Wednesday, August 3, 2016

Silver Diamine Fluoride - An Old Remedy Finds Its Way Back to Dentistry

Silver Diamine Fluoride

There’s been a lot of buzz lately about a “new” product in dentistry. Maybe you’ve read the New York Times article or seen a friend post it on Facebook lately- it’s called Silver Diamine Fluoride (or SDF). We’ve put together a little FAQ for you.
  • So what’s this miracle stuff all about?
    • Well, for one thing, it’s kind of retro! It’s been around for decades, but somehow been forgotten by modern dentistry in the US. It’s actually been used in Japan for over 80 years! It’s a great medication to apply to cavities as an interim procedure so we can delay treatment of cavities as well as prevent new ones from forming.
  • What is it and what does it do?
    • SDF is a clear colored liquid containing silver ions & fluoride that, when applied to a cavity, binds with the tooth material and can stop the cavity from growing. It also actively kills the cavity causing bacteria, so it can help prevent new cavities from forming elsewhere in the mouth.
  • How do you use it?
    • The dentist applies it on a dry cavity surface (tooth) with a little tiny puffy brush, waits a minute, then rinses with water. It’s recommended to repeat the procedure again after 2-4 weeks, and possibly a 3rd time another 2-4 weeks later. Reapplication at subsequent cleaning appointments is also recommended.  Pretty cool stuff!
  • Awesome! Any downsides?
    • This clear liquid, when bound to a cavity, turns BLACK. So where you once had a brown spot (cavity), you now have a black spot (stopped cavity). Also, if a drop of it gets on the skin or clothing, it could darken a spot on the skin (temporarily- like a henna tattoo). Or your clothes. We are really careful not to let that happen, but it could!
  • Well that sounds great! We should be using it on everyone! I don’t want my kids getting cavities!  
    • It is pretty great, BUT….(there’s always a but!) say we put it on a cavity- that’s a big open hole. Food is constantly getting pushed down into that hole every time we eat, which can be painful! Additionally, that remaining tooth structure is weakened because it is thinner and has a higher chance of cracking- which can lead to further problems. Also, black holes in teeth aren’t the look most of us are going for, so most people will want to restore eventually for esthetic reasons.
  • Ok, so who is this best for?
    • In both the current literature & practice, we are finding it best for very young children who have cavities but are too young to sit through longer dental procedures, as well as overall lowering of cavity risk in those who have very high cavity rates. It’s also great for our medically compromised & behaviorally challenged patients for both treatment and prevention. Remember, ultimately we still plan to restore these teeth for reasons we mentioned previously. This is still just an interim treatment for most patients!