Nanosilver fluoride as a caries arresting agent: A narrative review

Dental caries is the most prevalent oral disease that continues to affect almost every country in the world. The contemporary management of dental caries focuses on non-restorative, non-invasive, and micro-invasive treatment approaches that arrest or reverse the caries process at a lesion level and reduce the loss of sound tooth structure. One of these approaches is the employment of caries arresting agents that possess antibacterial and remineralizing properties. Silver diamine fluoride (SDF) has drawn significant attention as an efficient caries arresting agent in children and adults. The major limitation with the use of SDF is the dark black staining of the carious tissue that compromises the esthetics. Silver ions are known for their antimicrobial effects, and silver nanoparticles (AgNPs) have the added advantage that it increases the surface area for exposure to the microbes. Literature reports that AgNPs have antimicrobial potential against predominant cariogenic flora. It has led to the development of nanosilver fluoride (NSF), a new colloid based on AgNPs, chitosan, and fluoride. It has shown to overcome the clinical limitations of SDF as it does not cause carious lesion staining. However, the current scientific literature lacks a comprehensive review of the benefits of using NSF for caries prevention and arrest. Thus, the purpose of this paper was to review the studies and clinical trials on NSF as a caries arresting agent, including antibacterial actions and modulation of the demineralization-remineralization balance.