Evaluation of the Remineralization Capacity of Water-based Silver Fluoride

Silver diamine fluoride, which can arrest dental caries, is alkaline and may cause mild soft tissue irritation. Water-based silver fluoride has a neutral pH, which is closer to the physiological range, and is biocompatible for use in the oral environment. This study aimed to evaluate the effect of water-based silver fluoride on remineralizing early enamel lesions by comparing it with other fluoride agents through microhardness and quantitative light-induced fluorescence measurements. An in vitro study with intact bovine incisors was performed. Artificial enamel lesions were induced and subjected to microhardness and quantitative light-induced fluorescence testing. Specimens were randomly divided into 4 groups for treatment. The specimens in group I were treated with water-based silver fluoride and potassium iodide, group II with silver diamine fluoride and potassium iodide, group III with sodium fluoride varnish, and group IV with distilled water. After 8 days of pH cycling, the specimens were subjected to microhardness and quantitative light-induced fluorescence testing. Water-based silver fluoride and silver diamine fluoride showed the greatest increases in microhardness and quantitative light-induced fluorescence, with no significant differences between the two. Sodium fluoride varnish also exhibited a significant increase in microhardness and quantitative light-induced fluorescence, but the differences were smaller than those for water-based silver fluoride and silver diamine fluoride. Water-based silver fluoride is considered useful in a clinical setting for remineralizing enamel lesions, with the advantages of no risk of tissue burn and improved taste and smell.