Module 8 Flashcards
What is the benefit for SDF?
Simple treatment
It stops decay progressing.
What are the risks of SDF?
Decay may continue to develop and further treatment such as fillings or extractions may be required
SDF permanently discolours areas of tooth decay black
Temporary stain to the skin, lips, gums and cheek for 1-3 weeks
Staining to clothing
Temporary metallic taste
Discolouration of tooth coloured fillings
“It permanently discolours the decayed
area of teeth black. Healthy parts of
the tooth do not discolour.
What are the disadvantages of SDF liquid?
It can temporarily stain the skin, lips, gums
and cheeks brown or white for 1-3 weeks,
this will then disappear.
It can also discolour tooth coloured fillings,
polishing these fillings can help remove
this stain but it may stay visible at the join
between the tooth and the filling.
In the unlikely event of SDF being
accidentally spilled on clothes, it can leave
a stain that does not come out.”
What are the alternatives to SDF?
No action (decay will get worse) Application of fluoride varnish Fillings Caps Tooth removal.
What is SDF?
SDF liquid contains silver and fluoride which work together to stop decay progressing further. It is a clear liquid, that has a temporary metallic taste while it is being painted on to teeth.
What is involved in the treatment with SDF?
To protect your child’s lips and gums, your dentist will first apply petroleum jelly (or an
alternative) and also place cotton wool next to their teeth. Their teeth will then be dried.
The SDF liquid is painted on to the teeth for 1-3 minutes. Following this the teeth are dried
a second time. Sometimes, the dentist may then place a filling over the top.
This is all done in one appointment. A second appointment may be made to come
back 2-4 weeks later to check the teeth and apply more SDF liquid if needed.
SDF liquid is usually reapplied every 6 months.
How should the parent prepare the child for the visit?
There are no special preparations required. However, SDF cannot be used if your child has:
An allergy to silver or another heavy metal, or another component of SDF
Painful gums, ulcers or sores in their mouth
Please tell the dentist if you think that any of the above apply to your child
What are the 3 components of SDF?
Silver, fluoride and ammonium ions.
What are the 2 reasons for the licensed use of riva star in the uk?
Tooth sensitivity and cleansing cavities.
What are the indications for the use of SDF?
● Asymptomatic cavitated carious lesions in primary teeth
● Lesions that are, or can be made, cleansable
● Non-restorable dentinal lesions
● Several carious lesions that may not all be treated in one visit
● Root surface carious lesions (primary and permanent teeth)
● MIH cases to reduce sensitivity
● Pre-cooperative children, children and adults whose behaviour/medical conditions limit invasive restorative treatment
● Where there is a need to “buy time” to avoid or delay treatment with sedation or GA
● Patients with high caries risk with medical or psychological conditions that limit other treatment approaches eg patient with dental phobia, medical conditions or disabilities
● Patients who already have a high standard of brushing or are likely to be responsive to measures to change behaviour to carry out frequent, high quality toothbrushing or other methods to clean carious lesions.
What are the contraindications for using SDF?
○ Not able or willing to brush and unlikely to. Patients (or parents) unable or unwilling to take responsibility
○ Potassium iodide is contra-indicated in pregnant or breastfeeding women, patients undergoing thyroid gland therapy or on thyroid medication or patients with known allergy to potassium or iodine.
○ Patients with ulceration, mucositis, stomatitis.
○ Patients with allergy to silver, fluoride or ammonia.
What other elements of prevention are required along with the placement of SDF?
○ Dietary Advice
○ Oral Hygiene Instruction
○ Fluoride.
After placement of SDF on a carious lesion what 5 things can occur as a result of the chemical reactions?
● Promotion of tooth desensitisation by blockage of the dentinal tubules
● Arrest of the carious lesion by blockage of the dentinal tubules
● Bacterial death
● Remineralisation of demineralised tooth tissue
● Inhibition of dentinal collagen degradation.
Describe why SDF is thought to be useful as a caries detection agent.
It only stains carious tooth tissue therefore it can be used to show the margins of carious enamel more clearly so that less sound tooth tissue is removed during preparation of a cavity.
What is the recommended time that should be taken for applying SDF?
● Up to 3 minutes - 1 minute minimum.
After the placement of SDF, what is the follow up period, what needs to be examined and what is the next course of action based on the results of this examination?
○ 2-4 weeks after the first application
○ If the lesion is still active = reapply
○ If the lesion is able to be restored, then use appropriate restorative material
○ If unrestorable then biannual SDF reapplication for better arrest rate.
