Salivary and urinary ion estimation after silver diamine fluoride application

Abstract

Aim or Purpose: The purpose of the study was to determine the salivary and urinary levels of fluoride and silver ions in children after silver diamine fluoride (SDF) application on dental carious lesions. Materials and Methods: After obtaining approval from Institute's ethics Committee (IECPG-637/25.11.2020), 60 children (4-6 years with ≥3 caries lesions) were recruited. Three ml of unstimulated whole saliva was collected at three time points; before, one and 24 hours after SDF application. Similarly, 3ml urine samples were collected before and 24 hours after SDF application. Fluoride(F)and silver (Ag) concentrations were determined by a fluoride ion-selective electrode (ISE) and inductively coupled plasma mass spectrometry (ICPMS) respectively. Wilcoxon Signed Rank test was used for data analysis. Level of significance was set at p-values < 0.05. Results: At baseline, 1-hour and 24-hours, salivary F concentrations (median, range, ppm) were 0.06 (0.01-0.41), 0.97(0.05-2.12), and 0.11(0.02-0.76) respectively, while baseline and 24-hour urinary F concentrations (ppm) were 0.33(0.02-0.79) and 0.43 (0.04-1.24) respectively. Salivary Ag concentrations (ppb) were 3.11 (0.97-9.34) at baseline, 4684 (3864.0-11920.99) at 1 hour, and 43.96 (17.32-171.09) at 24 hours after SDF application. Urinary Ag concentrations (ppb) were 1.97 (0-10.59) and 3.62(0-14.26) before and 24 hours after SDF application respectively. There were statistically elevated fluoride and silver ion concentrations at 24 hours after SDF application as compared to baseline. Conclusions: Salivary concentration of fluoride and silver ions elevated significantly at 1- and 24-hours following SDF application. The systemic absorption of fluoride and silver ions were minimal, their urinary concentrations were elevated at 1 hour and remained above the baseline even after 24 hours.