Silver Diamine Fluoride

How Cavities Work

Cavities, a.k.a. tooth decay, are caused by the acidic by-product of the bacteria in our mouths.  The bacteria eat sugar (or any simple carbohydrate), digest it, and produce acid.  When you don’t brush and/or floss perfectly, these bacteria hang out on the teeth.  The acid they create etches (softens and weakens) the underlying enamel.  This weak spot allows the bacteria to begin working their way into the tooth.  Once they infiltrate past the enamel, they continue to produce acid, which continues to soften the tooth.  This is the inevitable, and historically unstoppable, growth process of a cavity.

How Traditional Dental Fillings Work

One way to stop this inevitable growth is through a traditional dental filling.  The decay, which includes the softened tooth structure and the bacteria, is removed until only healthy, hard tooth structure remains.  The resulting hole, or cavity, is filled with a dental restoration.  Traditional dental filling materials will only adhere to healthy tooth structure.  This is why drilling is necessary.  Because drilling on a tooth causes pain, this is also why local anesthetic (an injection) is necessary.

How SDF Works

The silver in SDF kills bacteria and prevents future bacterial buildup on the site.  The fluoride in SDF remineralizes, or hardens, the tooth structure.  It does not replace missing tooth structure.

One application of SDF has an 80% success rate at stopping a cavity.  The highest success with SDF is achieved when it is applied to a cavity twice a year.

Because it is not a 100% guarantee, it is important for a patient receiving an SDF treatment to comply with all follow-up appointments.

How PFD  Uses SDF

Dr. Cara Kessler revolutionized the way Prosper Family Dentistry treats cavities when she joined our practice.  She has been using SDF since 2015 and taught the PFD staff about its great benefits.

Although SDF has been used for over 40 years in Japan, it only recently gained popularity and FDA approval in the US.  At Prosper Family Dentistry, we use SDF for two different purposes.  1) Its FDA-approved use for treating hypersensitivity, and 2) its more common off-label use for stopping cavities.

What to Expect During an SDF Treatment

Whether the patient is you, your child, or an elderly person, the treatment is carried out in the same manner.  The area around the tooth to be treated is coated with Vaseline, and the tooth itself is isolated with cotton.  The SDF, which is a colorless, odorless liquid, is painted onto the tooth for one minute.

In order to increase the fluoride release from the SDF treatment (and therefore improve the success rate of the treatment), it is then covered with a fluoride varnish.  Fluoride varnish is the sticky material painted onto most children’s teeth at the end of a dental cleaning.

If the cavity is located between the teeth, the liquid is applied to the tooth using dental floss.

A follow-up appointment is scheduled for 2-4 weeks later.  At this follow-up visit, the tooth is closely evaluated and then any holes are restored with a filling material.  This filling does not require injections or drilling into the tooth.

Any holes in the teeth need to be filled because food impaction increases the risk for more cavities in the future.  Dr. Jill and Dr. Cara will discuss the exact details of the specific procedures you need to stop a cavity.

Who Should Have SDF

  • Children – The most common use for SDF is in small children. An SDF treatment requires no injections and no drilling.  It can be completed very quickly at the initial evaluation.
  • Elderly patients – Many elderly patients have complicated medical problems, which makes the use of local anesthetic and dental procedures less safe. They are also less tolerant of lengthy dental procedures.
  • Special needs patients – Patients with special needs have traditionally been sedated to treat dental problems. SDF treatment allows them to have a fast, easy treatment in the dental chair.
  • Cancer patients – Many patients undergoing cancer treatment experience dry mouth and tooth decay. SDF can be used in order to stop the tooth decay and put off any necessary treatment until after cancer treatment is completed.
  • Patients needing a large amount of dental work – Using SDF to stop decay is a great way to slow down the progression of dental disease. This allows dentists and patients to space out needed dental treatment for the sake of time and money.

Why Isn’t Every Cavity Treated with SDF

Some people and/or teeth are not candidates for SDF (see below).  The biggest con of SDF treatment is a dark brownish-black staining of the decayed area.  A dark spot will be seen if the cavity is in an area visible when a person smiles or speaks.  It just does not qualify as “cosmetic” dentistry.  For this reason, most patients do not want it used on their cavities.

Who Should Not Have SDF

The following are considered contraindications for treatment with SDF.

  • Silver allergy
  • Any current mouth ulcers or sores
  • A tooth which does not show enough tooth structure protecting the nerve (due to extensive decay)
  • A tooth that causes pain

How to Find Out if You Are a Candidate for SDF Treatment

Call our office at 972-347-1145 to set up a consultation with Dr. Jill and Dr. Cara.  They will assess any areas of decay and discuss your treatment options including SDF.