Dr. Paula Ancelson’s Take on Silver Diamene Fluoride

The New York Times published an article about the Silver Diamene Fluoride, a newly approved cavity fighting treatment, and its potential impact on treating children’s tooth decay. No shots? No drilling? No tears? No way! Let’s discuss…

Tooth decay is the single most common disease of early childhood, five times more common than asthma. Cavities, or dental caries, are a chronic, infectious, transmissible disease that is totally preventable. When bacteria that live inside the mouth, strep mutans, have sugars to consume from our diet, they erode teeth and cause decay. What separates cavities from other bacterial diseases is that they are already antibiotic resistant and teeth, unlike skin or bones, do not repair themselves. A dental filling makes a decayed tooth as good as new. However, research shows that without improved diet, brushing, and flossing, fillings do not necessarily prevent future decay. By teaching the importance of oral health at age 1, we can help reverse the rising rate of childhood cavities in America.

There is currently a move in dentistry away from the traditional drill and fill (surgical) approach to a medical approach, trying to address the bacterial cause of tooth decay. Silver Diamine Fluoride (SDF) is a clear liquid medicine that actually stops the decay process once painted onto tooth decay. First, your pediatric dentist will dry off the cavity with air and cotton, and then you dentist will use a brush to paint SDF onto the decay and let it dry. And that’s it! The silver acts as an antibacterial agent and stops the decay from progressing, killing the bacteria. The fluoride remineralizes and strengthens the tooth, actually hardening the decay for a finite period of time. In fact, SDF has been shown to successfully help relieve tooth pain and hypersensitivity. Silver Diamine Fluoride has been available and widely used in many countries including Japan, New Zealand, Australia and others for decades but was only cleared for sale in the USA in August 2014 by the Food and Drug Administration (FDA).

For our pediatric patients, cavity treatment usually involves a shot, a drill, and filling material. SDF treatment is completely atraumatic to a child and to their teeth. The process is completely painless and does not involve the use of any instruments, drills, or anesthesia – just a small brush! This helps build a good relationship between children and dentists, avoiding potentially traumatic experiences. By stopping dental decay and killing the bacteria with Silver Diamene Fluoride, we are able to address the root of the issue. Although a child may need multiple SDF applications to be fully maintained, the treatment can last the lifetime of a baby tooth.

The only drawback is that SDF turns the decayed part of the tooth black. The healthy part of the tooth does not discolor. This treatment dramatically decreases the possibility of tooth pain, need for baby root canal treatment, or possible extraction by stopping dental decay from progressing. The good thing is that these teeth may be treated with white filling or crowns once the child is able to sit and cooperate for conventional treatment, concealing the darkness of the decay.

My mission as a Pediatric Dentist is to treat each child individually, taking into account his or her own unique needs. While proper brushing techniques, healthy nutrition, and early oral health assessment by a dental professional are the best ways to avoid tooth decay, cavities do happen and it’s important to know your options when they do.  Silver Diamene Fluoride presents a great new option in the field of pediatric dentistry, that may be right to treat your child’s cavities, tear, shots and drilling free.