The Silver Bullet - Silver Diamine Fluoride Use in Older Adults and Children
“Annual application of silver diamine fluoride prevented many more carious lesions than four-times-per-year fluoride varnish in both children and the elderly.” pg 19.
Consider silver diamine fluoride for patients who are at an extreme risk for caries with limited access to care and in nursing homes. Silver diamine fluoride (SDF), approved in Japan for caries arrest more than 80 years ago, was cleared by the Food and Drug Administration (FDA) in August of 2014, and has been available to the U.S. market since April 2015, with approved CDT code: D1354     –     “interim     caries     arresting     medication     application: Conservative    treatment    of    an    active    nonsymptomatic    carious lesion   by   topical   application   of   a   caries   arresting   or   inhibiting medicament    and    without    mechanical    removal    of    sound    tooth structure.” (1) SDF is described as a new, old approach to dental caries because early literature (1907) reports G.V. Black, the Father of Modern Dentistry, once gave protocol for silver nitrate solution on multiple caries arrest in children and root surfaces in adults. (2)  Both fluoride and silver ions contribute to mechanism of action. The silver acts as an anti-microbial agent killing bacteria and preventing the formation of new biofilm, while the fluoride acts to prevent further demineralization. Today, SDF is labeled a topically applied, inexpensive, non-invasive medicament that is only available in the U.S. from Elevate. The University of California, San Francisco, School of Dentistry provides practitioners with guidelines for clinical application and informed consent sample. Read more and download your copy now. References: 1. Horst J., Ellenikiotis H., & Milgram P., (2016). UCSF protocol for caries arrest using silver diamine fluoride: Rational, indications and consent. California Dental Association Journal, 44 (1). Retrieved from 2. Chiang H., Goolsby S., Chiangt, S., & Moon P., (2015). Silver diamine fluoride: A new weapon for caries arrest is now FDA approved in US. Virginia Dental Journal, 92 (3). Retrieved from
Online CE Available from Decisions in Dentistry: Caries Arrest with  Silver Diamine Fluoride