Description: Silver Diamine Fluoride (SDF) received FDA clearance in 2014. There are many uses of SDF including hypersensitivity relief, caries arrest, liner, occlusal barrier, gingivitis, and prevention. The latest in silver fluoride therapies in the US (used in Australia for 20+ years) is a two-step product that contains 40% Silver Fluoride (AgF) followed by 10% Stannous Fluoride (SnF2). Unlike other silver fluoride therapies that remove silver with the addition of potassium iodide (KI), this causes further deposition of the silver. This chemical reduction of silver with stannous fluoride, reduces silver ions (Ag+) to silver atoms (Ag0) that then produce nano silver particles (AgNPs) which serve as reservoirs for silver ions, continuing to deactivate the microbes present on the carious lesion surface. The first step is to apply the silver fluoride to the active lesion followed by the second step of stannous fluoride. This immediately provides clinician feedback (blackening/hardening of the lesion) that the carious lesion had been treated. If the black color remains, it is a sign that the lesion is not progressing and to leave the lesion alone. If it has lightened over time, reapplication of AgF/SnF2 or GIC restoration may be indicated. This can simplify diagnosis and reduce the need for other diagnostic aids (surface probing and restorations). This product is ammonia free and eliminates odor making it more tolerable for sensitive patients. It can also be ideal with more challenging patients, nursing home patients, and when you are unsure if you will see the patient again.
