The FDA has approved a chemical that has the potential to reverse small cavities and the treatment is more affordable than a routine filling. What’s the catch? Well the tooth turns black. Researchers are still working on an alternative treatment involving electrical remineralization, however they feel they are still a few years away from having a working prototype. For now we can use the current technique in areas where a blackened tooth will not be too unsightly or on baby teeth that will be shed in a short time. In either case it is a big step forward in cavity prevention. Check out the full article below or click here.

Silver Diamine Fluoride in Caries Management

“July 12, 2016 A recent article in the New York Times highlighted use of silver diamine fluoride (SDF) as an alternative approach to treatment of cavities in children.¹  The article highlighted that SDF was faster and cheaper than drilling and filling; and it mentioned the downside that when applied, SDF blackens the tooth.

Silver diamine fluoride (SDF) is a colorless liquid that at pH 10 is 24.4% to 28.8% (weight/volume) silver and 5.0% to 5.9% fluoride.²  Just as 5% sodium fluoride varnish has FDA clearance as a Class II medical device for the treatment of tooth hypersensitivity, FDA classified SDF as a fluoride and cleared its use as a Class II medical device for the same indication.  A number of products are currently available in other countries, but at this time, Advantage Arrest™ (Elevate Oral Care, L.L.C.) is the only commercially available SDF product for dental treatment in the U.S.³

Although FDA-cleared for use in the management of hypersensitivity, SDF received coverage in the Times for its use in treating cavities in children, although this might be more accurately described as caries control and management.  Likely a result of its fluoride content, when applied to a carious lesion, SDF has also been shown to lower caries risk of the adjacent tooth surface.⁴  While the Times article focused on the use of SDF in young children, it has also been shown to be effective in management of root caries in the elderly.^{5, 6}  It likely has additional applicability as an interim approach for managing problematic caries in individuals currently unable to tolerate more involved dental treatment.

SDF is not a complete solution to caries risk.  Single application has been reported to be insufficient for sustained benefit.⁷  Its downsides include a reportedly unpleasant metallic taste, potential to irritate gingival and mucosal surfaces, and the characteristic black staining of the tooth surfaces to which it is applied.³

A search of ClinicalTrials.gov for silver diamine fluoride returned 14 studies; 7 of which have been completed, 5 that are recruiting, and 2 that have not yet begun recruiting.⁸  This suggests that more scientific insight and news will likely be forthcoming about this product.” (ADA.org)