Global Oral Health Policies and Guidelines: Using Silver Diamine Fluoride for Caries Control

Abstract

Silver diamine fluoride (SDF) was developed in Japan in the 1960s. It is a clear solution containing silver and fluoride ions. Because of its anti-bacterial and remineralizing effect, silver diamine fluoride has been used in managing dental caries for decades worldwide. This paper aims to summarize and discuss the global policies, guidelines, and relevant information on utilizing SDF for caries management. SDF can be used for treating dental caries in most countries. However, it is not permitted to be used in mainland China. Several manufacturers, mainly in Australia, Brazil, India, Japan, and the United States, produce SDF at different concentrations that are commercially available around the world. The prices differ between contents and brands. Different government organizations and dental associations have developed guidelines for clinical use of SDF. Dental professionals can refer to the specific guidelines in their own countries or territories. Training for using SDF is part of undergraduate and/or postgraduate curriculums in almost all countries. However, real utilization of SDF of dentists, especially in the private sector, remains unclear in most places because little research has been conducted. There are at least two ongoing regional-wide large-scale oral health programs, using SDF as one of the components to manage dental caries in young children (one in Hong Kong and one in Mongolia). Because SDF treatment does not require caries removal, and it is simple, non-invasive, and inexpensive, SDF is a valuable strategy for caries management in young children, elderly people, and patients with special needs. In addition, to reduce the risk of bacteria or virus transmission in dental settings, using SDF as a non-aerosol producing procedure should be emphasized under the COVID-19 outbreak.

Is Silver Diamine Fluoride Effective in Arresting Enamel Caries? A Randomized Clinical Trial

“…Several systematic reviews have confirmed the effectiveness of 38% SDF in arresting the progression of dentine caries lesions with a success rate of 65–91% [ 5 , 18 ]. It is widely used for caries control in community settings in many countries [ 19 ]. Although 38% SDF has been strongly recommended for treating dentine caries lesions, its effectiveness in arresting the progression of enamel caries lesions remains uncertain.…”

Knowledge, Practices and Attitudes towards Silver Diamine Fluoride Therapy among Dentists in Japan: A Mixed Methods Study

“…Dentists in Japan are more familiar with the term Saforide than they are with SDF. Thus, the survey used the term Saforide to achieve a better understanding among the participating dentists [ 17 ].…”

Silver diamine fluoride therapy for dental care

“…Unfortunately, SDF is not yet available in all countries. Although government organisations and dental associations have developed guidelines for clinical use of SDF [1] , some countries have no guidelines for SDF use. Table 1 shows guidelines and current usage of SDF in some countries.…”

“…For many years, dentists in countries such as Argentina, Australia, Brazil, China and Japan have used silver diamine fluoride (SDF) as an anti-caries agent [1] . It is effective in arresting cavitated dentine carious lesions and preventing new caries development [2] .…”