CSL 8 SDF (hard)

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Questions and Answers

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.

False (B)

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.

<p>black</p> Signup and view all the answers

Match the following categories with their descriptions:

<p>Indications = Situations where SDF is recommended for use Contraindications = Scenarios where SDF should not be used Procedure = The steps taken to apply SDF Recall = Follow-up schedule after SDF application</p> Signup and view all the answers

Which condition does NOT represent a contraindication for SDF usage?

<p>Active cavitated dentinal lesions (B)</p> Signup and view all the answers

Fluoride in SDF stimulates remineralization of carious lesions.

<p>True (A)</p> Signup and view all the answers

What is the concentration of flouride level of silver diamine fluoride in ppm?

<p>44,800 ppm</p> Signup and view all the answers

What is the primary benefit of applying silver diamine fluoride (SDF) to a dental lesion?

<p>It prevents the breakdown of the dentinal organic matrix (A)</p> Signup and view all the answers

Silver ions in SDF have no antibacterial action.

<p>False (B)</p> Signup and view all the answers

How often should SDF be reapplied based on the most common protocols?

<p>Every 6 or 12 months</p> Signup and view all the answers

One drop of SDF can treat roughly ___ teeth.

<p>6</p> Signup and view all the answers

Match the following components with their respective functions in the SDF application process:

<p>Fluoride varnish = Keeps SDF in contact with the lesion Isolation with cotton rolls = Ensures proper application Informed consent = Legal requirement before application Air-drying the lesion = Prepares the surface for better contact</p> Signup and view all the answers

Flashcards

SDF (Silver Diamine Fluoride)

A colourless fluoride solution arresting active dentin caries; remnant silver inhibits biofilm, making dentin resistant to bacteria.

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

Soft or frank carious lesions in the dentin layer of a tooth.

Non-restorative Cavity Control

Treatment of cavities without filling or restoration that stops the spread of the cavity.

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Pulp involvement

Inflammatory or infectious condition of the tooth's pulp, often a serious concern.

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Primary teeth

Baby teeth; deciduous teeth.

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Inaccessible proximal lesions

Cavities in the spaces between teeth (proximal) that are hard to reach and treat.

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Remineralization

The process of restoring minerals to the tooth enamel, strengthening it.

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SDF Application

SDF (silver diamine fluoride) is applied to carious lesions to increase resistance to acid and enzymatic breakdown, increase mineral density, and inhibit bacterial growth.

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SDF Concentration

A 38% SDF solution contains 44,800 ppm fluoride and 255,000 ppm silver.

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Application Protocol

SDF is typically applied every 6 to 12 months, and one drop is generally sufficient to treat several teeth. Isolation of the treatment area is recommended.

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Patient Preparation

Informed consent is critical before SDF use, especially for children. Loose debris removal and lesion preparation are done before application.

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Post-Application Care

Patients should avoid eating or drinking for 30 minutes after SDF application. Fluoride varnish can be used to strengthen treatment effects and mask taste.

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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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