Estimation of fluoride ion concentration in urine after application of silver diamine fluoride in patients with severe early childhood caries

Abstract

Background: Despite the University of California San Francisco, the American Academy of Pediatric Dentistry (AAPD), and the Food and Drug Administration having approved the use of silver diamine fluoride (SDF) in arresting dentinal caries, literature available on its systemic absorption is limited. Aim: This study aimed to assess any systemic absorption of fluoride ion following the topical application of SDF in young children. Materials and Methods: Children aged between 3 and 6 years who were diagnosed with severe early childhood caries and required rehabilitation were recruited for the study. Before the onset of treatment for the arrest and control of caries, a baseline urine sample as a control was collected from the patient. In accordance with the manufacturer's instructions and AAPD guidelines, SDF was topically applied on a minimum of five carious teeth, following which additional urine samples were collected after 2 h and after 24 h, respectively, of application of SDF. The urine samples were stored at −20°C, and the estimation of fluoride ion concentrations in urine was then ascertained using a fluoride ion selective electrode. Results: The results revealed that the fluoride concentration in urine before application of SDF was 0.66 mg/L ± 0.25 mg/L, and following 2 h of application, it was 1.13 mg/L ± 0.23. However, 24 h postapplication, the urinary fluoride concentration was reduced to 0.63 mg/L ± 0.20, which is close to the baseline value of the control sample. Conclusion: There was no significant systemic absorption of fluoride following the application of SDF, and it could be adopted as an effective and safe agent in the armamentarium for managing caries in young children.

Keywords

• early childhood caries
• ion selective electrode
• silver diamine fluoride
• urinary fluoride