What is Silver Diamine Fluoride (SDF)?
What is old is new again!
About 100 years ago, dentists used to treat cavities with Silver Nitrate. This sometimes worked. It would arrest decay, harden the tooth, and basically the “rot” would stop. But then new drilling techniques, new filling materials, and new dentists saw that as an “old” way of treating decay; and saw a “drill and fill” model of treating cavities as the “best way” to treat cavities. Well to be honest, “drill and fill” is a SURGICAL model of treating cavities, but it doesn’t actually “TREAT” the disease itself.
Fast forward 100 years. There is a new product, reformulated as Silver Diamine Fluoride that works similarly to the older Silver Nitrate (only better, of course).
To apply SDF, we first dry the teeth (using air and cotton rolls), we dab on a single drop of SDF on the lesion for one minute, then we seal the lesion with fluoride varnish. We come back a few weeks later and repeat the process to ensure the treatment has taken hold in the lesion.
It is inexpensive, safe, painless, non-surgical, MEDICAL way to treat cavities and it actually goes to the root cause of cavities, -the bacteria that cause cavities.
(For more information about a medical model of treating cavities, see my blog Medical management of Caries (decay) Posted on ).
The downside? It turns the treated lesion black. This is both a good thing and a bad thing. Black isn’t very pretty, but it only shows up on a decayed tooth, not on sound tooth enamel. This helps a dentist see a lesion better so if “drill and fill” treatment plan is decided on later, the dentist can actually see the lesion being drilled and so the actual filling can be kept to a minimum. From a cosmetic standpoint, people don’t like to see blackened teeth, but they are teeth that are healthier and stronger.
For certain populations, such as very young children and people with cognitive issues, this is a blessing not to have to have to treat caries in a hospital setting.
Here is a link to a fact sheet about SDF.
Here is a link from a PBS report about SDF.
And lastly, another link to a dental publication about using SDF in older populations.
SDF was approved by the FDA in 2014. A new CDT #D1354 (dental treatment code) was created in 2016. Here in Oregon, the Oregon Board of Dentistry has recently allowed Dental Hygienists to treat teeth with SDF.
Let me know if you are interested in this exciting new (old?) treatment!
Ann Ossinger is a Registered Dental Hygienist who owns DoorStep DentalHygiene, LLC, a mobile dental hygiene service that provides dental hygiene services to people who would otherwise be unable to go to a regular dental clinic in the Linn-Benton Counties of Oregon. 541-990-0814. Please contact Ann if you have any questions!