Context

The conventional method of treating dental caries involves surgically removing the infected and softened dental tissue from the tooth and then filling the resulting hole with restorative material. The invasive nature of this treatment can make it difficult for some patients — for example, children and those with special needs — to tolerate. Silver diamine fluoride has, therefore, been developed as a potential non-surgical alternative to conventional restorative treatment.

Technology

Silver diamine fluoride is a liquid treatment that is applied to the teeth, making it less invasive than traditional procedures for treating dental caries. It has been used for many decades in Japan and other countries for the prevention and arrest of dental caries. In February 2017, 38% silver diamine fluoride was approved for use in Canada. Silver diamine fluoride is thought to have antimicrobial properties and to promote remineralization. It is also thought to cause relatively minimal adverse events, such as tooth discolouration and irritation to the gums.

Issue

A review of the clinical effectiveness, cost-effectiveness, safety, and guidelines related to silver diamine fluoride for the prevention and arrest of dental caries or hypersensitivity will help guide decisions regarding its use.

Methods

A limited literature search was conducted of key resources, and titles and abstracts of the retrieved publications were reviewed. Full-text publications were evaluated for final article selection according to predetermined selection criteria (population, intervention, comparator, outcomes, and study designs).

Results

The literature search identified 500 citations, with 16 additional articles identified from other sources. Of these, 11 met the criteria for inclusion in this review: 5 systematic reviews, 3 randomized controlled studies, 2 guidelines, and 1 economic evaluation.

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