The letters SDF stand for Silver Diamine Fluoride.  And it can stop cavities.  For those of you who have not heard of this substance, this article offers your child a cavity cure without the drill and fill routine.  Likewise, you might need to renew and update your knowledge of SDF.  Let’s look at the basics of this unique treatment, legitimatized by the AAPD only about a year ago.

What is Silver Diamine Fluoride (SDF)?

SDF Brings a New Tecnique for Fighting Decay.

There is a New Way to Treat Decay in Kids with Special Needs.

If a child has cavities in his or her primary teeth, you have a choice of how they might be treated.  Remember, cavities are not just holes in teeth.

They are symptoms of a bacterial infection called caries.  And we thought for years that only drilling out the infection and filling the tooth could stop caries.  Ah, but there is another option.  A dentist can delicately paint infected teeth with a 37% solution of silver diamine fluoride.

Not only will the cavity stop, but the tooth will get harder.  The decay is just painted away.

A Mini-Case Study:  Izzy’s Cavities and Options

For example, Izzy is five years old and she is a bundle of nerves and energy.  No one knows why she is terrified of the dentist’s office.  Her shrill screams are enough to peel the paint off the ceiling of the waiting room. She will barely tolerate having her teeth cleaned, much less drilled and filled.

Finding Options with SDF

SDF can treat some cavities, but not all. Each case should be judged on its own merits.

Kids are Cheering for SDF, a Painless and Affordable Alternative to Drill and Fill.

Thus, her worried parents are dismayed when the dentist diagnoses 4 ugly cavities.  Getting the injections and tolerating the sound of the drill will traumatize and terrorize her—and for what?

These are primary teeth, remember.  And they will fall out eventually.  Read on to discover a new option for Izzy.

  1. It is a known fact that the SDF treatment will hold dental decay at bay.  Thus, the first lesson of Silver Diamine Fluoride is that it is a great option for children who, for one reason or another, simply cannot tolerate fillings.
  1. If you were Izzy’s parents, you might rush to say, “That’s magical.  Let’s do that.”  However, do not be hasty in your decision.  The Silver Diamine Fluoride treatment has one really ugly side effect.  It turns the treated teeth a very unattractive shade of brownish black.

Before we tell you what Izzy’s parents decide about her treatment options, let’s review the background of this magical formula.

  1. Silver diamine fluoride is simply a solution containing ionic silver, fluoride, and ammonia.
  2. It effectively stops the progress of carious lesions (cavities) and prevents the development of future caries.
  3. The silver particles extend into the deeper into the dentin of the tooth. (Later they might cause bonding problems for composite resin restorations.  But remember, in this case, we are talking about baby teeth.)
  4. Meanwhile, the fluoride in this solution penetrates deeper into the tooth than other fluoride solutions.  This creates a sort of fluoride reservoir in the tooth structure.  This is a good thing.

“The fluoride component of SDF contributes to remineralization and fluorapatite formation.”  In turn, this produces “harder, more caries-resistant tooth structures.”

  1. The silver in this solution provides the antimicrobial activity for the material.  At the same time, it inhibits biofilm formation.
  2. And 20 extensive clinical studies and systemic reviews have proven all these are positive attributes of SDF

Who Should Have SDF?

  • SDF is a helpful tool when a caries case is extreme.

    In Some Cases, SDF is Your Best Option

    Experts state that SDF is perfect for patients who can not tolerate traditional dental care.  “For noncooperative, medically compromised patients, SDF may be a safe and minimally invasive treatment option.”

  • Other patients who also might directly and obviously benefit from it include “patients on a wait list for operating room treatment.”
  • It is also a fine option for “patients who are noncompliant with oral hygiene…”
  • In the third world countries, this relatively inexpensive treatment is  a boon to individuals with rampant or difficult-to-restore caries…”
  • Likewise, the SDF treatment rescues patients with failing prosthodontic work, and “patients who refuse extraction of non-restorable teeth.”
  • Likewise, it has been very effective for “patients whose temporary condition restricts them from traditional treatment.”

However, the beauty of this treatment is that we need not place a patient in any of these sub-groups to find helpful benefits with SDF therapy.  As the experts in the online magazine “Dental Decisions” state, “this is a viable option for any patient who desires minimally invasive dentistry.

How Parents are Coping with the Side Effect of Blackened Teeth

In view of the ugliness of blackened teeth, many parents must weigh the options.  We find that patients and parents do not care so much about the blackening effect of Silver Diamine Fluoride if the cavities are located at the back of the mouth.

If the decay problem is in the front teeth, more consideration is given to the cosmetic effects of the blackening.

Fear of the Drill Terrorizes Some Children.

New Material and Technique Promise A More Cheerful Time to Come.

Even more importantly, we have discovered that new research is hinting that “A nanoparticle-sized silver material was recently developed.”  The new material “may retain the antimicrobial properties of the larger-sized ion silver material without the discoloring effects.”

This could be wonderful news for patients and parents.  And if it comes to pass, we will bring you the first reports.

However, for now, for little Izzy and her parents, Silver Diamine Fluoride is a great option for treatment.  This is especially true since her cavities are not located in her front teeth.  In her case, the SDF is a kinder, gentler option for treatment.  At Dentistry for Children, any treatment option should be decided on an individual, case-by-case basis.