Nanosilver Fluoride—A Paradigm Shift for Arrest in Dental Caries in Primary Teeth of Schoolchildren: A Randomized Controlled Clinical Trial

Abstract

Background: Due to limited financial resources, poor access to basic oral care, and the high cost of restorative treatment, children of low-income nations have their general health, social well-being, and education opportunities affected by untreated dental caries. Arresting caries treatment (ACT) has been proposed to manage untreated dental caries in children of disadvantaged communities. Aims and objectives: The purpose of the present controlled clinical trial is to investigate the effectiveness of a new anticaries agent, nanosilver fluoride (NSF), preventing and arresting caries in children. Materials and methods: A total of 100 deciduous molars both maxillary and mandibular are randomly selected from 60 children of 4-9 years of age group, which were randomly divided into NSF experimental group and saline control group. Teeth were clinically diagnosed and treated by one masked examiner and followed up at 7 days, 5 months and 12 months by another calibrated examiner who was blinded to the type of treatment. The criteria of the ICDAS II were followed to determine the activity of lesion and the diagnosis of caries. The Pearson's Chi-square test was used to compare the groups during different follow-up examinations. Results: Seventy-eight percent of decayed teeth showed hard arrested dentine at 7 days; after 5-month analysis in the NSF group, 72.91% of the teeth showed arrested caries; and in the control group, only 34% of teeth showed arrest of caries. At 12-month analysis in the NSF group, 65.21% of teeth showed arrested cavities, and in the control group, 28.88% of teeth showed arrest of caries. Conclusion:The present study proves that NSF is an anticaries agent and presents a noninvasive option for caries arrest and treatment when applied directly to dentin caries lesions.

Effect of nanosilver mouthwash on prevention of white spot lesions in patients undergoing fixed orthodontic treatment - a randomized double-blind clinical trial

“…Moreover, AgNPs are capable of anchoring and penetrating the bacterial cell wall, causing structural changes to the cell membrane, such as cell membrane permeability and cell death. 24 …”

“…In this study, all patients used fluoridated toothpaste, and with the addition of the NS mouthwash, produced a significant effect in reducing WSLs as a result of the synergistic actions of the NS and fluoride combined. 24 …”

Preventive potential of nano silver fluoride versus sodium fluoride varnish on enamel caries like lesions in primary teeth: in vitro study

“…1 a). Silver nano particles were also validated using UV/Vis spectrophotometer (Thermo Electron- Evolution 300) to detect the UV/Vis absorption spectrum of the resulting solution [ 14 , 27 ] (Fig. 1 b).…”

“…Although data on NSF have shown promising results in arresting [ 12 , 14 ] and remineralizing pre-formed or pre-existing carious lesions [ 10 , 15 ], to the best of our knowledge, no published studies have investigated its effect on resisting demineralization of initially sound enamel in primary teeth. Therefore, the present in vitro study aimed to investigate the potential of experimental NSF formulation in prevention of demineralization of sound enamel compared to commercial 5% sodium fluoride varnish in primary teeth.…”

The antibacterial effect of nanosilver fluoride in relation to caries activity in primary teeth: a protocol for a randomized controlled clinical trial

“…Multiple in vitro researches have investigated the antimicrobial effects of AgNPs on carious tooth structures and have confirmed the substantial antibacterial effect of NSF on Streptococcus mutans and Lactobacilli [12][13][14][15][16]. Additionally, several studies [10,17,18] have reported that NSF is effective in arresting active dentine caries without any distinctive tissue pigmentation.…”