Dentistry without drilling

Silver diamine fluoride (SDF) is relatively new in Canada since its approval in 2017. In Japan and other countries, silver topical agents such as SDF and silver nitrate have been used safely for over 40 years to stop cavity progression and reduce tooth sensitivity. SDF contains a mixture of silver and fluoride. The silver content is an effective antimicrobial agent against cavity bacteria.

The fluoride component forms a protective layer through the remineralization process in and around the cavity. This special layer is more resistant to future cavities than a normal tooth structure and slows down the cavity process.

SDF application is simple and safe for children, even for the littlest ones. It involves drying the saliva from the cavity and painting the SDF liquid using a small brush. It is then left to be absorbed by the cavity and to dry for one minute followed by a big high-five to celebrate being finished! SDF dental treatment is most often used for very young children with anxiety or special health-care needs.

Once SDF is fully absorbed by the decayed area, the cavity becomes discoloured. SDF can be reapplied if the cavity starts progressing again.

When the progress of a cavity continues even with SDF application or when the size and location of the cavity makes it difficult to have an interim filling placed, we can consider a Hall technique crown. It’s an innovative way to manage cavities for young and apprehensive children, who’d otherwise require sedation or traditional surgical interventions.

Imagine dropping cavity bugs in cement and covering them with a cap to completely seal them off from the outside environment. Without the nutrition and fuel needed to survive, the process of cavities stop and the bacteria withers.

For carefully selected cavities, the Hall technique has an equivalent success rate to traditionally placed crowns. The first step involves placing a couple of elastics (safe even if swallowed) in between the teeth to make room. After 2-7 days, a stainless steel crown is placed on the tooth with dental cement. This avoids the use of any shots or drills that would normally be needed for placing a crown.

While drill-free management is an effective and realistic option for many children, it’s important to remember that not all cavities can be managed this way. Dr. Fran considers multiple factors, including the risk of getting new cavities, diet, oral hygiene and the child’s level of cooperation. At Glow, we always invite families to be part of  the decision-making process for your child’s best interest. Ask Dr. Fran if you have any questions about our non-invasive options!