One particular area of research I studied was the use of Silver Diamine Fluoride (SDF). I created an entire poster board and brochure with another three students that contained information about its uses, advantages, adverse effects, contraindications and our role as dental hygienists. This research was done to expand my knowledge about this up and coming treatment in the United States. This product can benefit populations that have trouble receiving routine dental care or have extreme dentin hypersensitivity. As a dental hygienist I want to know about as many products as possible so that I know what to recommend to my patients. This enhanced my clinical understanding because I now know why it is not widely recommended in the United States. It is not recommended because it causes irreversible black stain. However, in patients with special needs this product could be extremely beneficial in preventing decay and the need for invasive restorative dental treatment. It can also benefit this population by making them less uncomfortable during routine dental procedures due to its desensitizing effects. Once I am a hygienist I would like to discuss the use of this product with patients who may need it.

Below you will find each component of the brochure.

What is Silver Diamine Fluoride?

• Silver diamine fluoride (SDF) is a cost effective type of fluoride treatment that has been used in foreign countries for many years and is being investigated in the U.S. as an alternative to fluoride treatments for children.
• It is a colorless liquid that consists of silver, and fluoride.
• Each portion of the silver diamine fluoride serves a different purpose. The silver portion serves an antimicrobial, and the fluoride portion is used to re-mineralize broken down tooth structure.
• The Food and Drug Administration (FDA) has approved 38% diamine silver fluoride specifically because of its ability to reduce dentin hypersensitivity, but not to arrest or prevent caries. It’s ability to prevent caries is still under investigation.

Uses of SDF

• Controls or stops active dental caries in adults and children.
• Temporarily reduces tooth sensitivity.
• The silver component acts as an antimicrobial agent killing bacteria to prevent the formation of new plaque causing agents known as biofilm.
• The fluoride portion acts to prevent further demineralization of tooth structure.
• Any decayed areas will stain black. Stained teeth surfaces can be corrected with a filling or crown, but in the U.S., SDF is mainly used on posterior teeth of children so this may not be necessary.

Advantages:

• Treatment is noninvasive.
• Easy to use.
• Quick application.
• No need for anesthesia.

Adverse Effects

• When SDF is applied to the tooth surface it causes black staining where a carious lesion or demineralized tooth surface is located.
• SDF can also stain other areas such as the cheek or the lips. These stains on the mucosa are not permanent and will disappear within a few days or weeks.

SDF Contraindications:

• Do not use on individuals that have an allergy to silver or other heavy-metal ions.
• Do not use if the patient has oral ulcerations open wounds, stomatitis, and areas with pulp involvement or ulcerative gingivitis.
• Do not use as a part of restorative procedures (fillings or crowns).

Role of the Dental Hygienist

• Administration of SDF is done the same way as administering a Fluoride varnish. One drop on a micro brush is used to coat up to 5 tooth surfaces.
• Educate the patient on effects of diamine silver fluoride.
• Be sure the patient understands the staining process.
• Be aware of patient’s medical conditions in order to avoid administering treatment to patients in which it is contraindicated.
• Recognize the patient’s need for SDF.
• Administer SDF safely and correctly.
• Practice safe infection control.

References:

1.M. Karp, Jeffrey D.M.D., M.S. Sarvas, Elise D.D.S., M.S.D., M.P.H. Silver diamine fluoride arrests untreated dental caries but has drawbacks. 2015;8:5.

2.Bendit, Judy Zack. “The Dos and Don’ts of Silver Diamine Fluoride.” Pardon Our Interruption. N.p., 15 Aug. 2016. Web. 14 Mar. 2017.

3.”Everything You Need to Know About Silver Diamine Fluoride.” Kids Care Dental. N.p., n.d.Web. 15 Mar. 2017.

4.Sarvas, Elise, and Jeffrey M. Karp. “Silver Diamine Fluoride Arrests Untreated Dental Caries but Has Drawbacks.” AAP News.   N.p., 09 Mar. 2017. Web. 15 Mar 2017.

5.”Alliance for a Cavity-Free Future.” Alliance for a Cavity Free Future. N.p., n.d. Web. 15 Mar.2017.

6.Reisch, Marc S. “New Materials take a bite out of tooth decay.” CEN RSS. N.P.,n.d. Web. 15 Mar. 2017.