Global InformationSilver diammine fluoride information
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| Trade names | Fagamin, Advantage Arrest |
| Other names | Diammine Silver Fluoride, Diamine silver fluoride |
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| Formula | AgFH6N2 |
| Molar mass | 160.929 g·mol−1 |
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Silver diammine fluoride (SDF), also known as silver diamine fluoride in most of the dental literature, (although this is a chemical misnomer) is a topical medication used to treat and prevent dental caries (tooth decay) and relieve dentinal hypersensitivity.[1] It is a colorless (most products) or blue-tinted (Advantage Arrest, SilverSense SDF), odourless liquid composed of silver, ammonium and fluoride ions at a pH of 10.4 (most products) or 13 (Riva Star).[2] Ammonia compounds reduce the oxidative potential of SDF, increase its stability and helps to maintain a constant concentration over a period of time, rendering it safe for use in the mouth.[3] Silver and fluoride ions possess antimicrobial properties[1] and are used in the remineralization of enamel and dentin on teeth for preventing and arresting dental caries.[4][5]
SDF is also known as diammine silver fluoride, silver fluoride, and silver ammonium fluoride. It is frequently spelled "silver diamine fluoride" (with one m); however, this is a misnomer, as SDF contains two ammine (NH3) groups, not amine (NH2) groups.[6]
Based on the current, best available evidence, SDF can be used by licensed dental professionals. In the UK, this is classified as 'off-label' [7] use of a topical medicament for arresting caries as it is licensed for treatment of dentine hypersensitivity.[1] It is supported by a robust, extensive evidence base[8][9][10][11] with regard to its efficacy and can be used as long as the following criteria are realised: there is a body of evidence supporting its efficacy; and there is no alternative, licensed medicine.[12]
The product was cleared for sale by the U.S. Food and Drug Administration as a Class II medical device for the treatment of dentinal hypersensitivity,[13] and has been classified as an ‘effective, efficient, equitable and safe caries-preventative agent’ by the Institute of Medicine and the Millennium Goals of the World Health Organization in 2009.[1]
It is on the World Health Organization's List of Essential Medicines.[14]
- ^ a b c d Rosenblatt A, Stamford TC, Niederman R (February 2009). "Silver diamine fluoride: a caries "silver-fluoride bullet"". Journal of Dental Research. 88 (2): 116–25. doi:10.1177/0022034508329406. PMID 19278981. S2CID 30730306.
- ^ Zhao IS, Gao SS, Hiraishi N, Burrow MF, Duangthip D, Mei ML, et al. (April 2018). "Mechanisms of silver diamine fluoride on arresting caries: a literature review". review. International Dental Journal. 68 (2): 67–76. doi:10.1111/idj.12320. hdl:10722/242975. PMC 9378923. PMID 28542863.
- ^ Subbiah GK, Gopinathan NM (2018). "Is Silver Diamine Fluoride Effective in Preventing and Arresting Caries in Elderly Adults? A Systematic Review". Journal of International Society of Preventive & Community Dentistry. 8 (3): 191–199. doi:10.4103/jispcd.JISPCD_99_18. PMC 5985673. PMID 29911054.
- ^ Burgess JO, Vaghela PM (February 2018). "Silver Diamine Fluoride: A Successful Anticarious Solution with Limits". Advances in Dental Research. 29 (1): 131–134. doi:10.1177/0022034517740123. PMID 29355424.
- ^ Horst JA (February 2018). "Silver Fluoride as a Treatment for Dental Caries". Advances in Dental Research. 29 (1): 135–140. doi:10.1177/0022034517743750. PMC 6699125. PMID 29355428.
- ^ Lo EC, Duangthip (September 11, 2018). "Nonrestorative Approaches for Managing Cavitated Dentin Carious Lesions: Silver Fluoride". In Coelho S, Takeshita EM (eds.). Pediatric Restorative Dentistry. Springer. p. 143. ISBN 978-3-319-93426-6.
- ^ "Off-label or unlicensed use of medicines: prescribers' responsibilities". GOV.UK. Retrieved 2020-04-09.
- ^ Seifo N, Cassie H, Radford JR, Innes NP (July 2019). "Silver diamine fluoride for managing carious lesions: an umbrella review". BMC Oral Health. 19 (1): 145. doi:10.1186/s12903-019-0830-5. PMC 6626340. PMID 31299955.
- ^ Trieu A, Mohamed A, Lynch E (February 2019). "Silver diamine fluoride versus sodium fluoride for arresting dentine caries in children: a systematic review and meta-analysis". Scientific Reports. 9 (1): 2115. Bibcode:2019NatSR...9.2115T. doi:10.1038/s41598-019-38569-9. PMC 6376061. PMID 30765785.
- ^ Chibinski AC, Wambier LM, Feltrin J, Loguercio AD, Wambier DS, Reis A (2017). "Silver Diamine Fluoride Has Efficacy in Controlling Caries Progression in Primary Teeth: A Systematic Review and Meta-Analysis". Caries Research. 51 (5): 527–541. doi:10.1159/000478668. PMID 28972954. S2CID 5129645.
- ^ Gao SS, Zhao IS, Hiraishi N, Duangthip D, Mei ML, Lo EC, Chu CH (October 2016). "Clinical Trials of Silver Diamine Fluoride in Arresting Caries among Children: A Systematic Review". JDR Clinical and Translational Research. 1 (3): 201–210. doi:10.1177/2380084416661474. hdl:10722/234467. PMID 30931743.
- ^ Seifo N, Robertson M, MacLean J, Blain K, Grosse S, Milne R, et al. (January 2020). "The use of silver diamine fluoride (SDF) in dental practice". British Dental Journal. 228 (2): 75–81. doi:10.1038/s41415-020-1203-9. PMID 31980777. S2CID 210880141.
- ^ "510(k) Premarket Notification".
- ^ World Health Organization (2021). World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. hdl:10665/345533. WHO/MHP/HPS/EML/2021.02.