1) SILVER DIAMINE FLUORIDE (SDF) - Typically applied to posterior teeth only
SDF has been used in other countries for over 80 years. Silver has been used in dentistry in the United States as far back as the 1800's with early research papers published in 1891. The silver aspect of the product is antibacterial and has been shown to kill bacteria that cause both gum disease and cavities. The fluoride has many benefits including strengthening the tooth structure as well as reducing sensitivity. This product is easily applied in only a few minutes and is best done right after a cleaning. SDF has the ability to STOP decay in its tracks as seen in the links below but also has a great option of focused prevention. This material can infiltrate healthy tooth structure -even under fillings and crowns- to STOP DECAY OR PREVENT DECAY. It is recommended to be reapplied every 3-18 months depending on the situation and individual patient risk factors (dry mouth, a lot of existing dental work, plaque accumulation, etc.). This product creates a fluoride reservoir where applied which will get recharged every time fluoride toothpaste/mouthwash is used. The only consideration is potential staining from the silver. This ONLY occurs on weakened tooth structure and is why we typically only apply to back teeth.
* Some patients have "white spot lesions" or "decalcified" areas that could potentially stain from the silver. If there is a potential esthetic issue, we offer CURODONT which is listed below.
*Fillings are still necessary in certain situations depending on risk factors like food getting stuck, dry mouth, difficulty cleaning, poor oral hygiene, etc.
- https://www.rdhmag.com/patient-care/fluoride/silver-diamine-fluoride/article/14175344/silver-diamine-fluoride-sdf-dental-caries-in-older-adult-patients
- https://www.today.com/health/silver-diamine-fluoride-treating-tooth-cavities-without-drilling-t195501
- https://pubmed.ncbi.nlm.nih.gov/30829497/
- https://www.webmd.com/oral-hea...
2) CURODONT - DRILL-FREE CAVITY TREATMENT applied to front teeth or back teeth where there is weakened tooth structure that could be an esthetic concern
Curodont is a clear topical material that creates guided enamel remineralization. The material is painted on the teeth to create a peptide scaffolding in the damaged area to help demineralize the tooth and draw calcium, phosphate, and fluoride to the area over several weeks. This material is more technique-sensitive and is more costly than SDF but has no risk of discoloration. It has been backed by research as seen below. This material is currently not utilized under existing restorations/fillings/crowns but, as research continues, that may change. This has been used around braces to help reduce/prevent white spot lesions and can be very helpful for some younger patients since braces/brackets/wires are so difficult to clean around.
See the link below for research studies and information.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5449906/
- https://www.credentis.com/en/science-compact-review-summarizes-scientific-evidence-and-clinical-results-on-curodont-repair/
3) FLUORIDE VARNISH - Typically applied to children or adults every 6 months to a year.
Fluoride varnish is a sticky gel that is painted on the teeth to help prevent cavities. It replaced the foam or other gels with squishy trays that were previously used. Varnish is more effective as it is easier to apply, safer, reduces the chance of cavities by 50-70%, and comes in a variety of flavors like caramel, orange or cherry. Recent research has supported Fluoride Varnish application immediately after SDF (see above) is applied.
4) HOME OPTIONS- increased prevention for home use
There are plenty of options for increased prevention at home but we support the use of many different types of oral hygiene products listed below to reduce plaque, increase enamel strength, or reduce dry mouth.