Silver Compounds Cheat Sheet by schuettl

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

 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

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

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

 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

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

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

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