At Coastal Pediatric Dentistry our goal is to try to provide the best care to our young patients that we can. Occasionally, we have small children that have difficulty sitting still or cooperating for procedures, have extensive decay or are hyper-afraid of needles or drills. Fortunately, there is a fantastic alternative to drilling or anesthetic! We offer a painless, non-invasive, alternative that will kill the bacteria and arrest the decay in the teeth.
What is Silver Diamine Fluoride?
This procedure has been used for many decades to treat decay without the need to drill out the tooth decay (also called dental caries). In 2014, the U.S Food and Drug Administration (FDA) cleared SDF as a method of desensitizing and stopping the progress of decay, particularly in “baby” teeth.
The use of Silver Diamine Fluoride is a non-restorative procedure. This means there is no drilling or filling placed – it is a solution that is applied to the decayed portion of the tooth that shows either early or advanced decay. This is when part of the outer enamel or chewing surface is missing. SDF contains silver which will kill the bacteria that are causing tooth decay. In addition, it contains fluoride to help strengthen the outer layer of the tooth to resist additional decay from occurring. It can be applied more than once to the tooth over time to prolong and enhance the effects.
Applying Silver Diamine Fluoride (SDF) is considered an intervention, it does not ‘restore” the tooth. The benefit of using it is that it will help to prevent additional decay from occurring on the tooth, particularly when either it doesn’t make sense to restore a baby tooth that is about to fall out soon, or perhaps, there are multiple sites of decay present and financially, it may not be feasible to restore all the teeth. Another few reasons SDF is a viable solution for patients, is the patient may be anxious and not be able to sit still for a long period or even have either an intellectual or physical disability that makes restoring the baby teeth challenging and a simpler method to arrest the decay is preferred.
One of the drawbacks of using SDF is that it may cause the area of the tooth where the gel is applied to turn a dark or black color. For this reason, patients may not want it used in the front teeth. It is important for the patient to understand this in advance of treatment. It will not cause healthy enamel to turn black, just the decayed areas. It can be used as an interim treatment when treatment needs to be phased over time, either due to scheduling or financial issues. This procedure is best when applied again after six months and closely monitored for effectiveness.
If applied to a baby tooth, it will not affect the adult tooth that replaces it in a few months or years. The liquid is somewhat caustic and can cause brown or white stains on the surrounding tissues such as the lips or the tongue if it touches it. While this is more of a cosmetic annoyance, any tissue staining is temporary but it can last for up to three weeks. Because it stains, it can also potentially stain any clothes if it is dropped on those as well, so caution should be used when placing it, as well as excellent isolation.
It is advised to remove as much decay as possible with a hand instrument if there is loose decay or sharp edges prior to placing the solution. The entire process takes less than five minutes from start to finish for most patients. The SDF creates a hard covering over the decay and prevents additional decay from occurring.
At Coastal Pediatric Dentistry, we offer a variety of preventative and restorative solutions. When you and your child come in to see us at any of our convenient locations, we will explain alternative solutions to you. In many cases, doing early preventative treatment can prevent more invasive treatment as your child gets older.