title: Short term serum pharmacokinetics of diammine silver fluoride after oral application.
abstract: BACKGROUND
  There is growing interest in the use of diammine silver fluoride (DSF) as a topical agent to treat dentin hypersensitivity and dental caries as gauged by increasing published research from many parts of the world. While DSF has been available in various formulations for many years, most of its pharmacokinetic aspects within the therapeutic concentration range have never been fully characterized.
  
  
  METHODS
  This preliminary study determined the applied doses (3 teeth treated), maximum serum concentrations, and time to maximum serum concentration for fluoride and silver in 6 adults over 4 h. Fluoride was determined using the indirect diffusion method with a fluoride selective electrode, and silver was determined using inductively coupled plasma-mass spectrometry. The mean amount of DSF solution applied to the 3 teeth was 7.57 mg (6.04 μL).
  
  
  RESULTS
  Over the 4 hour observation period, the mean maximum serum concentrations were 1.86 μmol/L for fluoride and 206 nmol/L for silver. These maximums were reached 3.0 h and 2.5 h for fluoride and silver, respectively.
  
  
  CONCLUSIONS
  Fluoride exposure was below the U.S. Environmental Protection Agency (EPA) oral reference dose. Silver exposure exceeded the EPA oral reference dose for cumulative daily exposure over a lifetime, but for occasional use was well below concentrations associated with toxicity. This preliminary study suggests that serum concentrations of fluoride and silver after topical application of DSF should pose little toxicity risk when used in adults.
  
  
  BACKGROUND
  NCT01664871.
authors.affiliation: Area of Pediatric Dentistry, Universidad Catolica Santa Maria de Arequipa, San Jose S/N, Arequipa, Peru.
authors.forename: Elsa
authors.initials: E
authors.lastname: Vasquez
authors.forename: Graciela
authors.initials: G
authors.lastname: Zegarra
authors.forename: Edgar
authors.initials: E
authors.lastname: Chirinos
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Castillo
authors.forename: Donald R
authors.initials: DR
authors.lastname: Taves
authors.forename: Gene E
authors.initials: GE
authors.lastname: Watson
authors.forename: Russell
authors.initials: R
authors.lastname: Dills
authors.forename: Lloyd L
authors.initials: LL
authors.lastname: Mancl
authors.forename: Peter
authors.initials: P
authors.lastname: Milgrom
mesh_terms: D000328:Adult; D003807:Dentin Sensitivity / Q000517:prevention & control*; D005260:Female; D005459:Fluorides / Q000097:blood; D005460:Fluorides, Topical / Q000008:administration & dosage / Q000493:pharmacokinetics*; D005881:Gingiva / Q000187:drug effects; D006801:Humans; D008297:Male; D013058:Mass Spectrometry / Q000379:methods; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects; D000644:Quaternary Ammonium Compounds / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D012834:Silver / Q000097:blood; D018030:Silver Compounds; D055815:Young Adult
chemical_list: D005460:Fluorides, Topical; D000644:Quaternary Ammonium Compounds; D018030:Silver Compounds; D012834:Silver; C024633:silver diamine fluoride; D005459:Fluorides