Dental News - Dentist turns primary teeth black to explore caries management options

Dental Tribune International

Fri. 15. December 2017

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WINNIPEG, Canada: Treatment for dental cavities using silver diamine fluoride (SDF) could mean that fewer children would need to undergo complex dental surgeries or go under general anesthetic. Currently, Dr. Robert Schroth, dentist and University of Manitoba associate professor, is leading a small study involving 35 kids to test the use of SDF to stop the advance of tooth decay.

SDF—a clear liquid, which contains a high concentration of silver and fluoride—was approved by the Canadian Department of Health in February 2017. The very simple procedure is also cheaper and quicker than doing conventional fillings. Schroth says the treatment could help toddlers and younger children who are not yet able sit through a filling session without being put under anesthesia. It could also serve as a "stop-gap" for low-income families or people in remote areas where dental surgery is not readily available, halting the tooth decay until they can receive more complex treatment.

"Right now, I see this as really helpful for children who are very young, they might have some behavior management issues, and it's very difficult to perhaps do conventional treatment in the chair setting," Schroth explained. "These are inner-city, community-based dental clinics where often we tend to see individuals who are struggling financially, they don't have dental insurance quite often and otherwise without a product like SDF, they might fall through the cracks," he added.

Even though SDF has many advantages, there is one major downside: the chemical turns the treated area black, but the visual side-effect has not deterred many of the parents Schroth has worked with, he said. After all, the black spot left behind after the SDF treatments looks a lot like an untreated cavity. Schroth said: "From what we've had with our small sample to date, most parents seem to be very accepting of this, because they realize that they really didn't have an alternative."

At the moment, the treatment is not widely available in dentist offices yet and private insurance policies do not cover the treatment. While the Non-Insured Health Benefits Program is reviewing SDF, Schroth also pointed out that dentists need to develop clinical guidelines to figure out when to use SDF and in which cases. Potassium iodine is currently also being investigated by researchers to try and prevent the black staining.

Schroth is conducting the study in partnership with the Children's Hospital Research Institute of Manitoba in Canada. He's working with roughly 35 kids at Mount Carmel Clinic and ACCESS Downtown.