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Girl sitting in dental chair holding fake teeth

Delaying Tooth Decay with Silver Diamine Fluoride

Dental caries affect 1 out of 4 children aged 2 to 5 years old, according to the American Academy of Pediatric Dentistry. Today, there is a less invasive and more conservative way to treat dental decay in the pediatric population. Silver diamine fluoride was approved by the Food and Drug Administration in 2014 as a desensitizing agent to help with hypersensitive teeth. It is also used to arrest dental cavities.

Silver diamine fluoride works as an antimicrobial agent to prevent bacterial growth. It hardens the weakened tooth structure, inhibits plaque bacteria and stops the cavity from growing. This colorless/blue liquid is carefully applied to the affected teeth and stops the cavity from growing, arresting decay ideally until the tooth is ready to exfoliate. The procedure takes only a few seconds but may require multiple applications.

SDF is particularly desirable due to the fact that no anesthetic is needed for it to be applied, which is not the case with fillings and crowns. It is useful for children with special needs, younger than 3 or with challenging behavior or dental anxiety.

Dr. Rula Shalabi of Indigo Pediatrics Dentistry in Easley has been using SDF on her patients for several years. She often recommends this alternative to treating cavities in young children due to its high success rate in arresting decay.

“Our goal is to protect and keep baby teeth for as long as they need to remain in the mouth. When toddlers or children who are fearful of the dentist present with cavities, SDF can often be discussed as an option for treatment to avoid sedation at an early age. SDF allows us to arrest that decay so that we can gain time to earn the trust of our young patients. At times no further treatment is needed,” she explained.

Dr. Shalabi did mention that, of course, there are exceptions and that sometimes the teeth are too far gone with decay to use SDF.

“In those cases, the child may need a filling, crown or even an extraction,” she said.

SDF will not rebuild the tooth like a filling or crown would.

“Sometimes a tooth has a gaping hole that has to be filled. So SDF will not work for that as food and bacteria would get trapped in that hole,” she said.

“Baby teeth are space maintainers as jaws grow,” Dr. Shalabi explained. “If you lose a baby tooth prematurely, then you lose space for the permanent tooth. And then braces will undoubtedly be needed later down the road.”

She added, “Many special needs children will remember a traumatic experience where they were sedated for a dental procedure, and that is why it is best to avoid that if at all possible. They will only remember us touching that ‘hurt’ tooth, so SDF allows us to practice minimally invasive dentistry without causing fear.”

The only side effect of SDF is that it permanently stains the decayed part of the tooth black. It could also temporarily stain the skin, but this will go away after a few days.

Although SDF arrests cavities with a 90% success rate, Dr. Shalabi mentioned that the best treatment is preventive care.

“See a dentist every six months starting at 1 year of age or within six months after the first tooth erupts,” she said. “Brush your children’s teeth two to three times a day. And limit the frequency of snacking, sugary food and drinks, especially at bedtime.”

The National Institutes of Health reported that children with poor oral health are three times more likely than their counterparts to miss school as a result of dental pain.

“When children are in pain, they will develop fear, lose sleep and will not be able to concentrate at school,” Dr. Shalabi concluded.

Although SDF works great, it is not for every cavity and every tooth. Dr. Shalabi encouraged speaking to your dentist to discuss your options.

For information on SDF or Indigo Pediatric Dentistry, visit www.smilewithindigo.com or call 864-442-6770.

By Theresa Stratford

Filed Under: Pediatrics, Sponsored Medical Content

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