Dental medicine has advanced a lot recently. There are now some great new ways to treat cavities in children medicinally without numbing, drilling, or sedating.

Silver Diamine Fluoride

Silver diamine fluoride (SDF) is a minimally invasive way to treat cavities. It’s been used in other countries in Europe, Japan, Australia, etc., for a long time. The FDA approved it for use in 2014, and it became commercially available in 2015. SDF can stop current decay, harden the soft areas of the tooth, desensitize the tooth, and help prevent further decay.

Traditionally, when a dentist finds a cavity, they treat it surgically by anesthetizing the tooth, cutting away the decay and some healthy tooth with a drill, and placing a filling. SDF is a new way of treating these cavities medicinally AND in a minimally invasive way. The American Dental Association now says that non-restorative treatment options for cavities are the standard of care.

It only takes a drop to treat multiple teeth. I clean the teeth, dry them with air or wipe them dry with gauze, then apply the SDF with a microbrush to the cavity. I also like to apply a fluoride varnish over the SDF to seal it off from the oral cavity and to disguise the taste.

Pros of SDF:

• Easy, painless, and fast
• No need for local anesthetic (shots)
• Affordable
• Very safe–very low toxicity
• Desensitizes teeth
• Stops cavities from progressing and prevents future cavities from forming
• Alternative to sedations or general anesthesia

Cons:

• Metallic taste
• May require multiple applications
• Permanently stains the decayed part of the tooth black
• May require a traditional filling or a SMART filling to restore the form and function of a tooth or to cover the black staining
• Cannot be used if there is an infection in the nerve of the tooth

While I love using SDF, it is not a “silver bullet” for every cavity and every tooth. Please call me and ask for a consultation. I would love to evaluate your child and see if he/she is a good candidate for this exciting and innovative alternative to traditional dental treatment.

SMART Restorations

SMART is an acronym for Silver Modified Atraumatic Restorative Technique. SMART restorations use silver diamine fluoride in conjunction with glass ionomer cement to treat and fill in the cavity without numbing or sedating the patient.

Glass Ionomers take only minutes to place, form strong chemical bonds to the tooth, release fluoride to the tooth strengthening it, and seal off the cavity preventing further decay.

SMART restorations cover most of the discoloration left by SDF. If the patient is cooperative, I can use a slow speed drill to clean the edges of the cavity to produce a better looking result.