Safety issues related to the use of silver fluoride in paediatric dentistry.
Due to its exceedingly high fluoride content, 40% silver fluoride solution has the potential to cause fluorosis when used in young children. In vitro testing conducted in the present investigation indicates that application of 40% silver fluoride to deep carious lesions or its use as a 'spot' application agent could result in 3 to 4 mg of fluoride reaching the systemic circulation. As scientifically-based clinical trials on the safety of 40% silver fluoride have not been conducted, it would be appropriate for it to be withdrawn from further clinical use until proper testing and evaluation have been carried out. In view of the possibility that lower strength solutions of silver fluoride (1-4%) may be just as effective as 40% in 'arresting' deep caries, testing should focus on such solutions, particularly as the potential for toxicity from their fluoride content would be reduced by a factor of 10-40.
Gotjamanos
T
T
School of Oral Health Sciences, Faculty of Medicine and Dentistry, University of Western Australia.
D000287:Administration, Topical; D002327:Cariostatic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D002648:Child; D003731:Dental Caries / Q000378:metabolism / Q000628:therapy*; D005459:Fluorides / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D009050:Fluorosis, Dental / Q000209:etiology; D006801:Humans; D008963:Molar / Q000378:metabolism; D010377:Pediatric Dentistry; D012449:Safety; D018030:Silver Compounds / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D014094:Tooth, Deciduous / Q000378:metabolism
D002327:Cariostatic Agents; D018030:Silver Compounds; C105022:silver fluoride; D005459:Fluorides