The Effect of Silver Diamine Flouride on Oral Microbial Load

Silver Diamine Fluoride (SDF) is a non-invasive caries-arresting and desensitizing agent. A statistically significant correlation has been reported between adenosine triphosphate (ATP) bioluminescence scores and oral bacterial counts. Currently, no studies exist using ATP bioluminescence to measure change in oral microbial load after SDF application. Purpose: To evaluate and compare the oral bacterial ATP score, at initial and three month recall dental visits, between a control group receiving 5% sodium fluoride varnish and a studied group receiving 38% SDF. Methods: A total of 32 healthy subjects age 2-6 years were assigned in 1 of 2 groups according to preferred parental treatment selection: SDF or 5% sodium fluoride varnish. At initial and three month recall visits, a ATP bioluminescence swab test was carried out. Thereafter, the patient received either SDF or fluoride. Results: Recall ATP bioluminescence scores among both groups were significantly correlated with: treatment and plaque at recall. Within the fluoride group, the change in ATP bioluminescence score was significantly correlated with plaque at recall and dmft score. Within the SDF group, the change in ATP bioluminescence score was independent of all measured clinical variables. Conclusion: SDF and fluoride contribute to lowering the oral microbial load as measured by ATP bioluminescence at three month recall. SDF has a stronger intrinsic antibacterial effect when compared to fluoride varnish three months post treatment, as its effect was independent of all measured clinical variables.