Managing dentine erosion with silver diamine fluoride: An in situ study

Objectives: To evaluate anti-erosive effect and associated color change (ΔE00) of 38% silver diamine fluoride (SDF) on human dentine. Methods: A crossover in situ study involving 15 volunteers was conducted. Participants wore an intra-oral appliance carrying four dentine blocks for three 14-day treatment phases, separated by a 7-day washout period. Three treatments included weekly application of 38% SDF (255,000 ppmAg and 44,800 ppmF, Group SDF), daily application of stannous chloride/amine fluoride/sodium fluoride (800 ppmSn and 500 ppmF, Group SNF), and daily application of deionized water (Group DW). Appliances with dentine blocks were exposed to citric acid (pH 3.2), five daily extraoral erosive challenges. Dentine blocks were assessed for percentage surface microhardness loss (%SMHL), dentine loss, salivary pellicle morphology, crystal characteristics, dentine surface morphology, elemental composition, and ΔE00 by a microhardness tester, optical profilometry, atomic force microscopy (AFM), X-ray diffraction (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and spectrophotometry, respectively. Results: %SMHL of the experimental groups were SDF:23.3 ± 2.4, SNF:30.2 ± 2.0 and DW:42.4 ± 2.2 (SDFSNF>DW; p < 0.001). Conclusion: Weekly application of 38% SDF demonstrated significantly better anti-erosive protection but caused black staining on dentine surfaces. Clinical significance: SDF with weekly application has been demonstrated to be effective in preventing dentine erosion, although dentine staining remains a clinical consideration. © 2026 The Author(s)