Title Silver Diamine Fluoride Therapy Provides More Relief From Dentin Hypersensitivity When Compared to Traditional Desensitizing Agents
Clinical Question In a patient with persistent dentin hypersensitivity, is silver diamine fluoride therapy more efficacious for managing dental pain as compared to traditional desensitizing agents?
Clinical Bottom Line Silver diamine fluoride provides greater short-term relief from dentin hypersensitivity than oxalic-acid based desensitizers. This is supported by the results of a small pilot study with a 7-day follow-up.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
22924353Craig/201219 subjects with dentinal sensitivity on both sides of upper archRandomized Controlled Trial
Key resultsUsing a VAS (visual analog scale) experimenters measured the level of sensitivity on a scale of 1-10, pre- and post-treatment with silver diamine fluoride vs a traditional oxalic acid-based desensitizer. The mean difference between VAS at baseline and 7 days for teeth treated with silver diamine fluoride/potassium iodide was −1.71 compared to −0.69 for teeth treated with the oxalic acid-based preparation. This shows a greater decrease in sensitivity per teeth treated using silver diamine fluoride therapy vs. the oxalic acid based desensitizer (p = 0.0134).
Evidence Search ("silver diamine fluoride"[Supplementary Concept] OR "silver diamine fluoride"[All Fields]) AND desensitizing[All Fields]
Comments on
The Evidence
Validity: The study design was advantageous in that the experimental and control reagents were tested on the same patient, but on contralateral sides of the arch. There was 100% compliance, and recall bias was not an issue in this study. A major limitation of the study involves two of the authors and their patent for the application of silver diamine fluoride followed by potassium iodide. Additionally, the 7 day follow-up period for treatment effect was shorter than that which would be considered desirable to show valid effectiveness. Perspective: This study is relevant to general practitioners who use a combination of different therapies to manage dentin hypersensitivity. However, the study did not compare SDF to Gluma, Prevident, or other common desensitizing agents.
Applicability This treatment is feasible and was indicated for the patient in consideration. The potential benefits include decreased sensitivity and caries arrest. This has widespread application to dentists in practice who are interested in alternative methods of managing hypersensitivity. However, potential harms include permanent staining of nearby mucosa if the silver diamine fluoride contacts these tissues. Also, demineralized tooth structure will also be permanently stained black.
Specialty (General Dentistry) (Restorative Dentistry)
Keywords dentin hypersensitivity, silver diamine fluoride
ID# 3309
Date of submission 02/07/2018
E-mail Pirzadeh@livemail.uthscsa.edu
Author Amir Pirzadeh
Co-author(s) e-mail
Faculty mentor Karen Troendle, DDS, MPH
Faculty mentor e-mail TROENDLE@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available