New liquid treatment stops tooth decay painlessly

Dr. Katherine Roche hopes that now she can avoid drilling many of her patients’ teeth.

A few weeks ago, the Edmonton dentist received her first shipment of a new, non-invasive treatment for tooth decay called silver diamine fluoride.

When applied to an affected tooth, the fluid treatment stops decay by killing bacteria that have caused cavities. Soft areas in the tooth are then remineralized or hardened so that no drilling or filling is required.

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To date, Roche has tried about a dozen patients, some of whom are only five years old. But she already believes it “is truly revolutionizing care for children, the elderly and other patients who do not tolerate dental treatment well”.

“You just paint it on like a bit of varnish … no freezing and drilling. It takes a minute to apply this material,” said Roche, owner of Guardian Dental Clinic.

Silver diamine fluoride has been used in Japan, Australia, and Argentina for years. But it was only recently approved in Canada under the product name Advantage Arrest. Health Canada licensed Advantage Arrest in February to be used by dentists “to prevent, control and protect against tooth decay or tooth decay”.

Up until now, Canadian dentists have treated cavities by drilling away the soft, decaying areas of a tooth and replacing them with another substance, such as a composite or amalgam filling.

Silver diamine fluoride “is the easiest and easiest way to stop tooth decay that has already started,” said Benoit Soucy, director of clinical and scientific affairs for the Canadian Dental Association.

But, he added, it’s not for everyone – especially “anyone who is concerned about the look of their smile”.

This is because the main disadvantage of silver diamine fluoride is that it stains the tooth dark brown or black.

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It also does not fill in the parts of the tooth that have been corroded, although a dentist can rebuild the structure of a tooth after the material hardens. And it’s not the best option if the tooth decay is very advanced or if there is damage under the tooth, Roche says.

Still, according to Roche, silver diamine fluoride offers a better option for young children – who often cannot endure extensive dental work – than general anesthesia for traditional fillings.

In addition, discoloration of milk teeth does not affect adult teeth.

It is also cheaper than traditional fillings. In your clinic, one treatment with silver diamine fluoride is billed per unit of time. She can treat a whole mouth in 15 minutes, which she thought would cost no more than $ 100. For comparison, it would cost about $ 200 to fill a cavity.

Aside from the time and discomfort that comes with it, fillings also do nothing to fight the bacteria that are causing cavities. With fillings, “it’s surgery versus medicine,” Roche said.

But silver diamine fluoride reduces the risk of new cavities forming in the mouth due to what is known as the “zombie effect,” she said. “What happens is that bacteria pick up the silver ions and visit their other bacterial friends and distribute those silver ions … and kill those bacteria too.”

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A second treatment is recommended six months after the first.

Soucy emphasizes that if silver diamine fluoride is seen as the best approach for them, people shouldn’t be put off by the idea of ​​staining. It can be viewed as a “necessary evil” for certain people for whom treatment may prevent major dental problems in the future, he says.

Even so, he says, he doesn’t expect dentists to give up their drills anytime soon.

“It definitely won’t replace fillings,” he said. “This is an additional tool that can be used to address certain, very specific situations for which there were previously no good options.”

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