Treatment offers an alternative to ‘drill and fill’

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

Photo: Jan Fidler via Flickr

Photo: Jan Fidler via Flickr

A study presented this summer at an international dental conference has added to growing evidence that topical applications of silver diamine fluoride can serve as an effective treatment for tooth decay.

The paper, presented at the meeting of the International Association of Dental Research in South Korea, concluded that annual application the compound stopped the progress of root decay among community-dwelling elders living in Hong Kong.

The mixture, which is painted onto decayed lesions, contains fluoride, which helps remineralize the damaged tooth, and silver, which kills the bacteria that drive decay. The product has been used in Japan for more than 80 years, but only relatively recently has attracted the attention of U.S. oral health providers.

In 2014, silver diamine fluoride was cleared by the U.S. Food and Drug Administration to be marketed as a treatment for dental sensitivity in adults. Now some U.S. dentists have begun using it off-label as an alternative to drilling and filling teeth, as media that include DrBicuspid.com, the Baltimore Sun and the New York Times have reported.

There are a few drawbacks to its use, the stories note. Silver diamine fluoride blackens the decayed area of the tooth to which it is applied. In addition, the treatments are not always covered by insurance. On top of that, presence of deeper decay still may require a traditional filling.

But the fact that silver diamine fluoride can be painlessly and inexpensively brushed onto the teeth makes it an appealing treatment option, particularly for elderly, disabled and institutionalized patients as well as for young children who might otherwise need to be placed under anesthesia for dental treatment.

Public health dentists who worked for the original clearance for the use of the material in the United State are now seeking FDA approval for a dental caries indication for silver diamine fluoride, reported Donna Domino for DrBicuspid.com. Clinical trials are underway that could provide more evidence of its effectiveness.

Is silver diamine fluoride coming to a dental school or dental office in your community? A new tip sheet provides some resources to help you explore the growing interest in this non-invasive alternative to drilling and filling.

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