Silver Diamine Fluoride: Is this Drill-free Dental Procedure the Future for Kids’ Cavity Treatment?

Too many children in Arizona experience tooth decay. In fact, more than half of Arizona’s kindergarten children (52%) have decay experience, a level higher than the national average for 5-year-olds (36%), according to the Healthy Smiles Healthy Bodies Survey.

Silver Diamine Fluoride

Silver diamine fluoride can help fight childhood tooth decay and cavities through a painless, preventive dental care procedure.

The traditional treatment for cavities is to drill out the decay and provide a dental filling, which can be a scary experience for young kids. Silver diamine fluoride (SDF) may be the new answer to an old problem. First approved by the Federal Drug Administration in 2014 for use in the United States, this cavity-fighting, smile-saving serum wasn’t commercially available for dentist office use until 2016. In as little as 30 seconds, this clear liquid can be painted on the surface of teeth with early, non-symptomatic cavities to stop the progress of decay. No drills. No needles.

The Silver Diamine Fluroide (SDF) Timeline

SDF made its premiere in Japan 900 years ago and has been used overseas for over 30 years. It was first cleared in the U.S. for adults 21 and older as a tooth desensitizer. But as SDF studies grew, researchers began to see how it could slow cavity growth.

Finally in 2017, the American Academy of Pediatric Dentistry (AAPD) released new guidelines, recommending silver diamine fluoride for the treatment of cavities in children and adolescents, including those with special needs.

Delta Dental of Arizona dentist Dr. Jeanette MacLean was an early adopter of SDF, using the liquid as a first line of defense for kids experiencing tooth decay. In an article for the dental blog The Daily Floss, MacLean explains why she’s become such an advocate for the treatment, claiming it has dramatically reduced the number of minimal oral conscious sedation cases she does in her pediatric practice and completely eliminated the use of in-office deep IV sedation.

Drug-Free, Drill-Free and Fast

Fillings are uncomfortable for kids. Between anesthesia and procedure, filling a cavity can take up to 30 minutes. That’s a long time to ask a child to sit still and let the dentist work on a decaying tooth. For kids with dental anxiety, those 30 minutes can feel like an eternity and be wrought with fear.

With SDF there’s no drill, no drugs and the deed is done in less than 5 minutes. This makes the alternative treatment option ideal for many kids with special needs.

What About the Cons?

The positives of SDF outweigh the negatives, according to the AAPD. One downside is it darkens the tooth decay, turning its brownish tint to black. “People assume that parents will reject it because of poor aesthetics, (but) if it means preventing a child from having to be sedated or having their tooth drilled and filled, there are many parents who choose SDF,” MacLean said in a New York Times article exploring the merits of silver diamine fluoride.

SDF is also cited for its unpleasant, metallic taste and repeated applications may be required.

SDF isn’t available at every dental office nor is it the right treatment for every child with a cavity. If there is infection or if the decay is too severe, SDF cannot be used.

The Cost

Because it’s still relatively new, few dental insurance companies cover the cost of silver diamine fluoride. Instead, insurance companies may pay an alternate benefit for fluoride varnish. The caveat? Fluoride varnish is a preventive treatment and doesn’t stop the spread of decay.

Many parents who opt for SDF to treat early or non-symptomatic cavities pay out-of-pocket for the treatment, but it often costs less than a traditional filling.

If you’re interested in learning more about silver diamine fluoride, talk to your child’s pediatric dentist. Your child’s twice-yearly dental exam and cleaning is a great opportunity to do so.

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