Podcast
Questions and Answers
What is the main role of the silver in silver diamine fluoride (SDF)?
What is the main role of the silver in silver diamine fluoride (SDF)?
- Strengthen enamel
- Act as an antimicrobial (correct)
- Whiten teeth
- Promote fluoride absorption
Silver diamine fluoride is a restorative treatment method for carious lesions.
Silver diamine fluoride is a restorative treatment method for carious lesions.
False (B)
List one indication for using silver diamine fluoride in children.
List one indication for using silver diamine fluoride in children.
Active cavitated dentinal lesions.
Silver diamine fluoride discolors arrested carious tissue ___ when it is applied.
Silver diamine fluoride discolors arrested carious tissue ___ when it is applied.
Match the following categories with their descriptions:
Match the following categories with their descriptions:
Which condition does NOT represent a contraindication for SDF usage?
Which condition does NOT represent a contraindication for SDF usage?
Fluoride in SDF stimulates remineralization of carious lesions.
Fluoride in SDF stimulates remineralization of carious lesions.
What is the concentration of flouride level of silver diamine fluoride in ppm?
What is the concentration of flouride level of silver diamine fluoride in ppm?
What is the primary benefit of applying silver diamine fluoride (SDF) to a dental lesion?
What is the primary benefit of applying silver diamine fluoride (SDF) to a dental lesion?
Silver ions in SDF have no antibacterial action.
Silver ions in SDF have no antibacterial action.
How often should SDF be reapplied based on the most common protocols?
How often should SDF be reapplied based on the most common protocols?
One drop of SDF can treat roughly ___ teeth.
One drop of SDF can treat roughly ___ teeth.
Match the following components with their respective functions in the SDF application process:
Match the following components with their respective functions in the SDF application process:
Flashcards
SDF (Silver Diamine Fluoride)
SDF (Silver Diamine Fluoride)
A colourless fluoride solution arresting active dentin caries; remnant silver inhibits biofilm, making dentin resistant to bacteria.
Indications for SDF
Indications for SDF
Use SDF on primary teeth with active dentin cavities, minimal pulp involvement, limited or no cooperation, deep active carious lesions, inaccessible lesions, multi-surface lesions, or when restorations are difficult. Also a preferred choice for children with limited access to care.
Active dentin caries
Active dentin caries
Soft or frank carious lesions in the dentin layer of a tooth.
Non-restorative Cavity Control
Non-restorative Cavity Control
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Pulp involvement
Pulp involvement
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Primary teeth
Primary teeth
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Inaccessible proximal lesions
Inaccessible proximal lesions
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Remineralization
Remineralization
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SDF Application
SDF Application
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SDF Concentration
SDF Concentration
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Application Protocol
Application Protocol
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Patient Preparation
Patient Preparation
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Post-Application Care
Post-Application Care
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Study Notes
Non-restorative Cavity Control Using Silver Diamine Fluoride (SDF)
- Silver diamine fluoride (SDF) is a colorless fluoride delivery solution.
- SDF contains approximately 44,800 ppm fluoride and 255,000 ppm silver.
- SDF arrests active carious lesions, especially in dentin.
- SDF inhibits further biofilm formation.
- SDF strengthens treated dentin, making it more resistant to cariogenic bacteria.
- SDF remineralizes the lesion by stimulating fluoride activity.
- SDF stabilizes the solution with ammonia.
- SDF is economical and non-invasive for carious lesion management.
- SDF discolors the arrested carious tissue black.
- SDF is valuable for pre-cooperative children and in cases where operative care is limited by disabilities.
- SDF is a beneficial alternative when restorative options are unavailable or are unaffordable.
Indications for SDF Use
- Primary tooth surfaces with active cavitated dentinal lesions (frank soft carious lesions), no signs or symptoms of pulp involvement.
- Children with cooperation limited by age or disabilities where conventional operative dentistry is challenging.
- Deep active carious lesions, where clinicians desire to arrest lesion progression before restorative procedures.
- Inaccessible proximal lesions requiring extensive tooth preparation for restorations.
- Multi-surface dentinal lesions, or difficult to treat cavitated carious lesions.
- Lower anterior primary teeth, when the longevity of the restoration is questionable.
- Children with limited access to dental care.
Mechanism of Action (MoA)
- SDF increases resistance to acid and enzymatic digestion via silver protein conjugates.
- SDF increases the mineral density and hardness of hydroxyapatite and fluorapatite formation.
- SDF contains anti-protease activity, which prevents the breakdown of the dentinal organic matrix.
- SDF has a direct antibacterial action, killing cariogenic bacteria.
- SDF-treated lesions resist biofilm formation.
Application Procedure
- One drop of SDF is enough for roughly 6 teeth.
- Cotton rolls are sufficient for isolation.
- Superficial loose debris removal is required.
- Dry the lesion before SDF application.
- SDF application for a minute, followed by gentle drying.
- Isolate the application site for up to 3 minutes post-application.
- Apply fluoride varnish after SDF application to mask the taste and maintain contact with the lesion.
- Patients should avoid eating or drinking for 30 minutes post treatment.
Protocols
- Reapplication every 12 months (annual) or every 6 months (semi-annual).
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