What’s the Deal with Silver Diamine Fluoride in Pediatric Dentistry?


What's the Deal with Silver Diamine Fluoride in Pediatric Dentistry?

Silver diamine fluoride is a liquid treatment for tooth decay. It contains both fluoride and silver. When painted onto a tooth, it kills bacteria, stops decay, and seals any caries in the tooth. Although this treatment can be utilized on permanent teeth, it is not offered as a treatment option as often in adults. So, why is this treatment so frequently used in pediatric dentistry?

Why We Use Silver Diamine Fluoride in Pediatric Dentistry

There are many situations that arise in pediatric dentistry when the use of silver diamine fluoride is highly appropriate. It is a safe, affordable, quick, effective, and non-invasive treatment for cavities and tooth decay. This technique is very exciting for young, fearful or pre-cooperative children, special needs patients, and medically compromised individuals who may otherwise require sedation for traditional dental restorations such as fillings or crowns. It is also a great option for nursing homebound patients, the elderly, those that lack access to care, and those individuals without dental insurance or the funds to afford traditional dental restorations.
This all sounds wonderful, but why don’t dentists use silver diamine fluoride as often on adults?
The primary reason we don’t typically use this treatment on adult patients (or patients with permanent teeth) is that silver diamine fluoride leaves a permanent black-colored stain on the treatment area and does nothing to restore the tooth’s original shape or appearance. A black spot and an unfilled cavity on a baby tooth don’t pose much of a concern; it will eventually fall out with the tooth to make way for its replacement adult tooth. A black spot and a cavity on a secondary tooth, however, are permanent.
While the concerns around silver diamine fluoride are purely aesthetic, they’re significant enough for dentists to avoid using it as a treatment on permanent teeth whenever possible. Silver diamine fluoride won’t always be the best treatment option for every patient, but the AAPD’s treatment guidelines suggest that the benefits of silver diamine far outweigh the risks. As a result, they recommend using it when the pediatric dentist deems it the most appropriate option for a child.

Additional Options for Treating Cavities and Tooth Decay

In addition to silver diamine fluoride, children’s cavities can be treated the traditional way: removing the infected, decayed portion of the tooth and restoring it with a tooth-colored filling or crown. At Kenmore Pediatric Dentistry, Dr. Laura always works with the patient and the parent or guardian to determine the best treatment option based on the patient’s unique dental care needs.