Acidity, fluoride and silver ion concentrations in silver diamine fluoride solutions: a pilot study

Abstract

Background: There has been renewed interest in the use of silver diamine fluoride (SDF) for the management of carious lesions in high-risk groups. Previous studies have found a difference in clinical efficacy among different concentrations of SDF and discrepancies between ionic concentrations of fluoride (F) and silver (Ag) in SDF preparations. The aim of this study was to measure the free F, Ag ion concentrations and pH of a variety of commercially available SDF preparations. Methods: Seven SDF products used globally were evaluated for F and Ag ion concentrations using a calibrated ion-selective electrode and optical emission spectrometry respectively. Acidity was determined with a pH electrode. Results: The 30% SDF solution contained almost half the F concentration and a much higher Ag concentration than expected (16 343 ppmF and 246 000 ppmAg). Comparatively, the mean F concentration of the remaining six 38% solutions was 74 802 ppm (expected mean 44 800 ppm) ranging from 36 457 ppm to 120 760 ppm. The mean Ag concentration was 326 000 ppm (expected mean 253 870 ppm) and ranged from 246 000 ppm to 425 451 ppm. All solutions were found to be neutral or mildly alkaline in nature (pH 7-10.3). Conclusions: Wide variations between claimed and measured F and Ag ion concentrations exist among the different brands of commercially available SDF products.

The Cytocompatibility of Silver Diamine Fluoride on Mesenchymal Stromal Cells from Human Exfoliated Deciduous Teeth: An In Vitro Study

“…Neither Riva Star nor e-SDF had the expected concentration stated by the manufacturer. Patel et al [ 33 ] analyzed the fluoride concentration of seven types of SDF products. None of the SDF fluoride concentrations matched with the expected fluoride concentration indicated by the manufacturer.…”

Omissions make silver diamine fluoride paper impossible to interpret

“…To the Editor, I am writing in response to Patel and colleagues 'Acidity, Fluoride and Silver Ion Concentrations in Silver Diamine Fluoride solutions: a pilot study' 1 . Given concerns about quality control of fluorides produced in some countries, 2 work in this area is appropriate. However, this report raises methodological concerns.…”

Fluoride concentration in SDF commercial products

“…Dear Editor, We have read the paper entitled 'Acidity, fluoride and silver ion concentrations in silver diamine fluoride solutions: a pilot study' by J Patel et al published in the Australian Dental Journal. 1 We would like to congratulate the authors for this study and wish to make a contribution.…”

“…We evaluated different flasks of the same brand and the lots evaluated were reported in our publication (Table 1). Patel et al 1 evaluated only one flask of each brand of SDF and did not report the lots. We determined fluoride in the SDF products with an ion-specific electrode (F-ISE) by direct technique but the results were confirmed with the microdiffusion technique.…”

“…We determined fluoride in the SDF products with an ion-specific electrode (F-ISE) by direct technique but the results were confirmed with the microdiffusion technique. Patel et al 1 also analysed the SDF products with F-ISE by the direct technique but they did not present in the publication any details about accuracy and reproducibility of the calibration made for fluoride analysis.…”