Medical Management of Cavities

Alternatives to treat dental cavities

Traditionally, treatment of dental cavities in children required the removal of the diseased tooth structure followed by a filling or a crown to restore the tooth. The hurdles to traditional dental treatment in children (for example, behavioral issues due to age and/or limited cooperation, anxiety, special health care needs, complex medical history, etc.) have brought attention to finding alternatives to treat dental cavities, even if temporarily.

Silver topical products (not to be confused with “silver-fillings”), such as silver nitrate and Silver Diamine Fluoride (SDF) have been used in Japan for over four decades to stop cavities (caries) and reduce the sensitivity in teeth. During the last decade, other countries such as Australia, China, and Brazil have used similar compounds with equal success. While the exact mechanism of SDF in not fully understood by researchers, it is thought to be due to antimicrobial properties of silver and fluoride and how they interact with organic tooth structure.

Many studies and clinical trials have evaluated the use of SDF on preventing tooth decay while posing no risk when used in treating adults and children. The primary undesirable side effect  is the discoloration or staining of teeth with cavities, but in most cases it is outweighed by the desirable properties.

SDF is a very useful tool in preventing cavities and tooth decay, but it is only beneficial in some limited scenarios. At our pediatric dentistry in Vancouver, our dentists will be able to provide more information on when and where this treatment can be used. In typical cases, SDF will be an option for patients with behavioral or medical management challenges, patients with multiple cavities that may not all be treated in one visit, or patients with active cavities that show no signs of involvement with the tooth pulp.

While complicated in technique, the application of SDF is rather quick and simple. The team at our pediatric dentistry in Vancouver will take every precaution to protect the lips and skin of the patient, as SDF will cause temporary staining if it contacts the skin. A second application is recommended a few days later to sustain the treatment’s effectiveness in preventing the development of tooth decay. There are some variations in application protocols which will depend on the extent of decay, size of the lesion, location of the tooth, etc.

In very young children the application of SDF “buys time” for the patients and the dental team to revisit with more traditional dental treatment at a later time. Most parents have preferred this option to avoid the use of advanced behavioral guidance techniques such as sedation or general anesthesia to deliver traditional dental treatment. To improve esthetics, once the dental disease is controlled and as the patient’s circumstances allow, the dental cavities can be restored/filled.

It is also very important to address the cause of the caries/cavities in the first place. The patient/parent will need to focus on a balanced diet, reducing frequent exposure to sugars and carbohydrates and maintaining an optimal oral hygiene regimen.

Contact our pediatric dentistry in Vancouver today to find out if SDF treatment is the right option for your child.