Medical management of caries: silver diamine fluoride

Silver compounds like silver nitrate have been used as caries inhibitor and dentin sensitivity reliever for more than a century. In the early 1970s, silver and fluoride were combined to produce a Silver Diamine Fluoride (SDF) solution which became commercially available in Japan. In 2014, the FDA approved SDF for dentine hypersensitivity. SDF is used for arresting cavitated dentinal caries with no pulpal symptoms both in deciduous and permanent teeth. However, due to unaesthetic outcomes resulting in blackening of treated areas, SDF is not a popular choice for the treatment of permanent anterior teeth. Treating dentine hypersensitivity and arresting root caries in the elderly patients may be a viable option. Caries excavation prior to applying SDF is optional and it has been shown to reduce black staining which follows each application. SDF is available as a solution easily applied with a microbrush directly onto the carious surface. Once applied to a carious area, SDF causes darkening indicating material effectiveness in doing so. The biannual application of SDF has been shown to increase the rates of tooth remineralization.