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Caries Res. 2019 May 28:1-12. doi: 10.1159/000499578. [Epub ahead of print]

Effect of Silver Diamine Fluoride Treatment on Microbial Profiles of Plaque Biofilms from Root/Cervical Caries Lesions.

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Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA,
Department of Consulting for Statistics, Computing and Analytics Research, University of Michigan, Ann Arbor, Michigan, USA.
Department of Cariology, Restorative Sciences, and Endodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.
Forsyth Institute, Cambridge, Massachusetts, USA.
Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA.



To assess the effect of silver diamine fluoride (SDF) on microbial profiles present in plaque from root/cervical carious lesions, and its association with caries lesion arrest.


Twenty patients with at least one soft cavitated root/cervical carious lesion were included. One lesion/patient was randomly selected and treated with 38% SDF. Supragingival plaque samples were harvested at preintervention and 1 month postintervention. Using an MiSeq platform, 16S rDNA sequencing of the V3-V4 regions was used to determine bacterial profiles. Clinical evaluation of lesion hardness was used to evaluate arrest. t tests, principal component analysis (PCA), multidimensional scaling (MDS), and generalized linear models (GLMs) tests were used for statistical comparisons.


From a total of 40 plaque samples, 468 probe targets were observed. Although 60% of lesions became hard postintervention, PCA and MDS tests showed no distinct pre- and postintervention groups. In addition, pre- and postintervention differences in diversity (Shannon index) of microbial profiles between patients with and without lesion arrest were not statistically different. A likelihood ratio test for pre- versus postintervention differences within patients, i.e., adjusting for differences between patients using negative binomial GLMs, showed 17 bacterial taxa with significant differences (FDR <0.05).


Although 60% of lesions hardened after SDF treatment, this was not directly due to either overall statistically significant differences in microbial profiles or differences in microbial diversity. Nevertheless, there was a trend with some acid-producing species in that their relative abundance was reduced postintervention. The negative binomial GLMs showed 17 bacterial taxa that were significantly different after SDF treatment.


Antimicrobial effect; Bacterial taxa; DNA; Dental caries; HOMINGS technology; Silver diamine fluoride


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