Silver diamine fluoride

Silver diamine fluoride

Clinical data
Trade names	Saforide, Advantage Arrest, Cariesop, Bioride, FluoroplatV, Riva Star
Legal status
Legal status	US: Rx-only, 510(k) cleared class II medical device
Identifiers
Synonyms	Diamine silver fluoride, Diammine Silver Fluoride
CAS Number	34445-07-3
ChemSpider	142121
UNII	DDU19UEV1 Y
Chemical and physical data
Formula	AgF(NH3)2
Molar mass	160.927643 g/mol[1]

Silver diamine fluoride is a topical medicament (drug) used to treat and prevent dental caries (cavities) and relieve dentinal hypersensitivity.^[2][3] Silver diamine fluoride has been available in many countries including China, Japan, New Zealand, Australia and other for many decades. The product was cleared for sale in the USA in August 2014 by the FDA as a class II medical device for the treatment of dentinal hypersensitivity.^[4]

Clinical evidence

6 randomized clinical trials document a profound effect in arresting cavities, simply by drying the cavity and then applying this material.^{[5][6][7][8][9][10][11]}

2 randomized clinical trials document a profound effect in preventing cavities, by application to other surfaces that have cavities.^[5][6][7]

4 randomized clinical trials document a profound effect in preventing cavities, simply by drying the tooth surface and then applying this material.^{[11][12][13][14]}

A 2016 systematic review of the scientific literature and protocols for use was published in the California Dental Journal reported:^[15]

• "Risks related to SDF include, but are not limited to: The affected area will stain black permanently. Healthy tooth structure will not stain. Stained tooth structure can be replaced with a filling or a crown".
• "Ongoing Trials: Studies have recently begun to evaluate the ability of silver diamine fluoride to arrest interproximal carious lesions, to compare the relative efficacy of silver diamine fluoride to the combination of silver nitrate plus fluoride varnish and to compare the effects on populations with or without access to fluoridated water. Final reports from these studies will follow in the coming years".
• "Although many fell out, GIC or resin sealants outperformed silver diamine fluoride in preventing caries in the first molars of children, though the cost was ~20 times more".

Silver diamine fluoride stains cavities black. A completely darkened cavity is a strong indicator of success.^[14]

Precautions

Silver diamine fluoride will stain most surfaces black. Skin and soft tissue will discolor within minutes to hours after contact and fade away within a few days. Dentin and enamel with no demineralization present will receive surface (pellicle) stains that can be removed with pumice, while demineralized tooth structure will stain more permanently black. Silver diamine fluoride is corrosive to metal and glass. Contact to metal produces hydrogen gas and hydrogen fluoride while contact with glass will create silicone tetra-fluoride. It is a light sensitive clear liquid with a strong ammonia scent and should be stored in a cool, dark, dry place in a plastic container (LDPE or HDPE).^[16]

Nomenclature

Differences in nomenclature have led to confusion around this material. Silver diamine fluoride is also known as:

• silver fluoride,
• silver diammine fluoride,
• diammine silver fluoride,
• diamine silver fluoride,
• ammonical silver fluoride, and
• ammoniacal silver fluoride.

See also

• Amine Fluoride

References