A non-invasive, painless treatment option for cavities!

July 25, 2022, Kyle Isaacs

A little girl brushing her teeth against a white background.Have you or your children ever had a cavity (also called dental caries)? I would bet most of us have at one time or another. If you have never had one, you are so lucky! Since most of us have had cavities, it might not be surprising to learn that dental caries are the most common chronic disease for both children and adults. It is even five times more common than asthma! This means many young children will need treatment for dental caries at some point in their lives. Even though cavities are so common, it is amazing to know that they are totally preventable! If your little one gets a cavity, getting it fixed as soon as possible is important. Baby teeth are important for many reasons. Cavities can cause pain, making it harder to eat healthy foods and to concentrate in school. They can also affect our kid’s self-esteem, and if lost early, the space where the missing baby tooth is can close, leaving no room for the adult teeth to come in. Also, important to know that a cavity that has just started and is small usually does not cause pain. These smaller cavities are easier to treat, so going to the dentist by the time the first tooth comes in or your child’s first birthday is important. This way, we can see early changes and offer recommendations for preventing cavities.

What treatment options will your dentist recommend if your child has a cavity? For small cavities, your dentist might recommend a filling or stainless-steel crown to be done with nitrous oxide or other types of sedation. Sedation means using mild calming drugs to keep your child relaxed and calm while they receive dental care. Sometimes if a child has many cavities or tooth issues that need care, your dentist may recommend general anesthesia during the procedure.

Photo Credit: Dr. Eyal Simchi, Riverfront Pediatric Dentistry

What if there was a way to treat some of the cavities without sedation, general anesthesia, or even a numbing shot? I bet you would choose that for your child if you could. This treatment is called Silver Diamine Fluoride (SDF).  SDF is a non-invasive, painless treatment option for cavities that is painted on the tooth instead of drilling and filling the cavity.  It is a liquid made of silver, fluoride, water, blue coloring, and ammonia that kills the bacteria that cause cavities. SDF has been used in dentistry safely in Japan since the 1970s and here in the United States since 2015. The use of SDF has been well documented for its safe and successful ability to control tooth decay.

Silver Diamine Fluoride only has a few side effects. It will turn the part of the tooth with a cavity on it black (that means it’s working!). If you do not like the black color, a tooth-colored filling can be placed after the SDF has stopped the cavity. If the liquid gets on your tongue or gums, it will temporarily turn them black.  Your dentist will use cotton rolls around the tooth when putting SDF on to prevent that.  Some children report a bad taste after their teeth are treated with SDF, but brushing their teeth and mouth with toothpaste seems to solve that problem.

Photo Credit: Dr. Jeannette MacLean, Affiliated Children’s Dental Specialists

SDF works well, but it is not perfect.  It stops cavities about 80% of the time. In some situations, SDF is not the proper treatment for a cavity. This can happen when:

  • The cavity is too big
  • There is an infection in the tooth
  • The cavity has reached the tooth’s nerve
  • The person has a silver or heavy metal allergy

The teeth will still need traditional fillings, crowns, or extractions in these cases.

SDF is easily applied in less than a minute with some air and a small brush, no need to drill or get your child numb for this procedure. Usually, their teeth will be checked in 2-4 weeks to ensure the medicine is working, and possibly another application will be made at this next appointment. If fillings need to be done at some point, often no numbing is needed, and some teeth can be left without a filling until they come out. Dentists who use SDF have usually found that they have decreased the need for sedation or general anesthesia by more than 50%!

Cropped view of cute african girl sitting on dental chair looking at camera and smiling while dentists keeping probe and examining teeth in clinic.

Next time you take your little one to the dentist, ask if they offer SDF in their practice. If your child needs some treatment and there is no infection or abscess, ask for SDF before the traditional drilling and filling the cavity. If your dentist does not use SDF, you can look around to find one who does. Where I work, we have had several kids referred to us to apply for SDF because the pediatric dentist does not use it. So far, the cavities have stopped, and our little patients have had excellent and easy dental experiences. Parents are happy, kids are happy, and we are happy!