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VOLUME 19 , ISSUE 5 ( 2018 ) > List of Articles


Antibacterial Effect of Silver Diamine Fluoride on Cariogenic Organisms

Michael G Botelho, Yali Lou, Brain W Darvell

Keywords : Agar diffusion test, Ammonium fluoride, Antibacterial, Caries, Fluoride, Silver diamine fluoride, Silver nitrate

Citation Information : Botelho MG, Lou Y, Darvell BW. Antibacterial Effect of Silver Diamine Fluoride on Cariogenic Organisms. J Contemp Dent Pract 2018; 19 (5):591-598.

DOI: 10.5005/jp-journals-10024-2304

License: CC BY-NC 3.0

Published Online: 01-04-2018

Copyright Statement:  Copyright © 2018; The Author(s).


Aim: To screen the possible antimicrobial activity of a range of clinically used, silver-based compounds on cariogenic organisms: silver diamine fluoride (SDF), silver fluoride, and silver nitrate. Materials and methods: Preliminary screening disk-diffusion susceptibility tests were conducted on Mueller–Hinton agar plates inoculated with Streptococcus mutans, Lactobacillus acidophilus, and Actinomyces naeslundii, organisms known to be cariogenic. In order to identify which component of the silver compounds was responsible for any antibacterial (AB) effect, and to provide controls, the following were also investigated at high and low concentrations: sodium fluoride, ammonium fluoride, ammonium chloride, sodium fluoride, sodium chloride, and sodium nitrate, as well as deionized water as control. A volume of 10 μL of a test solution was dispensed onto a paper disk resting on the inoculated agar surface, and the plate incubated anaerobically at 37°C for 48 hours. The zones of inhibition were then measured. Results: Silver diamine fluoride, silver fluoride, silver nitrate, and ammonium fluoride had significant AB effect (p < 0.05) on all three test organisms, although ammonium fluoride had no effect at low concentration; the remaining other compounds had no effect. Conclusion: Silver ions appear to be the principal AB agent at both high and low concentration; fluoride ions only have an AB effect at high concentration, while ammonium, nitrate, chloride and sodium ions have none. The anticaries effect of topical silver solutions appears restricted to that of the silver ions. Clinical significance: Silver compounds, such as SDF, silver fluoride, and silver nitrate have AB effect against cariogenic organisms and these may have clinical impact in arresting or preventing dental decay. Sodium fluoride did not have AB effect under the conditions tested.

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  1. Russell AD, Hugo WB. Antimicrobial activity and action of silver. Prog Med Chem 1994;31:351-370.
  2. White RJ. An historical overview of the use of silver in wound management. Br J Nurs 2001;10(15):S3-S8.
  3. Landsdown ABG. Silver in health care: antimicrobial effects and safety in use. Curr Probl Dermatol 2006;33:17-34.
  4. Darouiche RO, Meade R, Mansouri M, Raad II. In vivo efficacy of antimicrobial-coated fabric from prosthetic heart valve sewing rings. J Heart Valve Dis 1998 Nov;7(6):639-646.
  5. Darouiche RO. Anti-infective efficacy of silver-coated medical prostheses. Clin Infect Dis 1999 Dec;29:1371-1378.
  6. Hipler C, Elsner P, Fluhr JW. New silver-coated cellulose fibres: in vitro investigations into antibacterial and antimycotic activity. The 2nd European Conference on Textiles and the Skin, Stuttgart, Germany; 2004:No 5-1-29.
  7. Pyle BH, Broadaway SC, McFeters GA. Efficacy of copper and silver ions with iodine in the inactivation of Pseudomonas cepacia. J Appl Bacteriol 1992 Jan;72(1):71-79.
  8. Coward JE, Carr HS, Rosenkranz HS. Silver sulfadiazine: effect on the ultrastructure of Pseudomonas aeruginosa. Antimicrob Agents Chemother 1973 May;3(5):621-624.
  9. Richards RME. Antimicrobial action of silver nitrate. Microbios 1981;31(124):83-91.
  10. Fox CL, Modak SM. Mechanism of silver sulphadiazine action on burn wound infections. Antimicrob Agents Chemother 1974 Jun;5(6):528-588.
  11. Thurman RB, Gerba CP. The molecular mechanisms of copper and silver ion disinfection of bacteria and viruses. Crit Rev Environ Control 1988;18:295-315.
  12. Fuhrmann GF, Rothstein A. The mechanism of the partial inhibition of fermentation in yeast by nickel ions. Biochim Biophys Acta 1968 Nov;163(3):331-338.
  13. Bragg PD, Rainnie DJ. The effect of silver ions on the respiratory chain of Escherichia coli. Can J Microbiol 1974 Jun;20(6):883-889.
  14. Gardner AF, Higel RW. An evaluation of agents used in cavity sterilization. Aust Dent J 1962 Feb;7(1):53-61.
  15. Stebbins EA. What value has argenti nitras as therapeutic agent in dentistry? Int Dent J 1891;7:53-61.
  16. Miller WD. Preventive treatment of the teeth, with special reference to silver nitrate. Dental Cosmos 1905;47:913-922.
  17. Howe PR. A method of sterilizing, and at the same time impregnating with a metal, affected dentinal tissue. Dental Cosmos 1917;59:891-904.
  18. Muntz JA, Dorfman A, Stephan RM. In vitro studies on sterilization of carious dentin. I. Evaluation of germicides. J Am Dent Assoc 1943 Dec;30(23):1893-1900.
  19. Prime JM. Further extending use of Howe's ammoniacal silver nitrate in control of dental caries. Dental Cosmos 1935 Nov;77(11):1046-1059.
  20. Prime JM. Preventive dentistry. J Am Dent Assoc 1940;27: 1213-1222.
  21. Zander HA. Use of silver nitrate in the treatment of caries. J Am Dent Assoc 1941 Aug;28(8):1260-1267.
  22. Zander HA, Burrill DY. Penetration of silver nitrate solution into dentin. J Dent Res 1943;22:85-87.
  23. Englander HR, James VE, Massler M. Histologic effects of silver nitrate of human dentin and pulp. J Am Dent Assoc 1958 Nov;57(5):621-630.
  24. Lansdown A, Williams A. Bacterial resistance to silver-based antibiotics. Nurs Times 2007 Feb-Mar;103(9):48-49.
  25. Yamaga R, Yokomizo I. Arrestment of caries of deciduous teeth with diamine silver fluoride. Dent Outlook 1969;33:1007-1013.
  26. Lou YL, Botelho MG, Darvell BW. Erratum to “Reaction of silver diamine fluoride with hydroxyapatite and protein” [J Dent 39 (2011) 612–618]. J Dent 2012;40:91-93.
  27. Yamaga R, Nishino M, Yoshida S, Yokomizo I. Diamine silver fluoride and its clinical application. J Osaka Dent Univ 1972 Sep;12:1-20.
  28. Suzuki K, Ohkubo T. Infected root canal treatment by Ag(NH3)2F solution—especially stump teeth treatment. Dent Outlook 1974;43:99-102.
  29. Hori T, Kawamura K, Kajiwara T, Nagao K, Isoda K, Itsumi T. Effect of application of 3.8% Ag(NH3)2F solution as a disinfectant. Dent Outlook 1975;46:495-500.
  30. Klein U, Kanellis MJ, Drake D. Effects of four anticaries agents on lesion depth progression in an in vitro caries model. Pediatr Dent 1999 May-Jun;21(3):176-180.
  31. Llodra JC, Rodriguez A, Ferrer B, Menardia V, Ramos T, Morato M. Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren. 36-month clinical trial. J Dent Res 2005 Aug;84(8):721-724.
  32. Chu CH, Lo ECM. Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children. J Dent Res 2002;81:767-770.
  33. Craig GG, Powell KR, Cooper MH. Caries progression in primary molars. 24-month results from a minimal treatment programme. Community Dent Oral Epidemiol 1981 Dec;9(6):260-265.
  34. de Almeida LdFD, Cavalcanti YW, Valença AMG. In vitro antibacterial activity of silver diamine fluoride in different concentrations. Acta Odontol Latinoam 2011;24(2):127-131.
  35. Lou YL, Botelho MG, Darvell BW. Reaction of silver diamine fluoride with hydroxyapatite and protein. J Dent 2011 Sep;39(9):612-618.
  36. Tobias RS, Browne RM, Wilson CA. Antibacterial activity of dental restorative materials. Int Endod J 1985 Jul;18(3):161-171.
  37. Balouiri M, Sadiki M, Koraichi Ibn Souda S. Methods for in vitro evaluating antimicrobial activity: a review. J Pharm Anal 2016 Apr;6(2):71-79.
  38. Barry AL. Agar diffusion test. In: Barry AL, editor. The antimicrobial susceptibility test: principles and practices. Philadelphia, PA: Lea & Febiger; 1976. pp. 163-213.
  39. Tobias RS. Antibacterial properties of dental restorative materials: a review. Int Endod J 1988 Mar;21(2):155-160.
  40. Rolla G, Löe H, Schiott CR. The affinity of chlorhexidine for hydroxyapatite and salivary mucins. J Periodontal Res 1970;5(2):90-95.
  41. de Soet JJ, Weerheijm KL, van Amerongen WE, de Graaff J. A comparison of the microbial flora in carious dentine of clinically detectable and undetectable occlusal lesions. Caries Res 1995;29(1):46-49.
  42. Hahn C-L, Falkler WA, Minah GE. Microbiological studies of carious dentine from human teeth with irreversible pulpitis. Arch Oral Biol 1991;36(2):147-153.
  43. Hoshino E. Predominant obligate anaerobes in human carious dentin. J Dent Res 1985 Oct;64(10):1195-1198.
  44. Edwardsson S. Bacteriological studies on deep areas of carious dentine. Odontol Revy 1974;32:1-143.
  45. Emilson CG. Potential efficacy of chlorhexidine against mutans streptococci and human dental caries. J Dent Res 1994 Mar;73(3):682-691.
  46. Gibbons RJ, Socransky SS, Sawyer S, Kapsimalis B, Macdonald JB. The microbiota of the gingival crevice area of man. II. The predominant cultivable organisms. Arch Oral Biol 1963 May-Jun;8:281-289.
  47. Bradshaw DJ, Marsh PD, Hodgson RJ, Visser JM. Effects of glucose and fluoride on competition and metabolism within in vitro dental bacterial communities and biofilms. Caries Res 2002 Mar-Apr;36(2):81-86.
  48. Maltz M, Emilson CG. Susceptibility of oral bacteria to various fluoride salts. J Dent Res 1982 Jun;61(6):786-790.
  49. Gotjamanos T, Afonso F. Unacceptably high levels of fluoride in commercial preparations of silver fluoride. Aust Dent J 1997 Feb;42(1):52-53.
  50. Gotjamanos T, Orton V. Abnormally high fluoride levels in commercial preparations of 40 percent silver fluoride solution: contraindications for use in children. Aust Dent J 1998;43(6):422-427.
  51. Gotjamanos T, Orton V. Fluoride ion concentration in 40 per cent silver fluoride solutions determined by ion selective electrode and ion chromatography techniques. Aust Dent J 1998 Feb;43(1):55-56.
  52. Kilian M, Larsen MJ, Fejerskov O, Thylstrup A. Effects of fluoride on the initial colonization of teeth in vivo. Caries Res 1979;13(6):319-329.
  53. Hamilton IR. Effects of fluoride on enzymatic regulation of bacterial carbohydrate metabolism. Caries Res 1977;11 (Suppl 1): 262-291.
  54. Rickles NH, Becks H. The effect of topical applications of sodium fluoride on the oral flora of young adults. J Dent Res 1952 Feb;31(1):94-101.
  55. Kilian M, Thylstrup A, Fejerskov O. Predominant plaque flora of Tanzanian children exposed to high and low water fluoride concentrations. Caries Res 1979;13(6):330-343.
  56. Beighton D, McDougall WA. The effects of fluoride on the percentage bacterial composition of dental plaque, on caries incidence, and on the in vitro growth of Streptococcus mutans, Actinomyces viscosus, and Actinobacillus sp. J Dent Res 1977 Oct;56(10):1185-1191.
  57. Brown LR, White JO, Horton IM, Dreizen S, Streckfuss JL. Effect of continuous fluoride gel use on plaque fluoride retention and microbial activity. J Dent Res 1983 Jun;62(6):746-751.
  58. Wright DE, Jenkins GN. The effect of fluoride on the acid production of saliva-glucose mixtures. Br Dent J 1954;96:30-33.
  59. Bowden GH, Hamilton IR. Competition between Streptococcus mutans and Lactobacillus casei in mixed continuous culture. Oral Microbiol Immunol 1989 Jun;4(2):57-64.
  60. Clincha C. Does dental fluoride use have clinically significant effects on oral bacteria? Fluoride 2010;43:205-214.
  61. Tatevossian A. Fluoride in dental plaque and its effects. J Dent Res 1990 Feb;69 Spec No:645-652, 682-683.
  62. Lynch RJM, Mony JM, ten Cate JM. The effect of fluoride at plaque fluid concentrations on enamel de- and remineralisation at low pH. Caries Res 2006;40(6):522-529.
  63. Lynch RJM, Navada R, Walia R. Low-levels of fluoride in plaque and saliva and their effects on the demineralisation and remineralisation of enamel; role of fluoride toothpastes. Int Dent J 2004;54(5 Suppl 1):304-309.
  64. Marsh PD. The role of microbiology in models of dental caries. Adv Dent Res 1995 Nov;9(3):244-254, 255-269.
  65. Marsh PD. Dental plaque: biological significance of a biofilm and community life-style. J Clin Periodontol 2005;32 (Suppl 6): 7-15.
  66. Sissons CH, Cutress TW, Hoffman MP, Wakefield JS. A multistation dental plaque microcosm (artificial mouth) for the study of plaque growth, metabolism, pH, and mineralization. J Dent Res 1991 Nov;70(11):1409-1416.
  67. Donoghue HD, Perrons CJ, Hudson DE. The role of H2O2 and the lactoperoxidase-SCN-H2O2 system on the interaction between two bacteria originating from human dental plaque, Streptococcus rattus (mutans) BHT and Streptococcus mitior LPA-1, grown on human teeth in an artificial mouth. Arch Oral Biol 1985;30(7):519-523.
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