By Mary Otto
A University of California San Francisco (UCSF) study published earlier this year laid out a protocol for the use of silver diamine fluoride (SDF) for arresting the disease process that drives tooth decay.
“Until now, no option for the treatment of dental caries in the United States besides restorative dentistry has shown substantial efficacy. Silver diamine fluoride is an inexpensive topical medicament used extensively in other countries to treat dental caries across the age spectrum,” wrote the authors.
The UCSF team also developed guidelines for the use of SDF and an informed consent form for use by patients.
The authors built upon earlier work done by other researchers including a widely cited systematic review published in 2009 entitled “Silver Diamine Fluoride: A Caries “Silver Fluoride Bullet?”
“The availability of a safe, effective, efficient, and equitable caries-preventive agent appears to meet the criteria of both the WHO Millennium Goals and the US Institute of Medicine’s criteria for 21st century medical care,” observed the authors of the Silver Bullet paper.
In a recent “Science in the News” article, the American Dental Association noted that a search of ClinicalTrials.gov for SDF returned 14 studies; 7 of which have been completed, 5 that are recruiting, and 2 that have not yet begun recruiting.
“This suggests that more scientific insight and news will likely be forthcoming about this product,” the article noted. The ADA’s embrace of silver diamine fluoride has been somewhat guarded, as the article noted.
“SDF is not a complete solution to caries risk. Single application has been reported to be insufficient for sustained benefit. Its downsides include a reportedly unpleasant metallic taste, potential to irritate gingival and mucosal surfaces, and the characteristic black staining of the tooth surfaces to which it is applied.”
Because it has been classified as a topical fluoride, dental auxiliaries are also beginning to explore the use of silver diamine fluoride.
The Oregon Board of Dentistry moved to allow dental auxiliaries to apply silver diamine fluoride soon after it was cleared for marketing by the Food and Drug Administration in 2014, Donna Domino reported for DrBicuspid.com.
“And, since dental auxiliaries in most states are authorized in most states to apply SDF, they can now apply SDF,” she wrote.
Earlier this year, the California Dental Hygienists Association issued a statement to members promoting the use of the compound to halt decay and address sensitivity.
“With the exception of restorative dentistry, to date there has been no other option in the U.S. to stop the progression of dental decay. With the recent approval by the FDA, there is a now a new protocol in stopping cavity progression; Silver Diamine Fluoride (SDF). With an application similar to fluoride varnish, SDF is very simple and quick to apply. The application is as simple as drying the tooth and applying the SDF to the decayed teeth. Clinical evidence suggests a twice yearly application until the baby tooth is lost or the tooth can receive a permanent filling,” the group wrote.
In a March article for Oregon’s Wilsonville Spokesman, reporter Jake Barton examined the work of a local dentist and researcher who has helped bring attention to the wider potential use of silver diamine fluoride.
“When Wilsonville dentist Steve Duffin began to look for a way to address soaring rates of dental disease at his Keizer clinic 10 years ago, he didn’t expect to find his way into a burgeoning movement in the world of American dentistry,” Barton wrote.
“But when he began to practice a long-forgotten technique for treating cavities without fillings, he discovered what he calls a “miracle” that he believes has the potential to change the lives of the millions around the world who face poor access to dental care.”
Is there a story about silver diamine fluoride in your community?
Mary Otto, AHCJ’s topic leader on oral health, is writing blog posts, editing tip sheets and articles and gathering resources to help our members cover oral health care. If you have questions or suggestions for future resources on the topic, please send them to mary@healthjournalism.org.
