Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Oral Health
Published in: BMC Oral Health 1/2020

Open Access 01-12-2020 | Caries | Research article

Clinical efficacy and the antimicrobial potential of silver formulations in arresting dental caries: a systematic review

Authors: Kausar Sadia Fakhruddin, Hiroshi Egusa, Hien Chi Ngo, Chamila Panduwawala, Siripen Pesee, Lakshman Perera Samaranayake

Published in: BMC Oral Health | Issue 1/2020

Login to get access

Abstract

Background

The use of silver-formulation as microbicide to arrest dentinal caries is gaining popularity. The primary objective of the present appraisal was to systematically review the clinical (in vivo) applications and antimicrobial potential of silver-containing formulations in arresting dentinal caries. Our secondary aim was to sum up the available in vitro applications of silver-containing formulations against cariogenic microbes isolated from dentine lesions.

Methods

Ovid MEDLINE, EBSCO host, Web of Science, and Cochrane Library databases was searched between January 2009–May 2019.

Results

In vivo: We observed conflicting evidence of antimicrobial efficacy of SDF on a diverse array of microbial taxa present in carious dentine of primary and permanent teeth. Moreover, there is insufficient evidence on the application of AgNP-fluoride as an effective microbicidal against cariogens of dentine lesions.
In vitro: We found a good evidence of microbicidal efficacy of silver diamine fluoride (SDF) on selective cariogenic microbes in human dentine model. Additionally, a good evidence was noted of in vitro application of silver nanoparticles (AgNPs) as a useful microbicidal against S. mutans adhesion, growth and subsequent biofilm formation in human dentine models.

Conclusions

Taken together, in vitro evidence indicates the promising antimicrobial potential of silver-based formulations (SDF and nanosilver) against the predominant cariogenic flora, particularly from dentine lesions. Post-treatment clinical data of either the bactericidal and bacteriostatic effects of SDF or nanosilver are sparse. Furthermore, the current understanding of the specific size, concentration, antimicrobial mechanisms, and toxicological aspects of nano-silver compounds is inadequate to draw firm conclusions on their clinical utility.
Appendix
Available only for authorised users
Literature
1.
Klein MI, Hwang G, Santos PHS, Campanella OH, Koo H. Streptococcus mutans-derived extracellular matrix in cariogenic oral biofilms. Front Cell Infect Microbiol. 2015;5:10.PubMedPubMedCentralCrossRef
2.
Aas JA, Griffen AL, Dardis SR, Lee AM, Olsen I, Dewhirst FE, Leys EJ, Paster BJ. Bacteria of dental caries in primary and permanent teeth in children and young adults. J Clin Microbiol. 2008;46(4):1407–17.PubMedPubMedCentralCrossRef
3.
Richards VP, Alvarez AJ, Luce AR, Bedenbaugh M, Mitchell ML, Burne RA, Nascimento MM. Microbiomes of site-specific dental plaques from children with different caries status. Infect Immun. 2017;85(8):e00106–17.PubMedPubMedCentralCrossRef
4.
Kianoush N, Adler CJ, Nguyen KA, Browne GV, Simonian M, Hunter N. Bacterial profile of dentine caries and the impact of pH on bacterial population diversity. PLoS One. 2014;9(3):e92940.PubMedPubMedCentralCrossRef
5.
Becker MR, Paster BJ, Leys EJ, Moeschberger ML, Kenyon SG, Galvin JL, Boches SK, Dewhirst FE, Griffen AL. Molecular analysis of bacterial species associated with childhood caries. J Clin Microbiol. 2002;40(3):1001–9.PubMedPubMedCentralCrossRef
6.
Nadkarni MA, Caldon CE, Chhour K-L, Fisher IP, Martin FE, Jacques NA, Hunter N. Carious dentine provides a habitat for a complex array of novel Prevotella-like bacteria. J Clin Microbiol. 2004;42(11):5238–44.PubMedPubMedCentralCrossRef
7.
Chhour KL, Nadkarni MA, Byun R, Martin FE, Jacques NA, Hunter N. Molecular analysis of microbial diversity in advanced caries. J Clin Microbiol. 2005;43(2):843–9.PubMedPubMedCentralCrossRef
8.
Takahashi N. Oral microbiome metabolism: from “who are they?” to “what are they doing?”. J Dent Res. 2015;94(12):1628–37.PubMedCrossRef
9.
Pereira D, Seneviratne CJ, Koga-Ito CY, Samaranayake LP. Is the oral fungal pathogen Candida albicans a cariogen? Oral Dis. 2018;24(4):518–26.PubMedCrossRef
10.
Xiao J, Grier A, Faustoferri RC, Alzoubi S, Gill AL, Feng C, Liu Y, Quivey RG, Kopycka-Kedzierawski DT, Koo H, et al. Association between Oral Candida and Bacteriome in children with severe ECC. J Dent Res. 2018;97(13):1468–76.PubMedPubMedCentralCrossRef
11.
Ricketts D, Lamont T, Innes NP, Kidd E, Clarkson JE. Operative caries management in adults and children. Cochrane Database Syst Rev. 2013;3:Cd003808.
12.
Schwendicke F, Frencken JE, Bjorndal L, Maltz M, Manton DJ, Ricketts D, Van Landuyt K, Banerjee A, Campus G, Domejean S, et al. Managing carious lesions: consensus recommendations on carious tissue removal. Adv Dent Res. 2016;28(2):58–67.PubMedCrossRef
13.
Innes NP, Frencken JE, Bjorndal L, Maltz M, Manton DJ, Ricketts D, Van Landuyt K, Banerjee A, Campus G, Domejean S, et al. Managing carious lesions: consensus recommendations on terminology. Adv Dent Res. 2016;28(2):49–57.PubMedCrossRef
14.
Banerjee A, Frencken JE, Schwendicke F, Innes NPT. Contemporary operative caries management: consensus recommendations on minimally invasive caries removal. Br Dent J. 2017;223(3):215–22.PubMedCrossRef
15.
Banerjee A, Watson TF, Kidd EA. Dentine caries: take it or leave it? Dent Update. 2000;27(6):272–6.PubMedCrossRef
16.
Bjørndal L, Simon S, Tomson P, Duncan H. Management of Deep Caries and the exposed pulp. Int Endod J. 2019;52:949–73.PubMedCrossRef
17.
Oong EM, Griffin SO, Kohn WG, Gooch BF, Caufield PW. The effect of dental sealants on bacteria levels in caries lesions: a review of the evidence. J Am Dental Assoc (1939). 2008;139(3):271–8 quiz 357-278.CrossRef
18.
Griffin SO, Oong E, Kohn W, Vidakovic B, Gooch BF, Bader J, Clarkson J, Fontana MR, Meyer DM, Rozier RG, et al. The effectiveness of sealants in managing caries lesions. J Dent Res. 2008;87(2):169–74.PubMedCrossRef
19.
Paddick JS, Brailsford SR, Kidd EA, Beighton D. Phenotypic and genotypic selection of microbiota surviving under dental restorations. Appl Environ Microbiol. 2005;71(5):2467–72.PubMedPubMedCentralCrossRef
20.
Knutsson G, Jontell M, Bergenholtz G. Determination of plasma proteins in dentinal fluid from cavities prepared in healthy young human teeth. Arch Oral Biol. 1994;39(3):185–90.PubMedCrossRef
21.
22.
Zavgorodniy AV, Rohanizadeh R, Swain MV. Ultrastructure of dentine carious lesions. Arch Oral Biol. 2008;53(2):124–32.PubMedCrossRef
23.
Klasen HJ. A historical review of the use of silver in the treatment of burns. II. Renewed interest for silver. Burns. 2000;26(2):131–8.PubMedCrossRef
24.
Morris GV, Kozdryk J, Gregory J, Jeys L. The use of silver-coated orthopaedic implants: are all silvers the same? Curr Orthop Practs. 2017;28(6):532–6.CrossRef
25.
Shawcross J, Bakhai A, Ansaripour A, Armstrong J, Lewis D, Agg P, De Godoy R, Blunn G. In vivo biocompatibility and pacing function study of silver ion-based antimicrobial surface technology applied to cardiac pacemakers. Open Heart. 2017;4(1):e000357.PubMedPubMedCentralCrossRef
26.
Ammons MC, Ward LS, James GA. Anti-biofilm efficacy of a lactoferrin/xylitol wound hydrogel used in combination with silver wound dressings. Int Wound J. 2011;8(3):268–73.PubMedPubMedCentralCrossRef
27.
Yamamoto K, Ohashi S, Aono M, Kokubo T, Yamada I, Yamauchi J. Antibacterial activity of silver ions implanted in SiO2 filler on oral streptococci. Dent Mater. 1996;12(4):227–9.PubMedCrossRef
28.
Youravong N, Carlen A, Teanpaisan R, Dahlén G. Metal-ion susceptibility of oral bacterial species. Lett Appl Microbiol. 2011;53(3):324–8.PubMedCrossRef
29.
30.
31.
Lansdown ABG. A pharmacological and toxicological profile of silver as an antimicrobial agent in medical devices. Adv Pharmacol Sci. 2010;2010:910686.PubMedPubMedCentral
32.
33.
Lansdown AB. Silver. I: its antibacterial properties and mechanism of action. J Wound Care. 2002;11(4):125–30.PubMedCrossRef
34.
Dodes JE. The amalgam controversy: an evidence-based analysis. J Am Dent Assoc. 2001;132(3):348–56.PubMedCrossRef
35.
Rosenblatt A, Stamford TC, Niederman R. Silver diamine fluoride: a caries “silver-fluoride bullet”. J Dent Res. 2009;88(2):116–25.PubMedCrossRef
36.
Zhao IS, Gao SS, Hiraishi N, Burrow MF, Duangthip D, Mei ML, Lo EC-M, Chu C-H. Mechanisms of silver diamine fluoride on arresting caries: a literature review. Int Dent J. 2018;68(2):67–76..
37.
Mei ML, Lo ECM, Chu CH. Arresting dentine caries with silver Diamine fluoride: What's behind it? J Dent Res. 2018;97(7):751–8.PubMedCrossRef
38.
39.
Auffan M, Rose J, Bottero J-Y, Lowry GV, Jolivet J-P, Wiesner MR. Towards a definition of inorganic nanoparticles from an environmental, health and safety perspective. Nat Nanotechnol. 2009;4:634.PubMedCrossRef
40.
Morones JR, Elechiguerra JL, Camacho A, Holt K, Kouri JB, Ramirez JT, Yacaman MJ. The bactericidal effect of silver nanoparticles. Nanotechnology. 2005;16(10):2346–53.PubMedCrossRef
41.
Shang L, Nienhaus K, Nienhaus GU. Engineered nanoparticles interacting with cells: size matters. J Nanobiotechnol. 2014;12(1):5.CrossRef
42.
Nel AE, Mädler L, Velegol D, Xia T, Hoek EMV, Somasundaran P, Klaessig F, Castranova V, Thompson M. Understanding biophysicochemical interactions at the nano–bio interface. Nat Mater. 2009;8:543.PubMedCrossRef
43.
Xia T, Kovochich M, Brant J, Hotze M, Sempf J, Oberley T, Sioutas C, Yeh JI, Wiesner MR, Nel AE. Comparison of the abilities of ambient and manufactured nanoparticles to induce cellular toxicity according to an oxidative stress paradigm. Nano Lett. 2006;6(8):1794–807.PubMedCrossRef
44.
Burgess JO, Vaghela PM. Silver Diamine fluoride: a successful Anticarious solution with limits. Adv Dent Res. 2018;29(1):131–4.PubMedCrossRef
45.
Gao SS, Zhao IS, Hiraishi N, Duangthip D, Mei ML, Lo ECM, Chu CH. Clinical trials of silver Diamine fluoride in arresting caries among children: a systematic review. JDR Clin Transl Res. 2016;1(3):201–10.CrossRef
46.
Gao SS, Duangthip D, Wong MCM, Lo ECM, Chu CH. Randomized trial of silver nitrate with sodium fluoride for caries arrest. JDR Clin Trans Res. 2019;4(2):126–34.PubMed
47.
Freire PL, Stamford TC, Albuquerque AJ, Sampaio FC, Cavalcante HM, Macedo RO, Galembeck A, Flores MA, Rosenblatt A. Action of silver nanoparticles towards biological systems: cytotoxicity evaluation using hen's egg test and inhibition of Streptococcus mutans biofilm formation. Int J Antimicrob Agents. 2015;45(2):183–7.PubMedCrossRef
48.
Lu Z, Rong K, Li J, Yang H, Chen R. Size-dependent antibacterial activities of silver nanoparticles against oral anaerobic pathogenic bacteria. J Mater Sci Mater Med. 2013;24(6):1465–71.PubMedCrossRef
49.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.PubMedPubMedCentralCrossRef
50.
Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. Bmj. 2009;339:b2700.PubMedPubMedCentralCrossRef
51.
Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. Bmj. 2011;343:d5928.PubMedPubMedCentralCrossRef
52.
Milgrom P, Horst JA, Ludwig S, Rothen M, Chaffee BW, Lyalina S, Pollard KS, DeRisi JL, Mancl L. Topical silver diamine fluoride for dental caries arrest in preschool children: a randomized controlled trial and microbiological analysis of caries associated microbes and resistance gene expression. J Dent. 2018;68:72–8.PubMedCrossRef
53.
Mitwalli H, Mourao MDA, Dennison J, Yaman P, Paster BJ, Fontana M. Effect of silver Diamine fluoride treatment on microbial profiles of plaque biofilms from root/cervical caries lesions. Caries Res. 2019;53(5):555–66.PubMedCrossRef
54.
Karched M, Ali D, Ngo H. In vivo antimicrobial activity of silver diammine fluoride on carious lesions in dentin. J Oral Sci. 2019;61(1):19–24.PubMedCrossRef
55.
56.
57.
Urquhart O, Tampi MP, Pilcher L, Slayton RL, Araujo MWB, Fontana M, Guzmán-Armstrong S, Nascimento MM, Nový BB, Tinanoff N, et al. Nonrestorative treatments for caries: systematic review and network meta-analysis. J Dent Res. 2019;98(1):14–26.PubMedCrossRef
58.
Trieu A, Mohamed A, Lynch E. Silver diamine fluoride versus sodium fluoride for arresting dentine caries in children: a systematic review and meta-analysis. Sci Rep. 2019;9(1):2115.PubMedPubMedCentralCrossRef
59.
60.
Hon L, Mohamed A, Lynch E. Reliability of colour and hardness clinical examinations in detecting dentine caries severity: a systematic review and meta-analysis. Sci Rep. 2019;9(1):6533.PubMedPubMedCentralCrossRef
61.
Chen H, Jiang W. Application of high-throughput sequencing in understanding human oral microbiome related with health and disease. Front Microbiol. 2014;5:508.PubMedPubMedCentral
62.
Tanner ACR, Kent RL, Holgerson PL, Hughes CV, Loo CY, Kanasi E, Chalmers NI, Johansson I. Microbiota of severe early childhood caries before and after therapy. J Dent Res. 2011;90(11):1298–305.PubMedPubMedCentralCrossRef
63.
Santos VE Jr, Vasconcelos Filho A, Targino AG, Flores MA, Galembeck A, Caldas AF Jr, Rosenblatt A. A new “silver-bullet” to treat caries in children--nano silver fluoride: a randomised clinical trial. J Dent. 2014;42(8):945–51.PubMedCrossRef
64.
Chu CH, Mei LEI, Seneviratne CJ, Lo ECM. Effects of silver diamine fluoride on dentine carious lesions induced by Streptococcus mutans and Actinomyces naeslundii biofilms. Int J Paediatr Dent. 2012;22(1):2–10.PubMedCrossRef
65.
Mei ML, Ito L, Cao Y, Li QL, Lo EC, Chu CH. Inhibitory effect of silver diamine fluoride on dentine demineralisation and collagen degradation. J Dent. 2013;41(9):809–17.PubMedCrossRef
66.
Mei ML. Li Q-l, Chu C-H, Lo EC-M, Samaranayake LP: antibacterial effects of silver diamine fluoride on multi-species cariogenic biofilm on caries. Ann Clin Microbiol Antimicrob. 2013;12:4–4.PubMedPubMedCentralCrossRef
67.
Hamama HH, Yiu CK, Burrow MF. Effect of silver diamine fluoride and potassium iodide on residual bacteria in dentinal tubules. Aust Dent J. 2015;60(1):80–7.PubMedCrossRef
68.
Besinis A, De Peralta T, Handy RD. Inhibition of biofilm formation and antibacterial properties of a silver nano-coating on human dentine. Nanotoxicology. 2014;8(7):745–54.PubMed
69.
Schwass DR, Lyons KM, Love R, Tompkins GR, Meledandri CJ. Antimicrobial activity of a colloidal AgNP suspension demonstrated in vitro against monoculture biofilms: toward a novel tooth disinfectant for treating dental caries. Adv Dent Res. 2018;29(1):117–23.PubMedCrossRef
70.
Noronha VT, Paula AJ, Duran G, Galembeck A, Cogo-Muller K, Franz-Montan M, Duran N. Silver nanoparticles in dentistry. Dent Mater. 2017;33(10):1110–26.PubMedCrossRef
71.
Targino AG, Flores MA, dos Santos Junior VE, de Godoy Bene Bezerra F, de Luna Freire H, Galembeck A, Rosenblatt A. An innovative approach to treating dental decay in children. A new anti-caries agent. J Mater Sci Mater Med. 2014;25(8):2041–7.PubMedCrossRef
Metadata
Title
Clinical efficacy and the antimicrobial potential of silver formulations in arresting dental caries: a systematic review
Authors
Kausar Sadia Fakhruddin
Hiroshi Egusa
Hien Chi Ngo
Chamila Panduwawala
Siripen Pesee
Lakshman Perera Samaranayake
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Caries
Published in
BMC Oral Health / Issue 1/2020
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-020-01133-3

Other articles of this Issue 1/2020

BMC Oral Health 1/2020 Go to the issue

Research article

Suitability of MDA, 8-OHdG and wild-type p53 as genotoxic biomarkers in metal (Co, Ni and Cr) exposed dental technicians: a cross-sectional study

Research article

The influence of two forms of chlorhexidine on the accuracy of contemporary electronic apex locators

Review

The use of PEEK in digital prosthodontics: A narrative review

Research article

Accuracy of remote diagnoses using intraoral scans captured in approximate true color: a pilot and validation study in teledentistry

Research article

Marginal and internal fit of full ceramic crowns milled using CADCAM systems on cadaver full arch scans

Research article

Efficacy of propolis-based mouthwashes on dental plaque and gingival inflammation: a systematic review