Page 17 - GP Fall 2020

delays to restorative dentistry. It was an ap- References Teresa (Terri) Skalyo,
propriate therapy for the cases presented. 1. Horst JA, Ellenikiotis H, Milgrom PL. UCSF Pro-
tocol for Caries Arrest Using Silver Diamine Fluo- DDS, FAGD is a graduate
ride: Rationale, Indications and Consent. J Calif Dent of SUNY Stony Brook
CDT code for SDF is D1354- Interim Assoc. 2016;44(1):16-28. School of Dental Medicine,
caries arresting medicament application. 2. Sarvas,E. The History and Use of Silver Diamine Class of 1994. She is the
However, the current reimbursement var- Fluoride in Dentistry: A review.J Calif Dent Assoc Vol current president-elect
ies among states and insurance companies. 46, Nº 1. of the NYSAGD and has
3. Slayton RL, Urquhart O, Araujo MWB, et al.
Evidence-based clinical practice guideline on non- a private practice in
As with all dental procedures, you may restorative treatments for carious lesions: A report Geneva, NY.
want to have patients sign a consent form from the American Dental Association. J Am Dent
Assoc. 2018;149(10):837-849.e19. doi:10.1016/j.
that outlines all the risks and benefits of the adaj.2018.07.002. Analia Veitz-Keenan, DDS
use of SDF. 4. Alvear Fa B, Jew JA, Wong A, Young D. Sil- is a private practitioner
ver Modified Atraumatic Restorative Technique and the current secretary
Pretreatment of dentin with SDF does not (SMART): an alternative caries prevention tool. Sto- for the NYSAGD. She is
maEduJ. 2016;3(2):18-24.
adversely affect bond strength of resin 5. Crystal YO, Marghalani AA, Ureles SD, et al. a Clinical Professor in
composite to dentin. 8 Use of silver diamine fluoride for dental caries the Department of Oral
management in children and adolescents, including Maxillofacial Pathology,
Some contraindications exist to the use of those with special health care needs. Pediatr Dent Radiology and Medicine
2017;39(5):E135-E145.
SDF including patients with a silver aller- 6. Chibinski AC, Wambier LM, Feltrin J, Loguercio and the Director of Evidence-Based
gy or with a significant adjacent mucosal AD, Wambier DS, Reis A. Silver diamine fluoride has Dentistry in the Department of Epidemiology
lesion, and it should not be applied to ex- efficacy in controlling caries progression in primary and Health Promotion at NYU College of
teeth: a systematic review and meta-analysis. Caries
posed pulp tissue. Res. 2017;51(5):527-541. Dentistry. She is a graduate of NYU College
of Dentistry, Class of 1999.
7. Hendre AD, Taylor GW, Chávez EM, Hyde S. A
With all the pros and cons, we will likely systematic review of silver diamine fluoride: Effective-
see more of SDF in the future of dentistry. ness and application in older adults. Gerodontology.
2017;34(4):411-419. doi:10.1111/ger.12294.
8. Quock RL, Barros JA, Yang SW, Patel SA. Ef-
fect of silver diamine fluoride on microtensile bond
strength to dentin. Oper Dent 2012;37(6):610-6.
Consent to use Silver Diamine Fluoride
Silver Diamine Fluoride Silver diamine fluoride (SDF) is an an- These side effects may not include all of the possible situations
timicrobial liquid. SDF can be used to treat cavities to help stop reported by the manufacturer. If you notice other effects, please
tooth decay. SDF can also be used to treat tooth sensitivity. SDF talk with your dental provider.
may require application every six to 12 months, or more often as
determined by the dentist. Patients should not be treated with SDF if: Allergic to silver OR if
there are painful sores or raw areas on gums (i.e., ulcerative gingi-
The procedure: vitis) or anywhere in the mouth (i.e., stomatitis).
• Drying the affected area.
• Placing a small amount of SDF on the affected area. Every reasonable effort will be made to ensure the success of SDF
• Allowing SDF to dry for one minute. treatment. There is a risk that the procedure will not stop the decay
• Application of a fluoride varnish over the area. and no guarantee of success is granted or implied. If tooth decay is
not arrested, the decay will progress. In that case, the tooth will re-
Treatment with SDF does not eliminate the need for dental fillings quire further treatment, such as repeat SDF, a filling or crown, root
or crowns to repair function or esthetics. Benefits of SDF: canal treatment or extraction. If you decide not to have the SDF
• SDF can help stop tooth decay. application for your child, it may result in continued deterioration
• SDF can help relieve sensitivity. of tooth structures. Symptoms may increase in severity.
Risks related to SDF include, but are not limited to: Alternatives to SDF application include but are not limited to the
• The affected area will stain black permanently. Healthy following:
tooth structure will not stain. Stained tooth structure can be • Use of repeated applications of fluoride varnish or other an-
replaced with a filling or a crown. timicrobials (e.g., chlorhexidine) to limit the progression of
• Tooth-colored fillings and crowns may discolor if SDF is tooth decay.
applied to them. Color changes on the surface can normally • Depending on the extent of decay, placement of a filling or
be polished off. The edge between a tooth and filling may crown or extraction of the affected tooth, this may require
remain stained. advanced treatment modalities such as sedation or general
• If accidentally applied to the skin or gums, a brown or white anesthesia.
stain may appear that causes no harm, cannot be washed off
and will disappear in one to three weeks.
• You may notice a metallic taste. This will go away rapidly.

I CERTIFY THAT I HAVE READ AND FULLY UNDERSTAND THIS DOCUMENT, AND ALL MY QUESTIONS WERE ANSWERED:

____________________________________________(Printed name of patient)
________________________________(signature of patient or parent) ___________________(date)
________________________________________(signature of witness) ___________________(date)
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