Effects of silver diamine fluoride preparations on biofilm formation of Streptococcus mutans

Clinical and primary evidence of silver diamine fluoride on root caries management

Root caries is a growing problem for the worldwide aging population. Silver diamine fluoride (SDF) contains high concentrations of silver and fluoride ions, which prevents and arrests root caries, as well as dentin caries in the primary teeth of young children. Unlike other fluoride products that mainly reduce the formation of new carious lesions, 38% SDF is an effective agent that can efficiently arrest the carious process, remineralize the decayed dental tissues, and protect the tooth structure against the formation of new caries lesions. The use of SDF can result in more caries-resistant tooth structures. Despite these merits, its clinical disadvantages are the deep penetration of silver ions and sequential formation of silver compounds, which cause esthetic concern due to the discoloration and impaired efficacy of dentin bonding after using SDF. Thus, this narrative review, by addressing the primary experimental results and clinical applications of SDF on root caries, proposes management methods for root caries in conjunction with the application of SDF. We propose a two-visit treatment protocol to take advantage of the SDF application for root surface caries and utilize the discoloration caused by SDF.

Solid-state NMR spectroscopy measurement of fluoride reaction by bovine enamel and dentin treated with silver diammine fluoride

OBJECTIVES

The aim of this study was to investigate the formation of fluoride compounds in bovine enamel and dentin treated with silver diammine fluoride (SDF) using ¹⁹F and ³¹P solid-state magic angle spinning nuclear magnetic resonance (MAS NMR) spectroscopy.

METHODS

Enamel and dentin powder, obtained from bovine teeth, were treated with 38% SDF for four minutes and then washed thoroughly with Milli-Q water. The dehydrated SDF-treated samples were then examined. ¹⁹F solid-state MAS NMR spectra were acquired and ¹H-³¹P cross-polarization (CP) experiments were performed on SDF-treated enamel and dentin powder. The surfaces of SDF-treated enamel and dentin blocks were observed by Scanning Electron Microscope (SEM).

RESULTS

¹⁹F MAS NMR detected a more pronounced signal intensity for the dentin sample than the enamel, indicating an increased reactivity of SDF for dentin, compared with enamel. ¹⁹F NMR spectra for the SDF-treated samples showed fluorhydroxyapatite (FHAp), and other fluoride compounds such as CaF₂ and the fluoride-substituted carbonate. The ¹H-³¹P CP intensities of prominent peaks were lower for the SDF-treated samples than the non-treated sample, indicating that the F^- ion replaced the OH^- ion in the lattice tunnel. SEM observations on the SDF-treated samples showed pronounced multiple precipitation and particles in dentin compared with enamel.

SIGNIFICANCE

The solid-state MAS NMR revealed the reaction of fluoride on enamel and dentin and the identification of fluoride compounds. In particular, the formation of FHAp indicates that SDF is effective in reducing the risk of tooth decay.