# A Concise Review of Silver Diamine Fluoride on Oral Biofilm
## 3 Results
### Application of Silver Diamine Fluoride on Bacteria  
#### 3.1.1 Antibacterial Effect  
A total of 15 studies reporting the antibacterial effects of SDF on bacteria are summarized in Table 1. Among them, 14 studies measured the antibacterial properties using monospecies bacteria such as _Lactobacillus acidophilus_, _Streptococcus sobrinus_, _Enterococcus faecalis_, and _Actinomyces naslundii_. However, subgingival microbial biofilm specimens were used on 24 adults with severe periodontitis [22]. The majority of the included studies that explored bactericidal properties were operated in vitro on dentin or enamel samples, with no difference in the effect regarding the sample material. Only one research study was conducted in vivo [23]. The longest study duration was 21 days, whereas the shortest one was 14 min. They also revealed that biofilm treated with SDF had fewer bacteria compared with that treated with water or other interventions. However, one study did not detect any significant difference among the study groups [24]. Among the included studies, eight out of nine studies reported that SDF inhibited the growth of _Streptococcus mutans_ through colony-forming unit counts. Two studies revealed that SDF also had an antibacterial function in _Lactobacillus acidophilus_ and _Actinomyces naslundii_. In addition, only one out of the two studies reported that SDF reduced the amount of _Enterococcus faecalis_[25] while the other reported reduced _Lactobacillus rhamnosus_[26]. One study reported that a 38% and a 19% SDF solution inhibited cultivable bacteria without any significant difference [27]. Only _P. micra_ and _S. constellatus_ belong to red- and orange-complex species recovered from SDF-treated specimens.  
\begin{table}
\begin{tabular}{c c c c c c} \hline
**Authors, Year** & **Setting** & _Candida_ **Species** & **Period; Assessment** & **Intervention Group** & **Main Findings** \\ \hline \multirow{4}{*}{[PERSON] et al., 2020} & In vitro; & & 3 days; & \multirow{2}{*}{Gp1: 3.8\% SDF} & CFU: Gp1,Gp2 \textless{} Gp3 \\  & human & & & & \\  & dentin & & & & \\  & & & & & \\  & & & & & \\  & & & & & & \\  & & & & & & \\  & & & & & & \\  & & & & & & \\  & & & & & & \\  & & & & & & \\  & & & & & & \\  & & & & & & \\ \hline \end{tabular}
\end{table}
Table 3: Studies on the antifungal effect of silver diamine fluoride.  
Furthermore, some studies reported that the live-to-dead ratios of _Streptococcus mutans_, _Lactobacillus acidophilus_, and _Actinomyces naslundii_ in biofilm were significantly lower after the application of SDF [23; 24; 25; 26; 27]. Only [PERSON] and co-workers reported that a 5.25% sodium hypochlorite solution had a significantly higher live-to-dead ratio of _Enterococcus faecalis_ compared with the study's SDF group [27]. Only one study reported that the antibacterial effects of nano silver fluoride varnish and the potency of propolis fluoride varnish were comparable with a 38% SDF varnish. Another study compared the minimum inhibitory concentration and the minimum bactericidal concentration of propolis fluoride and nano silver fluoride for the inhibition of biofilm formation [28].