Drill-free cavity procedure provides alternative to sedation

HOUSTON – Sedation and anesthesia as a means of reassuring young patients before dental patients are at great risk and, in the worst case, can lead to the death of a child. As an alternative to sedating a patient, some dentists are turning to a painless and less expensive alternative treatment for tooth decay.

The product, named Silver Diamine Fluoride, was approved by the FDA in 2014, but has been used in other countries for decades. Traditionally, voids are fixed by drilling out and filing the decay area. The alternative treatment doesn’t require drilling and just paints a few drops of liquid on the decay area. Because it’s painless, odorless, and relatively quick, there’s no need to inject a local anesthetic like novocaine or give an oral sedative before the procedure begins. Treatment must be reapplied every six months, which can happen during a patient’s routine cleaning appointments. The disadvantage is that the liquid turns the area of ​​the tooth to which it was applied a dark brown color within a short time after application. But for kids who have it applied to baby teeth that eventually fall out, it’s a safer alternative to drilling a cavity and calming the child down.


“Sedation is a big risk. There is no risk with this product, ”said Dr. Ron Hickerson for using the product on both adult and pediatric patients in his practice at the memorial.

The risk of sedating young patients, especially with oral cocktails, is a risk that malpractice lawyers see in civil lawsuits and dental office orders.

“You strap those kids down and calm them down, and that’s where you get into trouble,” said Greg Myers, a former dentist who became an attorney.

Myers said in his 20 years as a lawyer he has seen a handful of cases where a child has died after being given an oral tranquilizer. An example of this happened recently in the Dallas area. The Texas Board of Dental Examiners disciplined a dentist in March 2014 who gave a sedative cocktail to a four-year-old. This child died after an unexpected reaction to the drugs.

“Sedation is a continuum that goes from minimal to deep, and you can never predict how a particular child will react to such drugs,” Myers said.


Channel 2 Investigates found that only a handful of dentists in the Houston area have purchased the new alternative treatment from the company that markets it. Dr. Hickerson says it’s just another tool that he has in his tool belt.

“It’s not a panacea for tooth decay or tooth decay,” he said.

The process is far less expensive than filling a cavity. Hickerson estimated the treatment would only cost about $ 20.

Read more about Silver Diamine Flouride Here.

To learn more about dental office deaths and why the Texas Board of Dental Examiners is out of control, click Here.

If you have a story you’d like to investigate, email investigative producer Lauren Sweeney at [email protected]


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