The Rising Horizon of Silver Diamine Fluoride as an Anti-Caries Agent in Pediatric Dentistry: A Narrative Literature Review

The field of pediatric dentistry has been greatly evolving, bringing forth a vast repertoire of innovations, techniques, and advances in its different streams.Among the various domains of pediatric dentistry, it is the arena of preventive pediatric dentistry or more aptly called "minimally invasive dentistry" that has emerged as an important concept in the modern oral health care system.Out of the several preventive regimens available in pediatric dentistry, silver diamine fluoride (SDF) has been the material of choice as an anti-caries agent for arresting further progression in incipient carious lesions.SDF is known for its excellent antibacterial, anti-cariogenic, remineralizing, and desensitizing properties that enhance patients' acceptability toward a non-invasive preventive approach than for an invasive oral procedure.Not only its superior properties but also its better handling characteristics of an easy, quick, and hassle-free application have made SDF highly convenient to use in day-to-day clinical practice.SDF has proved to be a boon in the case of children who lacks access to the conventional oral health-care set-up or in children with special healthcare needs to maintain a caries-free oral environment.However, there is a major disadvantage associated with SDF application and it is the appearance of blackish stains on the teeth surfaces applied with SDF.This unaesthetic appearance, however, can be easily overcome by the use of a saturated potassium iodide solution or the use of glass ionomer cement or composite to mask the stained teeth surfaces.Several evidence-based studies and clinical trials have been conducted to gain insight into the mechanism of action of SDF, which is yet to be unraveled.Hence, this narrative literature review presents a succinct account of SDF emphasizing strongly on its evolutionary trend, debated mechanism of action, and specific procedural steps to use it in a clinical set-up.