SAFETY ISSUES RELATED TO THE USE OF SILVER FLUORIDE IN PAEDIATRIC DENTISTRY
T Gotjamanos, Perth, Australia
Abstract from Australian Dental Journal 42, (3) 166-168 1997 (June)

Dus to its exceedingly high fluoride content, 40% silver fluoride solution has the potential to cause fluorosis when used in young children. In vitro testing coonducted in the present investigation indicates that application of 40% silver fluoride to deep carious lesions or its use as a 'spot' application agent could result in 3 to 4 mg of fluoride reaching the systemic circulation.

As scientifically-based clinical trials on the safety of 40% silver fluoride have not been conducted, it would be appropriate for it to be withdrawn from further clinical use until proper testing and evaluation have been carried out. In view of the possibility that lower strength solutions of silver fluoride (1-4%) may be just as effective as 40% in 'arresting' deep caries, testing should focus on such solutions, particularly as the potential for toxicity from their fluoride content would be reduced by a factor of 10-40.

Key words: Fluorosis; Silver fluoride; Toxicity.
Reprints: T Gotjamanos, University of Western Australia School of Dentistry, 179 Wellington Street, Perth WA 6000, Australia.

UNACCEPTABLY HIGH LEVELS OF FLUORIDE IN COMMERCIAL PREPARATIONS OF SILVER FLUORIDE
T Gotjamanos and F Afonso, Perth, Australia
Abstract from Australian Dental Journal 42 (1) 52-53 1997 (February)

Instead of expected fluoride ion concentrations of around 60,000 ppm, commercial preparations of 40 per cent aqueous silver fluoride were found to contain 120,000-127,000 ppm. Information received from the Western Australian Chemistry Centre which provided independent confirmation of the higher than expected [F] indicates that the currently available commercial preparations contain silver di-fluoride rather than silver fluoride.

In view of the potential of fluoride-containing products such as dentifrices (1,000-1,500 ppm F) and topical fluoride gels and solutions (6,000-12,000 ppm F) to cause adverse effects if excessive quantities are ingested, any product that contains 120,000 ppm [F] should be regarded as carrying a high risk of toxicity when used on young children.

Key words: Silver fluoride; Adverse effects.
Reprints: T Gotjamanos, University of Western Australia School of Dentistry, 179 Wellington Street, Perth WA 6000, Australia.