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Alternative for fill and drill treatment of cavities


By: Andrea K. McDaniels,

Heather got a big surprise when she took her 4-year-old son for a routine dental checkup — young Eli had several cavities and needed eight crowns on his back teeth.

The Baltimore mom worried about her child undergoing such a complex medical treatment, which the doctor said would require general anesthesia.

“I could not wrap my head around the fact that my kid would have to go through a procedure of this magnitude,” Powell said.

Desperate for an alternative, Powell began searching the Internet for other options. She discovered a handful of dentists around the country who use a mixture called silver diamine fluoride to freeze cavities, preventing the infection from spreading. The clear concoction is simply painted on — a process that takes mere seconds per tooth. The silver makes the tooth hard.

Powell was sold.

But use of silver diamine fluoride is not widespread and not usually offered as an option to patients. Some dentists have not even heard of the treatment. Powell had difficulty finding a doctor who used it, finally persuading her dentist to order it and try it on her son.

While dentists around the world have used silver diamine fluoride for decades, it wasn’t approved for use in the United States by the Food and Drug Administration until the past year and then only for limited use as a device to treat teeth sensitivity in adults and not cavities. Dentists who use it to treat cavities do it off label — when a drug is used for purposes other than intended.

Some dentists and patients are turned off because the process turns the spot on the tooth where it’s applied permanently black.

Yet for all the critics, there is a growing movement among some dentists in favor of its use. Clinical trials at least two universities — the University of Michigan and the University of Iowa — are underway, seeking to gather more evidence of its effectiveness that could eventually pave the way for an FDA application for treatment of cavities. Supporters of the treatment call it a less invasive option then the traditional “drill and fill” methods that may scare young children, and even adults. It also is a much cheaper option.

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