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PPR takes deep dive look at silver diamine fluoride and fluoride varnish

November 13, 2017

By Michelle Manchir

Dentists who want to know more about using fluoride varnish or silver diamine fluoride as a way to treat or prevent caries can find clinical guidance and other insights in an issue of ADA Professional Product Review released in November.

Image of November PPRFor the report, available at, researchers from the ADA Science Institute and University of Michigan compared the release of fluoride from six different varnishes using a method developed by the University of Michigan School of Dentistry. Silver diamine fluoride was also tested at the ADA Laboratories using a similar method, which measured fluoride release into artificial saliva at different time points, starting at 10 minute and ending at four hours.

While the amounts of fluoride released varied across the tested brands, researchers found that all varnishes showed a similar pattern of release, consisting of an initial burst of fluoride followed by a sharp decline. An average of 30 percent of total fluoride released over the four hours was released within the first 10 minutes, and those levels dropped steeply before leveling out after an hour. Authors also found that, due to its less viscous nature, all of the fluoride in silver diamine fluoride was available within the first 10 minutes of application.

For more details on the study and to read the full report, visit

The issue also includes a Caries Corner article, written by a team of dentist authors led by ADA Council on Scientific Affairs member Dr. Margherita Fontana, a dentist with a Ph.D.

The authors write about clinical indications for both fluoride varnish and silver diamine fluoride; discuss potential treatment selection factors; address common misconceptions and questions about silver diamine fluoride; and mention CDT codes and insurance coverage when it comes to the treatments.

Finally, for dental professionals wondering how their colleagues use professional-use fluoride products, the issue of PPR includes an ADA Clinical Evaluators, or ACE, panel report, reflecting the responses of 350 U.S. practicing dentists who participate in the ADA Clinical Evaluators Panel. Dentists were asked about their frequency of fluoride varnish and silver diamine fluoride use and the purpose for it.

All ADA members are invited to be part of the ADA Clinical Evaluators Panel. Through participation, which includes completing brief monthly surveys, they will contribute to scientific reports developed by the ADA Science Institute. For more information or to join the panel, visit