Dentaltown August 2017 - 93

When no local dentist would give her any other
option, 2-year-old Tasahli's mother flew her son
from Oklahoma to Arizona to see Dr. Jeanette
MacLean and avoid general anesthesia in favor of
SDF and quadrant dentistry. Photo courtesy of
Dr. MacLean with parent's permission.

Conclusion
When current modes of prevention and
restorative treatment fail to control caries,
it raises certain questions. What could we
do differently? What could we do better?
Twetman and Dhar concluded in 2015 that
"There is lack of substantial evidence to
suggest that restorative treatment leads to
acceptable long-term clinical outcomes," and
"There is certainly a need to go beyond the
drill-and-fill dentistry and integrate other
concepts of disease management to ensure
long-term success."22
Is our profession ready for a paradigm
shift to a medical management of caries
model-one that incorporates early intervention with topical antimicrobials such
as SDF as a first line of defense? One that
uses minimally invasive restorations with
biocompatible materials such as glass ionomer
whenever possible?
The abundance of evidence-based data
supporting the efficacy of SDF is too strong
to ignore. As dentists, we owe it to ourselves
and our patients to never stop learning, never
stop reading, and never get too comfortable
or stuck in our current mode of thinking.

I encourage my colleagues to read the
evidence for themselves. SDF is not a panacea,
but it is a powerful oral medicine that satisfies
the triple aim of health care-increases
access, improves health and reduces cost-
and is a welcome addition to our tool kit. ■

10.

11.
12.

13.
References
1.
Duffin. "Back to the Future: The Medical Management of
Caries Introduction." J Calif Dent Assoc 2012; 40:852-8.
2.
Chu CH, Lo ECM, Lin HC. Eff ectiveness of silver diamine
fluoride and sodium fluoride varnish in arresting dentin caries
in Chinese preschool children. J Dent Res 2002;81(11):767770.
3.
Zhi QH, Lo ECM, Lin HC. Randomized clinical trial on
eff ectiveness of silver diamine fluoride and glass ionomer
in arresting dentine caries in preschool children. J Dent
2012;40(11):962-967. doi: 10.1016/j.jdent.2012.08.002.
4.
Yee R, Holmgren C, Mulder J, Lama D, Walker D, van
Palenstein Helderman W. Efficacy of silver diamine fluoride
for arresting caries treatment. J Dent Res 2009;88(7):644647. doi:10.1177/0022034509338671.
5.
Santos Dos VE, de Vasconcelos FMN, Ribeiro AG, Rosenblatt
A. Paradigm shift in the eff ective treatment of caries in schoolchildren at risk. Int Dent J 2012;62(1):47-51. doi:10.1111/
j.1875-595X.2011.00088. x.
6.
Llodra JC, Rodriguez A, Ferrer B, Menardia V, Ramos T,
Morato M. Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial. J Dent Res 2005;84(8):721724.
7.
Zhang W, McGrath C, Lo ECM, Li JY. Silver diamine
fluoride and education to prevent and arrest root caries among
community-dwelling elders. Caries Res 2013;47(4):284-290.
doi:10.1159/000346620.
8.
Liu BY, Lo ECM, Chu CH, Lin HC. Randomized trial on
fluorides and sealants for fissure caries prevention J Dent Res
2012;91(8):753-758. doi:10.1177/0022034512452278.
9.
Tan HP, Lo ECM, Dyson JE, Luo Y, Corbet EF. A randomized trial on root caries prevention in elders. J Dent Res

14.

15.

16.

17.

18.

19.

20.

21.

22.

2010;89(10):1086-1090. doi:10.1177/0022034510375825.
Monse B, Heinrich-Weltzien R, Mulder J, Holmgren C, van
Palenstein Helderman WH. Caries preventive efficacy of silver
diamine fluoride (SDF) and ART sealants in a school-based
daily fluoride toothbrushing program in the Philippines. BMC
Oral Health 2012;12(1):52. doi:10.1186/1472-6831-12-52.
Braga MM, et al. Eff ect of silver diamine fluoride for arresting
caries treatment. J Dent Res 2009; 88:644-7.
Duangthip D, et al. A randomized clinical trial on arresting
dentin caries in preschool children by topical fluorides, 18
month results. J Dent 2015; 444:57-63.
Fung MHT, et al. Arresting dentin caries with diff erent
concentration and periodicity of silver diamine fluoride. JDR
Clin Trans Res 2016; 1:143-52.
Dye, B. et al. Dental Caries and Tooth Loss in Adults in the
United States, 2011-2012. NCHS Data Brief, no.109, May
2015.
Horst J, Ellenikiotis H, Milgrom P. UCSF Protocol for caries
arrest using silver diamine fluoride: Rationale, indications and
consent. J Calif Dent Assoc 2016;44(1):17-28.
Gordan VV, Garvan CW, Blaser PK, Mondragon E, Mjor
IA. A long-term evaluation of alternative treatments to
replacement of resin-based composite restorations: results of a
seven-year study. JADA 2009;140(12):1476-84.
Moncada G, Martin J, Fernandez E, Hempel MC, Mjor IA,
Gordan VV. Sealing, Refurbishment and Repair of Class I and
Class II defective restorations. JADA 2099;140(4):425-432.
Worthen TB, Mueller W. Implications of parental compliance
on decision making in care provided using general anesthesia in
a low-income population. J Dent Child. 2000; 67:197-199.
Almeida AG, Roseman MM, Sheff M, Huntington N,
Hughes CV. Future caries susceptibility in children with
early childhood caries following treatment under general
anesthesia. Pediatric Dentistry 2000;22(4):302-306.
Quock RL, Barros JA, Yang SW, Patel SA. Eff ect of Silver
Diamine Fluoride on Microtensile Bond Strength to Dentin.
Operative Dentistry 2012;37(6):610-616.
Wu ID, Velamakanni S, Denisson J, Yaman P, Boynton
J, Papagerakis P. Eff ect of Silver Diamine Fluoride (SDF)
Application on Microtensile Bonding Strength of Dentin in
Primary Teeth. Pediatric Dentistry 2016;38(2):148-153.
Twetman S, Dhar. Evidence of Eff ectiveness of Current Th erapies to Prevent and Treat Early Childhood Caries, Pediatr
Dent. 2015, May-Jun;37(3):246-53.

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