parents preferred this option to advanced behavioral techniques such as sedation or general anesthesia., Practical Implications: Clinicians need to understand parental sensitivities regarding the staining effect of SDF to plan adequately for the use of SDF as a method of caries management in pediatric patients., (Copyright © 2017 American Dental Association. Published by Elsevier Inc. All rights reserved.)

Purpose: The purpose of this study was to investigate practice, teaching, and perceived barriers to the use of silver diamine fluoride and other caries control agents in U.S. pediatric dentistry residency programs., Methods: A 14-question survey regarding use and teaching of caries control agents was sent via email to residency program directors in 2015. Survey participants responded, using a web-based survey tool, by completing a paper and pencil survey instrument, or by interview., Results: Surveys were completed by 74 directors or associate directors (87 percent adjusted response rate). More than a quarter (25.7 percent) reported use of silver diamine fluoride, with 68.9 percent expecting to increase use. The use of silver diamine fluoride was not associated with region or program type. Programs reported commonly used caries control agents of fluoride varnish (100 percent), acidulated phosphate fluoride foam (48.6 percent), silver nitrate (9.5 percent), and povidone iodine (1.3 percent). Most felt silver diamine fluoride should be used only with high-risk patients (89.2 percent), and the majority agreed it could be used in primary and permanent teeth. The most frequently reported barrier to use of silver diamine fluoride was parental acceptance (91.8 percent)., Conclusions: Silver diamine fluoride is being rapidly adopted in graduate pediatric dentistry training programs, with the majority expecting to incorporate it into their teaching clinics and curricula.

Background: This manuscript presents evidence-based guidance on the use of 38 percent silver diamine fluoride (SDF) for dental caries management in children and adolescents, including those with special health care needs. A guideline workgroup formed by the American Academy of Pediatric Dentistry developed guidance and an evidence-based recommendation regarding the application of 38 percent SDF to arrest cavitated caries lesions in primary teeth. Types of studies reviewed: The basis of the guideline's recommendation is evidence from an existing systematic review 'Clinical trials of silver diamine fluoride in arresting caries among children: A systematic review." (]DR Clin Trans! Res 2016;1[3]:201-10). A systematic search was conducted in PubMed®/MEDLINE, Embase®, Cochrane Central Register of Controlled Trials, and gray literature databases to identify randomized controlled trials and systematic reviews reporting on the effect of silver diamine fluoride and address peripheral issues such as adverse effects and cost. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of the evidence and the evidence-to-decision framework was employed toformulate a recommendation. Results: The panel made a conditional recommendation regarding the use of 38 percent SDF for the arrest of cavitated caries lesions in primary teeth as part of a comprehensive caries management program. After taking into consideration the low cost of the treatment and the disease burden of caries, panel members were confident that the benefits of SDF application in the target populations outweigh its possible undesirable effects. Per GRADE, this is a conditional recommendation based on low-quality evidence. Conclusions and practical implications: The guideline intends to inform the clinical practices involving the application of 38 percent SDF to enhance dental caries management outcomes in children and adolescents, including those with special health care needs. These recommended practices are based upon the best available evidence to-date. A 38 percent SDF protocol is included in Appendix II. [ABSTRACT FROM AUTHOR]