Microbial population shift and metabolic characterization of silver diamine fluoride treatment failure on dental caries

Bidisha Paul, Maria A. Sierra, Fangxi Xu, Yasmi O. Crystal, Xin Li, Deepak Saxena, Ryan Richard Ruff

Research output: Contribution to journalArticlepeer-review


The objective of this pilot study was to describe the microbial profiles present in the plaque and saliva of children who continued to develop new carious lesions following treatment with silver diamine fluoride ("nonresponders") compared to caries active, caries-free, and children immediately receiving SDF treatment for untreated caries in order to identify potential microbial differences that may relate to a re-incidence of caries. Saliva and plaque samples from infected and contralateral sites were obtained from twenty children who were either caries free, had active carious lesions, were caries active and received SDF treatment immediately before sampling, or had previously received SDF treatment and developed new caries. In total, 8,057,899 Illumina-generated sequence reads from 60 samples were obtained. Reads were processed using the Quantitative Insights Into Microbial Ecology pipeline. Group differences were assessed using Analysis of Variance Models and Tukey Honest Significant Differences. To identify significant taxa between treatment groups, Linear discriminant analysis Effect Size (LefSe) and Analysis of Differential Abundance Taking Sample Variation Into Account were used. Differential abundant analysis indicated that members of the Lachnospiraceae family were significantly enriched in non-responders and the genus Tannerella and species Granulicatella adiances were also highly abundant in this group. LefSe analysis between non-responders and SDF-treated groups revealed that genera Leptotrichia and Granulicatella were enriched in non-responders. We observed the highest abundance of phosphotransferase system and lowest abundance of lipopolysaccharide synthesis in non-responders. The microbiome in dental biofilms is responsible for initiation and progression of dental caries. SDF has been shown to be effective in arresting the progression carious lesions, in part due to its antimicrobial properties. Findings suggest that the differential abundance of select microbiota and specific pathway functioning in individuals that present with recurrent decay after SDF treatment may contribute to a potential failure of silver diamine fluoride to arrest dental caries. However, the short duration of sample collection following SDF application and the small sample size emphasize the need for further data and additional analysis.

Original languageEnglish (US)
Article numbere0242396
JournalPloS one
Issue number3
StatePublished - Mar 2021


  • Carnobacteriaceae/genetics
  • Child
  • Cross-Sectional Studies
  • DNA, Bacterial/chemistry
  • Dental Caries/drug therapy
  • Dental Plaque/microbiology
  • Discriminant Analysis
  • Fluorides, Topical/therapeutic use
  • Humans
  • Leptotrichia/genetics
  • Microbiota
  • Pilot Projects
  • Principal Component Analysis
  • Quaternary Ammonium Compounds/therapeutic use
  • Saliva/microbiology
  • Sequence Analysis, DNA
  • Silver Compounds/therapeutic use
  • Treatment Failure


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