Silver complex fluoride (SCF) may be an effective treatment for preventing caries while avoiding the staining associated with silver diamine fluoride (SDF), according to a study recently published in the Journal of Dentistry.
Due to SCF’s antimicrobial effects, it may treat caries by limiting the growth of Streptococcus mutans (S. mutans) biofilm and decreasing dentin demineralization, the authors wrote.
“We recently developed a novel SCF formulation designed to preserve the antibacterial benefits of silver while reducing aesthetic concerns,” wrote the authors, led by Grace Xu of the University of Hong Kong Faculty of Dentistry in China (J Dent, January 29, 2026, Vol. 167, 106528).
With the goal of measuring lesion depth, researchers aimed to detect a minimum difference between SCF, SDF, and the negative control group. Dentin blocks with artificial carious lesions were treated with SCF, silver diamine fluoride as the positive control, or water as the negative control, they wrote.
The samples were then exposed to S. mutans biofilm and pH cycling for seven days to simulate a high-caries-risk environment. Biofilm characteristics and dentin changes were analyzed using multiple techniques, including scanning electron microscopy (SEM), confocal laser scanning microscopy (CLSM), colony-forming unit (CFU) counting, microcomputed tomography, Fourier transform infrared (FTIR), and x-ray diffraction (XRD).
SEM showed heavy bacterial growth on dentine surfaces treated with water while much less growth was observed on surfaces treated with SCF or SDF. CLSM and CFU analysis confirmed these findings, with SCF and SDF producing higher proportions of dead bacteria and significantly lower bacterial counts compared with water (p < 0.001), they wrote.
Additionally, SEM images indicated that dentine treated with SCF had fewer exposed collagen fibers than dentine treated with water, suggesting better surface protection. Microcomputed tomography demonstrated that lesion depth and mineral loss were substantially lower in the SCF and SDF groups than in the water group (p < 0.001). FTIR and XRD analyses further showed improved mineral composition and more crystalline hydroxyapatite in SCF- and SDF-treated dentine compared with water-treated controls.
However, the study had limitations, as it only used one species of biofilm. In vivo dentin caries involves a more complex microbial community beyond S. mutans, highlighting the need for further research, the authors added.
“If SCF is successfully translated into clinical application, it may be a novel anti-caries agent for clinicians to arrest dentine caries,” Xu and colleagues concluded.
