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This page was published on Oct 31, 2018, edited on Oct 31, 2018 by Dr. Marina Krepkh (Pediatric Dentist) of Kids Dentistry Center

Dr. Marina Krepkh, a pediatric dentist in Brooklyn is now offers Silver Diamine Fluoride (SDF) as an alternative cavity treatment for children. Dubbed as a “magic bullet” for cavities in kids, SDF has long been used in Europe and Asia, and only recently approved for use in the US. SDF provides a safe and non-invasive way to stop cavities from progressing

Tooth Decay Can Spread and Cause Decay in Other Teeth

Childhood tooth decay rates are shocking, and it’s an issue affecting many children. In the United States, it’s estimated 6 out of 10 children have a cavity by age 8. One real problem is the prevalence of untreated cavities in baby teeth. Because tooth decay is a bacterial infection, it can spread and cause decay in other teeth, and which include a child’s permanent teeth.

Tooth decay if not treated can cause infection, and even tooth loss

Another concern is early tooth loss caused by tooth decay. When baby teeth are lost to soon, it can cause long-term problems for the child. It’s more likely that orthodontic treatment will be required because of overcrowding and teeth shifting out of position. Additionally, young children need their baby teeth, so they can learn to talk and to communicate properly with others, and of course, they need to eat a good diet that will help them grow and develop.

Is Silver Diamine Fluoride the Answer for Treating Childhood Tooth Decay?

Not surprisingly, lots of children are terrified of seeing a dentist, especially as their very first experience in the dental chair might be when they are in pain because of a cavity. It’s a situation where silver diamine fluoride could be helpful. Instead of being faced with the dentist’s drill, a child’s cavity is painted with silver diamine fluoride, providing a far less frightening experience for a nervous kid. So, how does it work?

How Silver Diamine Fluoride Work?

Silver diamine fluoride helps to fight the bacteria-causing cavities. It’s a product that is being hailed as the latest and possibly most significant innovation in pediatric dental care after the introduction of fluoridated water. By killing the bacteria that cause tooth decay, silver diamine fluoride can help to harden the tooth, preventing further decay. It’s a great way for small children to comfortably receive dental care, without the need for uncomfortable injections, drills or possibly dental sedation.

It’s a treatment that certainly isn’t new because it’s been used in Europe for quite some time and in Japan for decades. Currently, SDF has been cleared by the American Dental Association for use in US. Using silver compounds to treat cavities began to fall out of favor in the 1950s when fluoridated water and fluoride toothpaste were introduced.

Downside of Silver Diamine Fluoride

The only downside with silver diamine fluoride is that treated areas can turn black, making it obvious there is a cavity in a tooth. However, the black color indicates that the silver is reacting with the decay-causing bacteria, so it is a sure sign it is working because the silver diamine fluoride liquid doesn’t stain any healthy areas of the tooth.

What is even better is that when bacteria killed by the silver ions in contact with living bacteria, the silver is re-activated, so that the dead bacteria can kill the living bacteria. If needed, the dark color of a cavity can be minimized with a filling material called glass ionomer, although the cavity still may appear slightly gray. It seems a small price to pay for something that could easily treat a child’s tooth decay, especially as treatment is inexpensive yet very effective.

The procedure can be especially helpful when a child is still very young and will find it very hard to tolerate longer dental exams and treatments that are more invasive, or which potentially require dental sedation. With silver diamine fluoride, a pediatric dentist can buy a child some time until they get a little older and more able to cope with treatment, but in the meantime, their tooth decay is halted.

Silver diamine fluoride has been shown to be safe, but it’s still not a perfect cure for cavities. Treatment isn’t suitable for anyone with allergies to silver, and it cannot be used if a child has mouth ulcers (canker sores), or any sore spots on their gums. While treatment can halt the progression of most cavities, it isn’t effective all the time.

Effectiveness of SDF

It’s been shown to halt the progress of cavities in about 81% of cases of tooth decay when used twice a year, but successful treatment does depend on other factors. These factors include a child’s diet and their oral health, for example ensuring a child produces sufficient saliva to keep the mouth clean, fresh and comfortable. Often, a multifaceted approach to tooth decay prevention is the most effective.

Reducing Your Kids Risk of Tooth Decay

Diet is particularly crucial because the foods are given to a child influence the amount of time their teeth are exposed to sugars. Even the time at which they are given these foods can make an enormous difference. For example, children that are given sugary snacks in between meals are more likely to have cavities no matter how good their oral hygiene. Every time they eat something sugary, plaque bacteria that live in the mouth and which thrive on sugars produce acid and toxins that gradually erode tooth enamel, eventually causing cavities.

Parents often don’t realize their kid’s pediatric dentist can help with diet choices, offering tailored advice based on a child’s diet and their dental health. It’s the kind of advice that can be extremely useful, especially given the number of foods that are marketed as healthy, but which contain lots of hidden sugars.

Other Treatments That Can Help

Of course, silver diamine fluoride is just one treatment available to help fight tooth decay. Other options include more traditional fluoride treatments designed to strengthen children’s teeth.

  • Fluoride varnish is highly effective and is another quick and non-invasive treatment that is completely painless. The fluoride varnish is painted onto newly cleaned teeth and will gradually sink into the tooth enamel over several hours or even overnight. Although the varnish can make teeth appear slightly yellowish, they will look perfectly normal after the varnish is removed during tooth brushing.
  • Dental sealants is another possibility which can be applied to a child’s back teeth and which are designed to protect their chewing surfaces. Usually, dental sealants are applied to a child’s newly erupted adult back teeth, but they can sometimes be used to protect children’s primary teeth, especially when a child is more prone to tooth decay.

Perhaps the most critical ongoing treatments are regular tooth brushing and flossing and visits to the pediatric dentist and hygienist. You’ll find your child’s dentist is extremely helpful when it comes to dental education because they can provide practical advice on brushing and flossing which could make all the difference to your kid’s dental health.

Regular hygiene appointments are also crucial for removing the buildup of plaque and calculus from your child’s teeth, helping to ensure their teeth and their gums stay strong and healthy.

Dr. Marina Krepkh
7708 4th Avenue 1st floor
Brooklyn, NY 11209
(718) 491-5300

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