Journal Article

Effects of silver diamine fluoride on oral bacteriome and mycobiome: a randomized clinical trial

Singh, Sarbjeet, Chelikani, Prashen, Manerkar, Mayura, de Jesus, Vivianne Cruz, Lee, Victor H. K., Bertone, Mary, Mittermuller, Betty-Anne, Schroth, Robert J.

2025

Overview

Background Silver diamine fluoride (SDF) is a simple and non-invasive agent used to arrest early childhood caries (ECC). This study aimed to investigate potential changes to the oral microbiome in children with ECC who were treated with SDF and sodium fluoride (NaF) varnish at three different frequency regimens. Methods Forty-five children ( n  = 15 per group) with ECC were recruited from community-based dental clinics in Winnipeg, Canada into an open-label, parallel-group, randomized clinical trial testing three different treatment frequency regimens of SDF. A total of 195 carious lesions were treated with two applications of 38% SDF and 5% NaF varnish (and assessed over three study visits one month, four months, or six months apart. Dental plaque samples were collected at each visit. Sequencing of the V4-16 S rRNA and ITS1 rRNA genes were used to study the supragingival plaque microbiome. Results Microbial diversity analyses showed no significant differences in the overall microbiome after SDF treatment. However, significant changes in the abundance of specific bacteria and fungi, particularly Lactobacillus spp., Bifidobacterium spp., and Candida spp., were observed after treatment. Furthermore, overabundance of Streptococcus mutans and Candida dubliniensis at baseline was observed in children who had at least one caries lesion not arrested after one SDF application, compared to those who had 100% arrest rates. The overall arrest rates for treated carious lesions were 75.9% at the second visit and 92.8% at the third visit. Arrest rates were higher for all lesions after two applications of SDF with NaF varnish, and applications one month and four months apart had higher arrest rates (95.9% and 98.5%) than six months (81.1%) apart. Conclusions Applications of SDF with NaF varnish were an effective modality for arresting ECC, with higher arrest rates after two SDF applications. No loss of diversity but changes in the abundance of specific bacteria and fungi were observed after SDF treatment. Trial registration ClinicalTrials.gove NCT04054635 (first registered 13/08/2019).

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Bacteria / Care and treatment / Cariostatic Agents - administration & dosage / Cariostatic Agents - pharmacology / Cariostatic Agents - therapeutic use / Child / Child, Preschool / Children / Children & youth / Clinical trials / Dental caries / Dental Caries - drug therapy / Dental Caries - microbiology / Dental Caries - prevention & control / Dental plaque / Dental Plaque - microbiology / Dentistry / Diseases / Early childhood caries / Female / Fluoride treatments / Fluorides / Fluorides, Topical - administration & dosage / Fluorides, Topical - pharmacology / Fungi / General anesthesia / Humans / Lesions / Male / Medicine / Microbiome / Microbiomes / Microbiota (Symbiotic organisms) / Microbiota - drug effects / Molds (Fungi) / Mouth - microbiology / Mycobiome - drug effects / Oral and Maxillofacial Surgery / Pediatric research / Product development / Quaternary Ammonium Compounds - administration & dosage / Quaternary Ammonium Compounds - pharmacology / Quaternary Ammonium Compounds - therapeutic use / RNA / rRNA / Silver compounds / Silver Compounds - administration & dosage / Silver Compounds - pharmacology / Silver Compounds - therapeutic use / Sodium fluoride / Sodium Fluoride - administration & dosage / Sodium Fluoride - therapeutic use / Taxonomy / Teeth / Testing / Variance analysis