SDF Flashcards
what is the function of SDF
arrest caries in primary and permanent dentition
treat sensitivity
it can be used under GIC restorations as part of the Silver Modified Atraumatic Restorative Technique (SMART)
what are the constituents of SDF and what is the function of each
Silver - bactericidal so disrupts cariogenic biofilm
Fluoride - promotes remineralisation
Ag and F work synergistically to arrest caries and are stabilised in ammonia
SDF also inhibits collagen degradation
SDF permanently colours caries black and can stain soft tissues brown for 1-3 weeks
what is the function of potassium iodide
in theory it reduces staining caused by SDF
it may reduce the efficacy of SDF at arresting caries
what are the indications for SDF
children whose age/behaviour/medical conditions/anxiety exclude other treatment methods
children who need to delay treatment (for sedation or GA)
children whose family are compliant with preventative advice
asymptomatic cleanable cavities into dentine where other treatment is not possible
pre cooperative patients
as part of acclimatisation prior to other treatment
in conjunction with SMART
what are the contraindications for SDF
irreversible pulpitis, abscess, sinus
PA radiolucency or pulp involvement on radiograph
allergy
active ulceration or mucositis
pregnant or breastfeeding
thyroid medication or therapy
what pre op action should you take before placing SDF
check pt ID and medical history
valid informed consent
PPE for operator, nurse, patient
pre op photos and radiograph if indicated
SDF kept in fridge when not in use
change gloves as required to minimise staining
what are the clinical stages of SDF
petroleum jelly on soft tissues (lip and gums)
ensure teeth are clean, free of debris, dry
use silver brush to pierce the silver capsule and carefully apply solution with micro brush
use one capsule per patient; max one capsule per visit
leave to dry (minimum 1 minute, ideally 3 minutes)
if using potassium iodide - pierce foil of green capsule and apply to treatment site with green brush; continue application until the creamy white solution on lesion turns clear
if part of the smart technique - ask patient to rinse mouth with water, dry, apply GIC restoration
what are the post op procedures for SDF
follow up 2-4 weeks after first application to assess caries arrest
carry out reapplication if indicated - arrest is demonstrated by hard, darkened lesion
further SDF can be applied after 6 months, or teeth can be subsequently restored
clinical and radiograph follow up done as per caries risk and national guidance
what is the concentration of SDF
38%; 44,800ppm F
