Silver diamine fluoride with delayed restoration reduces tooth discoloration

INTRODUCTION: The standard treatment for caries is to apply silver diamine fluoride (SDF) to the tooth, followed by a composite resin or glass ionomer cement restoration (GIC). Tooth discolouration is an adverse effect of SDF. The aims of this study were to (1) determine whether applying a composite compared to a GIC restoration after SDF to caries-infected teeth results in less discoloration, and (2) determine whether immediate or delayed restoration application is associated with less discoloration. METHODS: Sixty samples of caries-infected teeth were divided into five groups: (1) control (SDF alone), (2) SDF plus immediate composite restoration, (3) SDF plus immediate GIC restoration, (4) SDF plus delayed composite restoration, and (5) SDF plus delayed GIC restoration. The delay between SDF and restoration for groups 4 and 5 was two weeks. Tooth color was measured at three sites for each sample at baseline before SDF application and at multiple times. RESULTS: When comparing the change between baseline color to the color at the last time measurement in all groups, we found that Group 4 (17.4 ± 4.3) and Group 5 (14.4 ± 5.3) changed the least compared to baseline and were not statistically significantly different from each other. CONCLUSION: Under laboratory conditions, delaying application of restoration for two weeks after SDF to samples of caries-infected teeth significantly reduced discoloration, with neither composite nor GIC being superior. If these findings are confirmed in a clinical setting, delaying restoration by two weeks could provide an inexpensive oral health strategy to reduce the negative aesthetic impact associated with SDF.