Am J Dent. 2019 Jun;32(3):152-156.

Cytotoxic effects of silver diamine fluoride.

Fancher ME¹, Fournier S², Townsend J³, Lallier TE⁴.

Author information

1

Private practice in Pediatric Dentistry, Knoxville, Tennessee, USA.

2

Department of Pediatric Dentistry, Louisiana State Health Sciences Center University School of Dentistry New Orleans, Louisiana, USA.

3

Division of Pediatric Dentistry, The Ohio State University College of Dentistry, Department of Dentistry, Nationwide Children's Hospital, Columbus, Ohio, USA, townsend.661@osu.edu.

4

Department of Cell Biology and Anatomy, Center of Excellence in Oral & Craniofacial Biology, Louisiana State Health Sciences Center University School of Dentistry New Orleans, Louisiana, USA.

Abstract

PURPOSE:

To investigate the effect of silver diamine fluoride (SDF) and fluoride varnish (FV) on human gingival fibroblasts (HGF) and bacteria.

METHODS:

HGF cell viability was assessed after exposure to various dilutions of SDF or FV. Hydroxyapatite (HA) discs treated with SDF, FV, or saline were rinsed in artificial saliva for 84 days. HGF were exposed to treated discs and viability assessed fluorescently. Oral bacteria were exposed to treated discs and survival quantified.

RESULTS:

At 0.01%, SDF was almost 100% cytotoxic to HGF. SDF and FV treated HA discs, induced near-complete cell death after 24 hours of contact. After rinsing FV discs for 21 days, cell survival exceeded 95%. SDF treated discs were toxic to HGF and bacteria after 9 weeks of rinsing.

CLINICAL SIGNIFICANCE:

SDF and FV can induce cell death. FV lost its cytotoxicity within 3 weeks, while SDF remained cytotoxic even after 9 weeks of rinsing. This research confirms that SDF has long lasting antimicrobial effects at very low concentrations although it does raise concerns regarding cytotoxicity. However, HGF cells are exposed to other cytotoxic substances in dentistry with little, if any, long-term effects