- Reservoir of fluoride
- Neutralizes imbalance in demineralization/mineralization
Where did this come from?
- Silver Nitrate used globally for >1000 years.
- AgF used in Japan for over 900 years, Cosmetic blackening of teeth, Known to prevent caries
- NH3 + added >80 years ago = SDF: Approved & monitored by Japan
- Available in Australia, Brazil, Argentina, Cuba, China since 1980s or before…
When would you use SDF?
- Extreme caries risk
- Behaviour or medical management challenges
- More lesions than treatable at 1 visit
- Difficult to treat lesions (including root surface caries)
- Patients without access to care
- Young patients’ wait‐listed for OR‐based dental treatment
How safe is SDF?
- No adverse reports in >80 years of use in Japan
- Contraindication – Silver allergy
- Relative contraindication: significant desquamative processes e.g. ulcerative gingivitis, stomatitis → Protect area by petroleum jelly
- Side effects: Small, white mucosal lesions disappear in 48 hours – Will stain the lesion black
Why I think SDF can be a game‐changer in Dental Public Health
- SDF arrests ~80% caries when used 2/year
- Powerful indirect prevention
- Benefits far outweigh risks
- Easily used in field settings
- May be applied by dental hygienists