A nonrestorative approach to the management of dental erosion is the foremost option: controlling dental erosion. The objectives of this study are to provide an overview and to summarise the effects and properties of topical anti-erosive agents as a nonrestorative treatment of dental erosion. A literature search was conducted on five databases of peer-reviewed literature—Cochrane Library, EMBASE, PubMed, Scopus and Web of Science—to recruit articles published between 1 January 2000 and 31 December 2021. The literature search identified 812 studies; 95 studies were included. Topical anti-erosive agents can be broadly categorised as fluorides, calcium phosphate-based agents, organic compounds and other anti-erosive agents. In the presence of saliva, fluorides promote the formation of fluorapatite on teeth through remineralisation. Calcium phosphate-based agents supply the necessary minerals that are lost due to the acid challenge of erosion. Some organic compounds and other anti-erosive agents prevent or control dental erosion by forming a protective layer on the tooth surface, by modifying salivary pellicle or by inhibiting the proteolytic activity of dentine collagenases. Topical anti-erosive agents are promising in managing dental erosion. However, current evidence shows inconsistent or limited results for supporting the use of these agents in clinical settings.

To investigate anti-erosive effect of silver diamine fluoride (SDF) against enamel erosion and assessed associated color change. This three-phase crossover in situ study compared anti-erosive effect of SDF and stannous chloride/amine fluoride/sodium fluoride mouthrinse (SNF) against distilled water (DW, control), while evaluating enamel color changes. Fifteen adults (27-35 years) wore palatal appliances with four-enamel blocks per phase, alternating 14-day intervention periods (weekly 38% SDF [255,000 ppm Ag, 44,800 ppm F], daily SNF mouthrinse [800 ppm Sn, 500 ppm F], or weekly DW) separated by 7-day washouts. Appliances were exposed with five 2 min extraoral erosive challenges (citric acid, pH 3.2) daily. Post-intervention analyses included salivary pellicle morphology (atomic force microscopy, AFM), enamel surface integrity (scanning electron microscopy, SEM), elemental composition (energy-dispersive X-ray spectroscopy, EDS), crystal structure (X-ray diffraction, XRD), surface microhardness loss (hardness tester), surface loss (optical profilometry), and color change (spectrophotometry). AFM revealed altered pellicle morphology in SDF and SNF groups. SEM demonstrated reduced enamel erosion in SDF and SNF versus DW. EDS confirmed Ag⁺ deposition in SDF and Sn²⁺ in SNF. XRD identified fluorapatite in SDF and SNF groups. SDF showed the lowest surface microhardness loss (21.7±1.0%) and surface loss (µm) (2.7±0.6), followed by SNF (30.0±1.1%; 3.2±0.7), and DW (42.4±1.0%; 5.4±0.8) (p<0.001). However, SDF caused greatest color change (ΔE₀₀=6.6±2.1), followed by SNF (ΔE₀₀=5.8±1.0), and DW (ΔE₀₀=3.6±1.7) (p<0.001). Weekly SDF application demonstrated superior erosion resistance compared to daily SNF, likely attributed to silver-fluoride-induced fluorapatite crystallization and pellicle structural reinforcement. However, enamel staining is an esthetic trade-off.

To evaluate anti-erosive effect and associated color change (ΔE₀₀) of 38% silver diamine fluoride (SDF) on human dentine. A crossover in situ study involving 15 volunteers was conducted. Participants wore an intra-oral appliance carrying four dentine blocks for three 14-day treatment phases, separated by a 7-day washout period. Three treatments included weekly application of 38% SDF (255,000 ppmAg and 44,800 ppmF, Group SDF), daily application of stannous chloride/amine fluoride/sodium fluoride (800 ppmSn and 500 ppmF, Group SNF), and daily application of deionized water (Group DW). Appliances with dentine blocks were exposed to citric acid (pH 3.2), five daily extraoral erosive challenges. Dentine blocks were assessed for percentage surface microhardness loss (%SMHL), dentine loss, salivary pellicle morphology, crystal characteristics, dentine surface morphology, elemental composition, and ΔE₀₀ by a microhardness tester, optical profilometry, atomic force microscopy (AFM), X-ray diffraction (XRD), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS), and spectrophotometry, respectively. %SMHL of the experimental groups were SDF:23.3±2.4, SNF:30.2±2.0 and DW:42.4±2.2 (SDF<SNF<DW; p<0.001). Dentine loss (μm) were SDF:4.2±1.1, SNF: 6.1±1.4, and DW:10.5±1.4 (SDF<SNFDW; p<0.001). Weekly application of 38% SDF demonstrated significantly better anti-erosive protection but caused black staining on dentine surfaces. SDF with weekly application has been demonstrated to be effective in preventing dentine erosion, although dentine staining remains a clinical consideration.