Kariesmanagement mit Silberdiaminfluorid - eine Literaturübersicht: Hintergrundinformation und Anwendung im Rahmen der zahnärztlichen Behandlung

Silver diamine fluoride (SDF) is a colorless, alkaline solution containing silver, fluoride, and ammonia. It is available in concentrations up to 38 %. Silver ions have an antimicrobial efficacy, fluoride ions are well known for inhibiting demineralization as well as promoting remineralization, and ammonia increases the local pH. Besides its original purpose to reduce dentin hypersensitivities, there has been an off-label use of SDF for caries prevention and arrest. The results of systematic reviews critically appraising the evidence of clinical trials reveal SDF is effective for caries prevention and arrest of root caries in elderly and for caries arrest of coronal caries in the primary teeth of children. For caries management, SDF may be applied to arrest asymptomatic, cavitated, active dentin caries, especially in patients at high caries risk, in those with multiple carious lesions, and in case other treatment options are contraindicated due to limited cooperation of the patient. The major disadvantage of SDF is the irreversible black staining of the carious lesion unless in a second step a potassium iodide solution is applied, which may reduce the discoloration. Which is why it is important to obtain informed consent of the patient and caregivers prior to the application of SDF. For pediatric dentistry, the simple and inexpensive use of SDF makes it a valuable option for caries management in uncooperative children to gain time until they become older and more receptive to other treatment options.