In this legislature here in Colorado, a new bill was passed that allows dental hygienists to apply silver diamine fluoride (SDF) under the supervision of a dentist.
Dr. Fred Guerra, with Guerra Dental in Colorado Springs, topical fluorides are nothing new. “Topical fluorides have been around since the 1970s and they have evolved. From trays and foam gels to liquid gels and topically applied varnishes. “
Colorado HB 18-1045 says the hygienists under direct or indirect supervision of a dentist can now legally offer this treatment, which can be very beneficial for certain populations.
Dr. Guerra thinks this is a great move: “Hygienists should be able to do this, either under the supervision of a dentist in their office, or some hygienists work independently in rural Colorado. It is entirely their responsibility and professional ability to do so. “
When used in early tooth decay, silver diamine fluoride effectively stops tooth decay in its pathways. Dr. However, Guerra explains why this particular fluoride treatment only makes sense in a few specific situations.
“It (SDF) has the effect of really stopping (dental caries) and also has a tendency to remineralize (the enamel), so it is popular with milk or milk teeth, even if it causes some discoloration. We know that these teeth are lost between the ages of 4 and 12 years. The hygienist has to let the parents know if they are using this particular fluoride, as this can lead to discoloration of the teeth. “
In addition to people in remote or rural areas, where trip to the dentist is likely to be infrequent and difficult, and where dental care may be lacking, there is another population group that can benefit from this new law, says Dr. Guerra.
“For people in nursing homes, people who suffer from Alzheimer’s and cannot take care of their teeth, (SDF) could be a tertiary measure to prevent (dental) caries.”
While SDF is highly effective, it’s likely not used much in high-density areas where dentists have many options when it comes to a topically applied fluoride.
Dr. Says Guerra, “The big downside is the coloration, and there are other products that are equally effective in the dental office so that most people in populous areas do not have to resort to SDF.”
If you have any questions, ask your dentist.
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