Silver Diamine Fluoride. Presented by Diana Pham, Dental Hygiene Student Kimberly Truong, Dental Hygiene Student Lamar Institute of Technology Dental Hygiene Program. Silver Diamine Fluoride “The Silver Bullet”. Importance to the Hygienist 2 components: Silver and Fluoride - PowerPoint PPT Presentation
Silver Diamine Fluoride
Silver Diamine FluoridePresented byDiana Pham, Dental Hygiene StudentKimberly Truong, Dental Hygiene Student
Lamar Institute of TechnologyDental Hygiene ProgramImportance to the Hygienist
2 components: Silver and Fluoride
Application: brush on, or dab with cotton swab
Silver Diamine FluorideThe Silver BulletIntroductionAnd today we will be presenting our topic: Silver Diamine Fluoride, or S-D-F. also nicknamed The Silver BulletSDF is related to the dental hygiene practice because it is another anti-caries option available that proves more effective than other fluoride treatments we have today.
There are 2 components that make up SDF; silver and fluoride. The diamine part refers to the two amino groups combined; it acts like the plus sign.The silver component of SDF serves as the antimicrobial effect in preventing infections.While the fluoride portion has an anti-caries effect, and also strengthens the tooth by remineralization.
SDF can be applied with a micro brush or cotton swab in one minute.How much is it? Research notes it is less expensive than other standard treatments.
2Origin: 1960s in JapanCentral Pharmaceutical Council of the Ministry of Health and WelfareDevelopment of Silver Diamine FluorideSDF originated in the1960s in Japan.It is accepted as a therapeutic agent by the Central Pharmaceutical Council of the Ministry of Health and Welfare.SDF is relatively unheard of in most first world countries, however it is offered in third world countries as an inexpensive treatment to those with low income.
3* To arrest and slow the rate of caries progression
Main Purpose of SDF
Silver Diamine Fluorides main purpose is to arrest and slow the rate of caries progression.
4Inhibits demineralization of tooth enamel
Promotes remineralization of tooth mineral, hydroxyapatite (HA)
As a result, successfully fights cariesMode of Action of SDFSilver Diamine Fluorides mode of action begins by inhibiting demineralization of tooth enamel, and then remineralizing with the tooth mineral, hydroxyapatite.
These hydroxyapatite crystals form fluorapatite crystals, which are more resistant to decay.
As a result, Silver Diamine Fluoride successfully fights caries by its tooth-strengthening and germicidal effects on the hydroxyapatite crystal, while also managing dentin hypersensitivity.
This allows for treatment and prevention at the same time.
5Silver Diamine Fluoride Application
Its clinical uses are to combat caries and strengthen tooth enamel.
Here we a significant difference in the remineralization of tooth #9; which has a cavity appearance to it.
This is due to the black staining of SDF, which has reached the dentin.
6Black stainingComponents of Silver and FluorideFluorosisDisadvantage
Like we mentioned earlier, the most concerning side effect associated with SDF is the black discoloration of carious dentin following treatment.
Other harmful side effects, mainly due to silver and fluoride are:Silver, being a heavy metal, has raised the issue of heavy metal concentration accumulation in the patients that receive SDF treatment; cause of discolorationFluorosis is the developmental disturbance of the enamel caused by excessive exposure to high concentrations of fluoride.7InexpensiveEasy to applyNon-invasiveRequires minimal trainingSlows and halts disease progressionAdvantages
From a financial perspective, SDF is more economical than NaFl varnishes.
Popular varnishes in the U.S. cost up to three-times as much as SDF for the same amount.
One application costs $35.79, whereas, a SDF product in Brazil costs $11.63 for the same amount; thats 3 times cheaper.
The major cost difference compared to other standard treatments make SDF a favorable option over others.
It is also, easy to apply, non-invasive, and minimal training is required. This means consumers do not have to be a trained professional, and can avoid dental fees and going to the dentist office8Sodium Fluoride vs. Silver Diamine Fluoride
Studies show SDF is more effective at arresting caries while just as effective in preventing dental decayClinical StudiesWhat sets SDF apart from other fluoride treatment option is the significant cost difference of SDF than standard treatments.
This is also the primary reason why it is recommended as an alternate in developing countries.
SDF is not only cost-effective, but also a more effective means to fighting caries.
In a successful case study of 220 young children, a 52% reduction in caries severity was found post treatment. This displayed signs of continued bacterial inhibition over time that held off the recurrent carious lesions.
Here are a few pictures of a child who has the black discoloration after SDF application.10FDA Approved in the U.S.More common in private practiceLong-term study and experimentsAccess to disadvantaged populationsFuture of The Silver BulletResearchers hope to introduce SDF to be FDA approved in the U.S. in order to use in private practice.
However, more long-term research and experiments need to be conducted for SDF toxicity and adverse effects, with the most concerning side effect being the black discoloration of carious dentin
Altogether, research believe SDF can be a solution to address the unmet dental needs of developing 3rd and 1st world countries.11Questions?
Chen, Alice, BSc, Mary Cho, BSc, Sari Kichler, BSc, MSc, Jeffrey Lam, BSc, MSc, Anum Liaque, BSc, and Sobia Sultan, BSsc, MSc. "Silver Diamine Fluoride: An Alternative to Topical Fluorides." Clinical Review 20.10 (2012): 1-14. Web. 12 Apr. 2014.Mei, May L., Quan-li Li, Chun-Hung Chu, Edward C. Lo, and Lakshman P. Samaranayake. "Antibacterial Effects of Silver Diamine Fluoride on Multi-species Cariogenic Biofilm on Caries." Annals of Clinical Microbiology and Antimicrobials 12.4 (2013): 1-7. Web. 12 Apr. 2014.Tan, H. P., E.C M. Lo, J. E. Dyson, Y. Luo, and E. F. Corbet. "Chlorhexidine Varnish, Sodium Fluoride Varnish, and Silver Diamine Fluoride Solution Can Prevent the Development of New Root Caries in Elders Living in Senior Homes in Hong Kong." J Evid Base Dental Practice 89.10 (2010): 1086+. SagePub. Journal of Dental Research, 29 July 2010. Web. 12 Apr. 2014.Fung, Marcus HT, May CM Wong, Edward CM Lo, and CH Chu. "Arresting Early Childhood Caries with Silver Diamine Fluoride-A Literature Review." Journal Of Oral Hygiene & Health 1.3 (2013): 1-5. EScience Central. Journal of Oral Hygiene & Health, 24 Dec. 2013. Web. 12 Apr. 2014.Chu, Chun-Hung, Angeline HC Lee, Liwu Zheng, May L. Mei, and Godfrey CF Chan. "Arresting Rampant Dental Caries with Silver Diamine Fluoride in a Young Teenager Suffering from Chronic Oral Graft versus Host Disease Post-bone Marrow Transplantation: A Case Report." BioMed Research Notes 7.3 (2014): 1-14. 3 Jan. 2014. Web. 12 Apr. 2014.Hung, CHU C., BDS, MDS, PDipDS. "Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Arresting Dentine Caries." Thesis. University of Hong Kong, 2004. Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Arresting Dentine Caries. University of Hong Kong, May 2004. Web. 12 Apr. 2014.