Silver diammine fluoride
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| Trade names | Fagamin, Advantage Arrest |
| Other names | Diammine Silver Fluoride, Diamine silver fluoride |
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| Formula | AgFH6N2 |
| Molar mass | 160.929 g·mol−1 |
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Silver diammine fluoride (SDF), also known as silver diamine fluoride in most of the dental literature (although this is a chemical misnomer), is a topical medication used to treat and prevent dental caries (tooth decay) and relieve dentinal hypersensitivity. It is a colorless (most products) or blue-tinted (Advantage Arrest, SilverSense SDF), odourless liquid composed of silver, ammonium and fluoride ions at a pH of 10.4 (most products) or 13 (Riva Star). Ammonia compounds reduce the oxidative potential of SDF, increase its stability and helps to maintain a constant concentration over a period of time, rendering it safe for use in the mouth. Silver and fluoride ions possess antimicrobial properties and are used in the remineralization of enamel and dentin on teeth for preventing and arresting dental caries.
SDF is also known as diammine silver fluoride, silver fluoride, and silver ammonium fluoride. It is frequently spelled "silver diamine fluoride" (with one m); however, this is a misnomer, as SDF contains two ammine (NH3) groups, not amine (NH2) groups.
Based on the current, best available evidence, SDF can be used by licensed dental professionals. In the UK, this is classified as 'off-label' use of a topical medicament for arresting caries as it is licensed for treatment of dentine hypersensitivity. It is supported by a robust, extensive evidence base with regard to its efficacy and can be used as long as the following criteria are realised: there is a body of evidence supporting its efficacy; and there is no alternative, licensed medicine.
The product was cleared for sale by the U.S. Food and Drug Administration as a Class II medical device for the treatment of dentinal hypersensitivity, and has been classified as an ‘effective, efficient, equitable and safe caries-preventative agent’ by the Institute of Medicine and the Millennium Goals of the World Health Organization in 2009.
It is on the World Health Organization's List of Essential Medicines, first added in 2021 for dental caries.