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Background  The microbiome of Severe-Early Childhood Caries (S-ECC), is characterized by an ecosystem comprising bacterial and fungal species, with a predominance of  Candida  species. Hence, an anti-cariogen effective against both bacteria and fungi would be valuable in the management of S-ECC.  Here we evaluate the antifungal effect of silver diamine fluoride (SDF) against 35-clinical yeast isolates (Ten-each of  C. albicans ,  C. krusei, C. tropicalis  and five  C. glabrata  strains) from dentinal caries-lesions from S-ECC.    Results  Disc-diffusion and time-kill assays as well as MIC 50  and MIC 90  evaluations against therapeutic concentrations confirmed the broad-spectrum anti-candidal potency of SDF. Ultrastructural images revealed morphologic aberrations of yeast-cell walls on exposure to SDF. All  C. krusei  and  C. glabrata  isolates were significantly more sensitive to SDF, relative to the standard antifungal fluconazole. Further, SDF appears to effectively abrogate filamentation of  C. albicans  even at very low concentrations.    Conclusions  Our data, for the first time, elucidate the antifungal potency of SDF, in addition to its known antibacterial activity, in the management of S-ECC.

Silver diamine fluoride (SDF) used in childhood caries management has potent antifungal activity against oral Candida species