A medicated liquid currently available as a tooth desensitizer for patients ages 21 and older has also demonstrated success in preventing cavities and stopping the progression of existing cavities.
An increasing number of dentists use this topical solution — silver diamine fluoride (SDF) — off-label for tooth decay prevention and treatment, and some have found it especially beneficial in treating children or those who suffer from dental phobia as an alternative to drilling and filling cavities. However, a recent article in The New York Times addresses some key considerations regarding SDF treatment.
Is SDF Your Teeth’s BFF?
Long used in Australia, China, Japan and elsewhere around the world, SDF was cleared by the U.S. Food and Drug Administration in 2014 for reducing teeth sensitivity. Because of SDF’s classification, and based on extensive clinical research demonstrating its effectiveness, off-label use for cavity treatment is permissible.
The authors of a 2009 study called SDF a “silver-fluoride bullet” in preventing and managing cavities. Earlier this year, representatives of the dentistry and medical programs at the University of California at San Francisco issued a protocol for SDF use in cavity treatment, noting its “ease of application and efficacy,” and that “multiple randomized clinical trials—with hundreds of patients each—support use for caries treatment.”
How SDF Works
Each component of silver diamine fluoride plays a complementary role. The silver is an antimicrobial that kills or prevents the growth of the bacteria that cause tooth decay. The fluoride promotes remineralization of the teeth, and the diamine acts as a bonding agent.
SDF can be brushed onto cavities, or onto teeth that are at risk for decay. Compared to other preventive measures and treatments, SDF is fast, cost-effective, and free of discomfort.
Drawbacks of SDF
So what’s not to like about silver diamine fluoride? The main disadvantage, as The New York Times article points out, is aesthetic. SDF turns the brownish tint of a cavity black; in fact, SDF stains most surfaces black. This is why dental sealants provide a better overall preventive choice.
The discoloration may be of little consequence if the affected tooth is a baby tooth that will eventually be replaced, or if it’s a molar that will otherwise not be visible. But it limits the teeth for which SDF is an appealing treatment option. SDF is also not yet widely covered by insurance or Medicaid, although it is a relatively inexpensive treatment that may be worth considering for some patients.Dr. Mark Dunayer is dedicated to providing compassionate, comprehensive dental care to patients in the Rockland County area. Please call B & D Dental Excellence today at