A major struggle that we have had in dentistry has been the inability to stop and reverse dental decay after it has started. There have been several products and initiatives that have helped the battle against dental decay, such as fluoridated water and topical fluoride varnish, however these options are best used as a preventative measure and can’t be relied upon after a cavity has formed.
The most reliable and definitive measure to treat decay is still removal of the decay and replacement with a dental restoration. However, there is another material called Silver Diamine Fluoride (SDF), which can be used in situations where a dental restoration is not feasible. SDF is a blue liquid that when applied to an area of decay, infiltrates into the lesion and initiates a remineralization process that stops the decay from progressing. This is a very easy process that can be done in less than a minute without anesthetic. After application, the lesion is monitored over time and SDF can be reapplied as needed. The one drawback to this process is that when the remineralization process takes place, the silver in the solution precipitates and darkens the area. Because of this, we use this product exclusively on back teeth so that it does not cause any esthetic issues. This material is generally reserved for our patients who are too young or too old to reasonably and safely undergo dental treatment.