July JADA evaluates research on silver diamine fluoride as remineralizing agent
In vitro studies support efficacy, but more clinical trials needed, according to researchers
While an evidence base of primarily in vitro studies suggests 38% silver diamine fluoride may be able to remineralize enamel and dentin, more high-quality clinical trials are needed before these findings can be routinely applied in daily clinical practice, according to the cover story of the July issue of The Journal of the American Dental Association.
The authors of “Remineralization of Carious Enamel and Dentin with 38% Silver Diamine Fluoride: A Systematic Review” aimed to evaluate the remineralizing effect of 38% silver diamine fluoride on carious enamel and dentin of primary and young permanent teeth. Their systematic review included 29 articles, including 25 in vitro studies, two randomized clinical trials, one crossover randomized clinical trial, and one in vivo and in vitro study.
Overall, the data indicated that 38% silver diamine fluoride is effective as a remineralizing agent for both enamel and dentin, suggesting it could potentially prevent and control the progression of caries. However, most of the in vitro studies had a high risk of bias, and the overall quality of the evidence included in the systematic review was rated as very low.
“The predominance of in vitro studies reflects the need for strict control of research variables, limiting the applicability of the results in a clinical setting. The translation of these findings into clinical practice should be done with caution, given the scarcity of high-quality randomized clinical trials in the literature,” the authors said in the review.
Other articles in the July issue of JADA discuss mouthguards’ influence on athletic balance, clearance considerations for medically complex adults and hereditary enamel defects with comorbidities.
Every month, JADA articles are published online at JADA.ADA.org. ADA members can access JADA content with their ADA username and password.
