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Silver Compounds Cheat Sheet by

Types of Silver Compounds

1) Silver Nitrate (AgNO3)
2) Sliver fluoride (AgF) *not popular
3) Silver diammine fluoride (SDF)

History of Silver

Silver has been used in dentistry since the 1840s, when silver nitrate was used to reduce the incidence of caries in the primary dentition
Silver is an anti-m­icr­obial agent used in medicine and dentistry due to its broad spectrum activity, low toxicity and lack of cross - spectrum bacterial resistance
What about silver in amalgam? It has not been shown to have long-term anticaries effects

Mechanism of Action?

We're not sure but the antimi­crobial effect is postulated to come from the release of silver ions via:
1) destru­ction of cell wall structure
2) denatu­ration of cytopl­asmic enzymes
3) inhibition of microbic DNA replic­ation
 

Silver Nitrate

About the Pulp: In the studies reviewed in this article, silver nitrate was shown to penetrate both sound and carious dentin, both vital and non-vital dentin and has a mild, self-l­imi­ting, localized effect on the pulp

Biocom­pat­ibility of Silver

Silver has been shown to be biocom­patible and is used for a range of medical devices
Excess silver accumu­lates in skin, liver, kidneys, spleen, corneas, gingiva, mucous membranes, nails; In areas of the body exposed to light, prolonged exposure to large amounts of silver compounds results in irreve­rsible pigmen­tation of the skin- called argyria- or eyes- called argyrosis.
Manufa­cturer (Saforide) of SDF recommends patient rinse mouth with water or saline after topical applic­ation of SDF to remove the excess agent
 

Silver Diammine Fluoride

Several RCTs show SDF to be more effective at arresting caries than fluoride varnish alone
Some studies show SDF to have a desens­itizing effect

Conclu­sions

Silver compounds are effective agents to prevent and arrest caries
Most obvious disadv­antage is discol­oration of demine­ralized tissue

Source

This sheet is a summary of a review published in the Journal of Dentistry in 2012

Silver compounds used in dentistry for caries manage­ment: a review.
Journal of Dentistry , 2012, Vol.40(7), p.531-541

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