An Exciting New Treatment for Cavities

Our patients at Designer Smiles know that we are committed to staying on the cutting edge of dentistry.  Our office is full of advanced dental technology, and our doctors spend countless hours in continuing education.  The goal of these strivings is to make dental care more efficient, safer, more predictable, and more comfortable.

We do not just try to do old things in new ways.  Sometimes we learn completely new ways of practicing dentistry!

What is SDF?

One of these new ways of practicing general dentistry comes in the form of a dental material called Silver Diamine Fluoride (SDF).  This material is new to us and new to the United States.  It has been used with great success for decades worldwide and for over 80 years in Japan.

SDF is a colorless liquid, about the consistency of water.  The two main ingredients are silver and fluoride, which are linked by an amine compound (which explains the name).  It tastes awful and typically leaves a stain on soft tissue like skin, lips, gums, etc . . .

What Does SDF Do?

SDF stops cavities!  Isn’t that exciting?

In the past, dentists have used various materials to slow down cavities and to prevent cavities.  SDF actually stops them.  There are decades of research to support this ability.

Of course, it is not 100% effective.  Nothing is.  Most studies show a success rate of greater than 80% at “arresting caries”.  That is the scientific term for “stopping cavities”.

SDF is also a great tool for treating sensitive teeth.  It hardens and strengthens enamel to block cold temperatures.  It can also treat the sensitivity caused by exposed root surfaces.

You see, the roots of our teeth do not have enamel covering them.  Without enamel, the underlying tooth structure, called dentin, easily transmits sensations of cold, hot, and sweets directly to the tooth’s nerve through tiny pores called tubules.  SDF plugs those tubules, preventing those sensations from reaching the nerve, and thus stopping tooth sensitivity.

How Does SDF Work?

To understand how SDF works, we first need to explain how cavities work.  Bacteria in our mouths eat sugar, and when they digest it, they produce acid.  This acid softens and weakens enamel, which allows the bacteria to sneak into the enamel, dissolving it as they go.  Once the bacteria have gotten past the outer layer of enamel, they start working their way into the underlying dentin, which is softer and easier to plow through.

The silver ions in SDF kill the cavity-causing bacteria.  Silver is well known for its antibacterial properties.  Silver stops the bacteria in their tracks.

Fluoride’s job is to remineralize the dentin or enamel.  To be clear, it cannot rebuild missing dentin or enamel.  But it can harden enamel or dentin that is still present.

So SDF kills the bacteria working their way through a tooth and harden the tooth structure that has been softened.  The cavity stops.

The Cons of SDF

“This sounds too good to be true!  There have to be some negatives.”  Yes, there are a few.

• SDF stains the cavity black, so there is an obvious cosmetic objection to SDF.
• SDF stops the cavity but does not replace missing tooth structure, so the hole is still a hole. This means you would still catch food and be at risk for gum disease.
• The silver it contains makes it dangerous for people with a silver allergy.
• It should not be used on patients with any open sores or ulcers in their mouths.

What is an SDF Treatment Like?

It is very simple!  We may place some type of barrier or protection on the gums nearest the cavity or sensitive surface being treated.  We apply the SDF liquid to the accessible cavity surface using a small brush.  We apply it to between-the-teeth cavities with floss.

That’s it.  Pretty simple.

Is There any Follow-Up Care Required?

YES!

Applying SDF to a cavity does not guarantee that you will never have a problem with that tooth again.  And remember the 80% success rate?  We cannot promise that it will work for you.

We must monitor every tooth treated with SDF very closely.  Some people require an additional application of SDF, and others with large cavities need to have the cavity filled in once it has been “arrested”.

Who is a Good Candidate for SDF Treatment?

SDF is not a cure-all for anyone with cavities.  Most of our patients are not okay with having black stain on their teeth.  And we are not okay with leaving large holes that collect food and lead to gum disease and cavities on neighboring teeth.  That being said, there are some particularly great candidates for SDF.  Here are the most noteworthy:

1. Very young children – Dental work can be traumatic for kids. Their baby teeth are going to fall out.  Stopping decay on children with SDF buys them time to get a little older and more mature before having to endure dental treatment.
2. Very old patients – Older patients present some unique challenges to dentistry. They have a higher risk for cavities due to multiple health problems with lots of prescription medications.  They sometimes have difficulty cleaning their teeth properly.  Their tolerance for long dental appointments is lower than it was when they were younger.  When they do not have a cosmetic objection to the dark staining, SDF is a great way to treat cavities in geriatric patients.
3. Patients with mental challenges – Many patients with mental challenges simply cannot make it through dental treatment without being sedated. Because SDF treatment is completely non-invasive and very quick, it is a great option for treating cavities in mentally challenged patients.
4. Patients with widespread dental problems, requiring extensive dental work – There are some cases when a person just cannot stay ahead of the cavities. Due to financial or time constraints, they can only complete so much dental work at a time.  The cavities that are put on the “back burner” slowly progress and get larger.  Sadly, by the time you get to the back burner cavities, they have grown and need more extensive treatment than was originally planned.  With SDF, you can stop that progression and buy more time to complete a large or complicated docket of dental work.  The staining is then temporary because it will be removed and repaired with a cosmetic filling eventually.  For people who feel that their cavities are in an out-of-control state of deterioration, being able to stop the cycle and gain a predictable treatment plan makes this side effect worth any temporary cosmetic embarrassment.

Are You Interested in SDF for Yourself or a Loved One?

Call Designer Smiles today to schedule a consultation with Dr. Ann and Lauren.  They will go over all of your options, including SDF treatment for cavities.