SDF

Question 1

What are the three components of SDF?

Answer 1

silver
fluoride
ammonium ions

Question 2

What is the licensed use of Riva Star in the UK?

Answer 2

• tooth sensitivity
• cavity cleansing

Question 3

What are the indications for the use of SDF?

Answer 3

• asymptomatic cavitated 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 e.g. dental phobia, medical conditions or disabilities

Question 4

What are the contra-indications of SDF?

Answer 4

• not able or willinng to brush and unlikely to
• potassium iodide is contra-indicated in pregnant or breastfeeding women, patients undergoing thyroid gland therapy or on thyroid medication or patients with knnow allergy to postassium or iodine
• ulceration, mucositis, stomatitis
• allergy to silver, fluoride or ammonia

Question 5

List 3 key elements of prevention that are required along with placement of SDF?

Answer 5

• dietary advice
• oral hygiene instruction
• fluoride

Question 6

After SDF placement, what are the things that can occur due to chemical reactions?

Answer 6

• promotionn 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 dential collagen degradation

Question 7

Describe why SDF is thought to be useful as a caries detection agent.

Answer 7

• only stains carious tooth tissue
• shows the margins of carious enamel more clearly so that less sound tissue is removed during cavity preparation

Question 8

What is the recommended time that should be taken for applying SDF?

Answer 8

up to 3 minutes
1 minute minimum

Question 9

When is the review post- SDF placement and what happens during this visit?

Answer 9

• 2-4 weeks after the first application
• if lesion still active, reapply SDF
• if lesion is restorable, restore with appropriate restorative material
• if unrestorable, then biannual SDF reappliation for better arrest rate

Question 10

What are the disadvantages of SDF?

Answer 10

• can temporarily stains the skin, lips, gums and cheeks brown or white for 1-3 weeks
• can discolour tooth coloured fillings
• can stain clothes
• permanently discolours decayed area of teeth black (not aesthetic)