Silver Diamine Fluoride: Stop cavities without drilling

    Posted January 16, 2017

    Silver Diamine Fluoride has recently been cleared by the FDA as a “breakthrough therapy drug for stopping cavities.” We couldn’t be happier. Since we adopted a Silver Diamine Fluoride protocol at our clinics in western Oregon we’ve stopped a lot of cavities dead in their tracks.

    It’s especially great news here, because our state has one of the highest cavity infection rates in the nation. I use the work “infection” because that’s what a cavity is – a bacterial infection. Before I tell you more about Silver Diamine Fluoride, let me give you a quick explanation about how cavities are born. It’s pretty simple:

    1. Sugar + bacteria = bacteria poop (which is very acidic)
    2. Acid eats a hole in your tooth
    3. A cavity is born!

    Yup, it’s that same simple information that’s been spoon fed into your brain since the wee days of kindergarten.

    Sugar + not brushing and flossing = yuck mouth.

    Now, if a patient has numerous cavities in their mouth, they have a chronic bacterial infection. Furthermore, bacterial infections are a communicable disease and can be passed from person to person. There are certain families that I treat that share a communicable chronic bacterial infection with each other, which more often than not means every member of the family has a mouth full of cavities and/or rotten teeth. It’s kind of weird that you can get a cavity from kissing someone or sharing a drink, but it’s true.

    What SDF does

    Now, let’s get back to the super exciting breakthrough Silver Diamine Fluoride, more commonly known as SDF, and why the FDA clearance as a drug is HUUUUUUUUUUGE! SDF is now our primary treatment option to prevent and/or stop cavities. We’ve adopted it at all of our clinics: Lincoln City, Newberg, West Salem, Eugene, Springfield, Roseburg, Eagle Point, Central Point, and Grants Pass. The best part is that we reduce the amount of shots that we have to give patients, especially children. I am thoroughly convinced we have reduced injections by 50 percent in all of our clinics since we started using SDF.

    I saw a segment on Good Morning America about Advantage Arrest’s SDF. The piece was titled “No More Drills,” and while it was really flattering and supportive, I wouldn’t go so far as to say, “no more drilling” at the dental office. Yet, judging by the data I’ve seen and from my own experience using SDF, I will say this:

    As a treatment for non-symptomatic cavities (that is, cavities that aren’t causing pain or so deep into the pulp that the infection is ultimately going to need a root canal), SDF can be up to 90 percent effective in stopping cavities from growing. (Sorry, nothing in medicine or dentistry works 100 percent of the time.) But something bigger and better than just stopping cavities may be happening. The most recent science indicates that SDF is not only killing the cavity that you paste this wonder solution on, but it could also be acting as a force field that prevents future cavities in your entire mouth – even on teeth that didn’t even receive the SDF application.

    BAM! That’s worth kicking your Grandma in the butt for! Especially during the 4th of July flag celebration in Eagle Point.

    What exactly is SDF?

    SDF is a compound containing, not surprisingly, silver, diamine and fluoride:

    Silver is the go-to antimicrobial metal used for thousands of years to prevent everything from wound infections to internal ailments. The only known side effect is that if you ingest too much your skin can turn blue. Some Asian countries have used silver for almost a hundred years for oral needs. Diamine is formed by basically marrying a couple of ammonia (nitrogen and a few hydrogens) together like second cousins from Central Point. Fluoride, of course, has been the gold standard for dental clinics in cavity prevention. The only problem is that it’s not very effective.

    I was first introduced to the science behind SDF a few years ago in Springfield, Ore., during one of our semi-annual corporate meetings. One of our dentists in Newberg suggested that we invite one of his former dental school colleagues to our meeting to discuss a new topical solution that was showing amazing results in stopping dental cavities from growing. The exact words from our Newberg dentist, “He’s got this stuff like a forcefield in the mouth – like the Starship Enterprise. Kickin’ bad aliens out of the galaxy.”

    This intelligent dialogue motivated me to reach out to Dr. Jeremy Horst, a kid dentist and a scientist at the University of California San Francisco. He’s one of the world’s leading experts in cavities and the bugs that cause them. My brother and I sat there during his presentation, absorbed every second of his two-hour presentation like 10-year-old girls at a Justin Bieber concert. Dr. Horst provided data going back years that showed continual and consistent applications were incredibly effective in arresting cavities and preventing new cavities. His powerpoint presentation included electron microscope pictures of cross sections of tooth structures with and without silver. Here they are. The first shows a more solid and less porous tooth surface than the second image, which shows an untreated tooth.

    Until the recent FDA cavity prevention approval, SDF was approved as a tooth desensitizing agent so we had to use it “off-label” as a treatment for arresting cavities. The new designation by the FDA allows us to use it specifically for treating cavities. This means that the FDA was compelled by the same data and research that was presented to me to give it a special “Breakthrough Therapy” designation. I also had the knowledge of working with SDF and seeing the results for myself. Nonetheless, it feels nice to be validated.

    Before I end this article and get on the road (have to be in Lincoln City by 8:30 and I’m still sitting on the couch in my underwear and Ugg slippers) I want to make the reader aware that SDF is not a miracle one-time application. In order for it to be effective, it takes continuous and consistent applications. The general protocol for SDF is two to four applications the first year and twice a year thereafter. It’s also a good idea to still brush and floss your teeth because, well, who likes stinky breath and dirty teeth?