The Efficacy of Silver Diamine Fluoride as a Caries Preventive Agent on Permanent Teeth: A Scoping Review

Abstract

Dental caries is a chronic condition that affects people of all ages and has a high prevalence in Indonesia. Applying silver diamine fluoride (SDF) as a topical fluoridation agent is one of the approaches to prevent bacterial interactions that lead to the development of carious lesions. This study aims to determine the efficacy of SDF as a caries preventive agent on permanent teeth. Article searches were conducted using the keywords “silver diamine fluoride” AND “permanent tooth OR permanent teeth” AND “caries OR dental caries” AND “remineralize” through digital databases including PubMed, Cochrane Library, Science Direct, and Google Scholar. Articles with randomized controlled trial or nonrandomized controlled trial designs, articles written in Indonesian or English, publications published within the last 5 years (2016–2021), and aligned with the PCC (population, concept, and context) framework were included. Articles that were not accessible in full text or in a paid format, those that were of the meta-analysis or systematic review study type, and those that did not evaluate the use of SDF as a caries preventive agent were excluded from consideration. This scoping review refers to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extensions for Scoping Reviews (PRISMA-ScR) guidelines. A total of 8 articles were reviewed, encompassing various locations, designs, and samples, which demonstrated the use of SDF resulted in a high percentage of fluoride release with a high degree of remineralization efficacy. The deposition of crystals or minerals into fissures and crevices caused by demineralization indicated a reduction in lesion depth and influenced the microhardness of enamel. SDF can stimulate the rehardening of tooth structures rich in calcium and phosphate. The solution of SDF has the potential to serve as an alternative substance for preventing caries in permanent teeth because it enhances mineral precipitation and mineral density, promotes the remineralization of hydroxyapatite in enamel by increasing fluoride, and increases tooth structure resistance to acid attack.