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Silver Diamine Fluoride: Stop cavities without drilling

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 word “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 number 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 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?

Eugene Dentist Homemade Toothpaste Recipe

It’s 9 pm and you’re watching TV with the family. Your kids are folded up and stuffed in every corner of the couch. The two smallest are asleep and your wife is reaching for the remote. She is being sweet and lazy, but her intent is to end the night and turn off the tube. You look at the kids who are still awake and whisper, “Late night. Get P.J’s and brush your teeth.” Then your oldest murmurs, “Dad, were out of toothpaste. We even used all of yours this morning.” Nothing like waiting until the last minute.

Although I am a dentist, I have to admit that I am not without faults. I often run out of toothpaste and floss…… kind of like the auto mechanic whose car is always broken down or the landscaper who never has time to cut his own grass. I have 5 kids, 1 dog, 2 cats, and a female gerbil named “Steve.” I forget things… even toothpaste. It happens a lot, especially when your oldest son spreads Colgate all over his face because he thinks that it kills zits. The poor kid is going through puberty so I won’t embarrass him. I won’t mention his name because Roseburg Oregon is a small town, but I can tell you that his name rhymes with “badam,” there is no “b” and it starts with an “A.”

Nonetheless, I have to imagine that almost everyone or every family gets stuck in a situation where they don’t have toothpaste and they don’t feel like walking through Walmart for a late night trip. So…… being the nice Roseburg Emergency Dentist that I am, I have decided to let you in on my “Roseburg Dentist Homemade Toothpaste Recipe.” This is a short list of ingredients. If you really want to get into the hippy or earthy recipes you can add peppermint or hemp seed or Google search “Organic homemade toothpaste recipes for people who like smelling like dead fish, but want that fresh feeling in their mouth.” I have created a short list for those who need to make a concoction quick and fast.

3 Tbsp. of baking soda
1 Tbsp. of finely ground Sea Salt
A few drops of vanilla, cinnamon, or any flavorful oil in your pantry.
1 tsp. of oil. Olive or coconut is preferred.
½ tsp of dried sage. If you don’t have it, no worries. Sage has a strong flavor for kids, but it’s a good anti-microbial.

1. Mix all this stuff together, but add the oil last. Add enough oil to make the consistency so that it holds on the end of your toothbrush.
2. Enjoy. The flavor is going to suck, but at least you won’t go to bed with Godzilla breath.

If you need more information or want to schedule a dental visit in Eugene or Lincoln City, Oregon just shoot us an email or call our office.

5 Things to Stop Tooth Pain Before Visiting The Dentist

If you are experiencing tooth pain and it’s after hours or you’re not close to a dental clinic here are 5 tips that can help reduce tooth pain. Remember that if pain persists or you experience a fever you should definitely see a dentist. We have locations in Roseburg, Eugene, Springfield, and Salem to serve your emergency dental needs.

Number 1. Check to see if you have food stuck between your teeth or between teeth and gums. Floss your teeth and rinse with warm salt water.

Number 2. Use an ice pack and press against your jaw or suck on an ice cube where you are experiencing pain.

Number 3. If ice isn’t helping use a heat pack in 20-minute intervals.

Number 4. Wet a black tea bag and place between the afflicted tooth and the gums. Black tea has been proven to reduce pain and bleeding.

Number 5. Take an over the counter pain medicine that does not include aspirin. Aspirin can hinder the healing process and increase bleeding.

If your pain still persists consult a dentist immediately. If you live in Western Oregon I would be more than glad to help you. Crisdental offers $48 emergency exams and we will always try to fit you in the same day for emergencies.

Crisdental announces the winner of the Civil War Football Tickets!

Crisdental, a group of Oregon dental clinics in Eugene, Springfield, Roseburg, and Salem announces the most recent winner of their Facebook prize give away. A pair of tickets to the annual Civil War Football game between the University of Oregon Ducks and the Oregon State Beavers. The tickets are premier tickets on the 50 yard line.

Click here to read the full story.

A Dental Halloween Story

Since we are coming up on Halloween I thought I would share a dental story that is a little creepy, but suitable considering the time of year. I have changed the names of the individuals for privacy reasons.

Last year while visiting my Eugene dental office I was interrupted by the receptionist while chatting with one of my associate dentist. Her face was bright red and eyes were wide open and her mouth was fumbling as she blurted out, “Dr. Bratland. There is a man on the phone who claims that he is a police detective in California. He said that he is investigating a murder and he wants to speak to the owner.”

I was caught a little off guard. I am a pretty stand up citizen and I haven’t had a traffic ticket in years so I don’t speak to police officers very often, especially about a murder victim.

“This is Dr. Bratland,” I said cautiously.
“Dr. Bratland. This is detective John Smith with the Siskiyou County Sheriff’s Department. We believe that one of your patients could have been murdered. The body was badly decomposed and wild animals have disturbed the remains so identifying the body is tough. We are investigating the death as a homicide unless we find evidence to the contrary. The forensic team is investigating cause of death and I have a few questions for you.”
“The forensics team pulled a dental implant out the deceased body today. There was a serial number on it and a manufacturer insignia. We called the manufacturer and gave them the serial number. They said that the implant was sold to you.”
“If I give you a serial number can you tell me the name of the patient who received it?”
“I think so, but it’s going to take me a little while to track it down. Probably within the hour.”

I wrote down the serial number the officer provided and sat down with the associate dentist and instructed him to pull a report of all the patients who received implants from us. We went through the list and found the matching serial number. I had an eerie feeling looking at the patient’s chart and realizing she was deceased.

The associate began to tell me stories about the patient and how she came into the clinic with a large sum of cash and wanted a full mouth restoration. She bragged about being a renegade farmer and selling her harvested crops in California. The picture slowly came to light. Her body was found on a remote country road in California. The vehicle she was driving had caught on fire. Wild animals had disturbed her body and possibly ran off with clothing and identification.

I haven’t followed the story and I don’t know with complete certainty that the patient was murdered, but the fact is that she isn’t alive anymore. I would have never thought I would help identify a body as a dentist, but there is a first time for everything. Hopefully it’s the last.