Treatment of Dental Caries with Diamine Silver Fluoride: Literature Review

Abstract Brazilian health care programs recommend the use of cariostatic solutions of silver diamine fluoride (SDF) or sodium fluoride varnishes for children 0 to 3 years old with high or moderate caries activity for the control of caries lesions. SDF is a safe, economical, efficient and non-invasive coadjuvant agent, exerting an antibacterial action capable of reducing superficial mineral loss of the enamel and can be used in the treatment of deciduous and permanent teeth. The objective of this literature review was to gather current information on describing the mechanism of SDF action’ and its clinical application in young children in caries prevention and paralysis. The PubMed / Medline and Cochrane Library databases were accessed by identifying the relevant studies published in English from 1960 to May 2017. The search strategy employed the keywords: “Silver diamine fluoride” and “Children “or “Infant” and “Caries prevention”. Data extraction was performed in: 19 in vitro studies; 10 review articles and 8 in vivo studies. It was possible to conclude that SDF is almost twice as effective compared to fluoride varnish in caries paralysis. However, the contact time of the solution and the optimal frequency of application of the SDF are still undefined, inducing new projects and clinical studies in the search for an adequate clinical protocol of this cariostatic. Keywords : Preventive Dentistry. Children. Dental Caries. Resumo Os programas de assistencia a saude brasileiros recomendam para o controle das lesoes de carie a utilizacao de solucoes cariostaticas de diamino fluoreto de prata - DFP ou vernizes de fluoreto de sodio para criancas de 0 a 3 anos com atividade de carie alta ou moderada. O DFP e agente coadjuvante seguro, economico, eficiente e nao invasivo, exercendo acao antibacteriana capaz de reduzir a perda mineral superficial do esmalte e, pode ser utilizado no tratamento de dentes deciduos e permanentes. O objetivo desta revisao de literatura foi reunir informacoes atuais sobre descrever o mecanismo de acao do DFP e sua aplicacao clinica em criancas de pouca idade na prevencao e paralisacao da carie. As bases de dados PubMed/Medline e Cochane Library foram acessadas identificando os estudos relevantes publicados em ingles, no periodo de 1960 a maio de 2017. A estrategia de busca empregou as palavras-chave: “Silver diamine fluoride” and “Children” or “Infant” and “Caries prevention”. A extracao dos dados foi realizada em: 19 estudos in vitro; 10 artigos de revisao e 8 estudos in vivo. Foi possivel concluir que o DFP apresenta-se quase duas vezes tao eficaz comparado ao verniz fluoretado na paralizacao de carie. Porem, o tempo de contato da solucao e a frequencia otima de aplicacao do DFP ainda estao indefinidos, suscitando novos projetos e estudos clinicos na busca de adequado protocolo clinico deste cariostatico. Palavra-chave : Odontologia Preventiva. Crianca. Carie Dentaria.