Silver-Based Topical Agents in Hypomineralised Teeth: A Scoping Review

This scoping review aims to systematically map the existing literature on the use of silver diamine fluoride (SDF), with and without adjunctive light curing, in the management of molar–incisor hypomineralisation (MIH). MIH is a common developmental enamel defect affecting approximately 13–14% of children worldwide. It is characterised by structurally weakened first permanent molars and, often, permanent incisors. Clinically, MIH presents significant management challenges due to rapid enamel breakdown, chronic hypersensitivity, increased caries susceptibility, and poor adhesion of restorative materials. These difficulties are further compounded by high treatment failure rates and behavioural barriers in young patients. Silver diamine fluoride has emerged as a minimally invasive approach that may address many of these limitations. Its dual action as a caries-arresting and desensitising agent makes it well suited for symptom control and lesion stabilisation in MIH. Additionally, laboratory studies have suggested that light curing SDF may enhance surface properties such as microhardness and mineral retention, while also allowing for shorter application times—an important factor in paediatric dentistry. However, while evidence is accumulating on the use of SDF in MIH, and separately on light-curing protocols for SDF in carious lesions, no review has synthesised the literature at their intersection. The purpose of this scoping review is to describe the extent, nature, and quality of published research on the use of silver-based agents—with or without light activation—in MIH-affected teeth. It includes clinical studies, laboratory studies, and ex vivo investigations examining outcomes such as caries arrest, hypersensitivity reduction, structural changes, application time, and patient-related measures. This review is conducted using the Joanna Briggs Institute methodology for scoping reviews and reported according to PRISMA-ScR guidelines. Its expected outcomes are to: Summarise the evidence supporting the use of SDF in MIH-affected teeth. Describe the effects of light curing on SDF in relevant dental substrates. Identify whether any studies exist combining SDF and light curing specifically in MIH. Highlight gaps in clinical evidence and provide direction for future research. By clarifying what is currently known and what remains unexplored, this review will support clinicians in non-invasive MIH management and guide future studies into light-activated SDF protocols for structurally compromised enamel.