Winchester Dental is proud to offer silver diamine fluoride treatment, a new dental option that can help to control tooth decay in certain patients. In this interview, Dr. Kelly Richardson, DDS explains how this treatment works, and which patients it can benefit.

Silver diamine fluoride is currently receiving attention as a possible way to control dental cavities. How does the treatment process work, exactly? Does the liquid work as a filling?
Silver diamine fluoride is a liquid that we paint on the teeth. It dries quickly. The silver is anti-microbial and helps to stop—but not reverse—the process of decay. It doesn’t replace fillings altogether, but is considered an interim caries-arresting agent. For example, in certain instances, we might use it on a child’s baby teeth to hold off the progress of cavities until the baby teeth fall out. But it can’t be used on cavities that are too large; that’s one of the limitations.

Is the treatment used only for children, or can it be used for adults as well?
Yes, it can be used for both children and adults, but since it doesn’t replace fillings, it’s really used as a temporary measure. So for adult patients, for example, we might use it for infirm individuals who might not be able to undergo the traditional cavity filling process for health reasons. Treatment with silver diamine fluoride can keep the progress of certain cavities under control.

After a cavity is treated with silver diamine fluoride (for example, in a permanent tooth), would the patient ever need to have it reapplied?
Yes, we would have to reapply it every six months.

Are all cavity patients eligible for silver diamine fluoride instead of traditional fillings?
As I said, silver diamine fluoride can’t be used on cavities that are too large; those cavities still require filling with the traditional process. We find that this treatment is appropriate for children—especially very young children, or those with extreme discomfort during dental visits—who have small cavities in their baby teeth (which they will eventually lose); for infirm adults who cannot undergo the traditional filling process; and for other adults whose teeth require treatment that must be delayed for one reason or another.

Can silver diamine fluoride be used protectively (before any cavities appear)?
Yes, it can be used protectively in the way that we use traditional fluoride varnish for certain patients. However, the liquid can stain teeth and irritate gum tissue, so we would really use it conservatively. But under the right conditions, if silver diamine fluoride is used on a single tooth with a cavity, it can help protect the neighboring teeth.

Besides eliminating use of the dental drill, what are the immediate benefits to patients?
The treatment is less expensive than a regular filling, but as I mentioned earlier, it must be applied repeatedly and that could add up, depending on the patient. The biggest benefits are for the kinds of patients I’ve described.

Are there any known side effects, risks, or disadvantages to patients treated with silver diamine fluoride?
When the liquid is applied, it will stain the application area black. So we likely wouldn’t use it on a front tooth unless we were preparing the patient for crowns or another restoration process during which the teeth or the affected area of the teeth might eventually be removed. But as far as we know, there are no significant health risks associated with this type of treatment.