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AU '18 - Peds III exam III > Silver Diamine Fluoride > Flashcards

Silver Diamine Fluoride Flashcards

1
Q

ingredients

A
  1. silver (25%)
  2. fluoride (5%)
  3. diamine ~ammonia (8%)
  4. deionized water (62%)
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2
Q

purpose of silver

A

antimicrobial. ..
1. denatures proteins
2. breaks cell walls and membranes
3. inhibits DNA replication

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3
Q

fluoride promotes what?

A

remineralization

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4
Q

purpose of diamine ~ammonia

A
  1. stabilizer

2. vaporizes at body temperature

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5
Q

how many mg of silver per drop?

A

9.5 mg

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6
Q

lethal dose of silver?

A

380 mg/kg

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7
Q

how many mg of fluoride per drop?

A

2.24 mg

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8
Q

potential toxic dose of fluoride?

A

5 mg/kg

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9
Q

lethal dose of fluoride?

A

~50 mg/kg

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10
Q

how many drops is lethal dose of silver for 10-kg child?

A

400 drops

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11
Q

how many drops is PTD of fluoride for 10-kg child?

A
  1. without 5% varnish: 22 drops

2. with 5% varnish: 17 drops

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12
Q

goals of SDF

A
  1. caries control and arrest

2. decrease dentin hypersensitivity

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13
Q

T/F: SDF is more effective than F varnish and interim therapeutic restorations

A

true

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14
Q

SDF stops and prevents what percent of lesions?

A

80%

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15
Q

T/F: diet and hygiene must also improve simultaneously with use of SDF

A

true

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16
Q

contraindications for SDF

A
  1. silver allergy
  2. irreversible pulpitis or pulpal necrosis
  3. (relative) ulcerative gingivitis
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17
Q

what does SDF taste like?

A

transient metallic or bitter taste so use fluoride varnish to cover up taste

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18
Q

how much would a drop cost per pt?

A

$0.60 cents per drop

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19
Q

indications for SDF

A
  1. rampant caries/caries control
  2. difficulty receiving tx
  3. difficult teeth
  4. teeth w/ limited time left in mouth
  5. savvy parents
  6. SDF results in less need for local anesthesia at restorative visit
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20
Q

SDF can be used on what type of teeth?

A
  1. ones w/ dentinal hypersensitivity
  2. active lesions
  3. posterior and anterior
  4. primary and permanent
21
Q

T/F: SDF requires numbing and/or drilling

A

false, doesn’t require either

22
Q

the black color indicates what?

A

that SDF is working

23
Q

if accidentally stained by SDF elsewhere, how long before it disappears?

A

within 1-3 wks

24
Q

how long should SDF be allowed to dry for?

A

~1 minute

25
Q

T/F: smooth and “open” surfaces are better when applying SDF than proximal or occlusal surfaces

A

true

26
Q

current guideline for number of SDF applications

A

apply every 6 months until lesion stable, restored or tooth exfoliates

27
Q

T/F: SDF needs to be cured with curing light

A

FALSE!!

28
Q

why should you not cure SDF?

A
  1. increases precipitation of silver out of solution at surface
  2. inhibits deep penetration of SDF into dentin
29
Q

when should SDF be done during the appt?

A

at the end

30
Q

clinical evaluation of SDF success

A
  1. “matte black”

2. lesion hard to Dycal instrument or perio probe

31
Q

radiographic evaluation of SDF success

A
  1. no progression of lesion

2. may have secondary dentin formation

32
Q

patient evaluation of SDF success

A
  1. absence of syms

2. decreased sensitivity

33
Q

waiting to rinse, eat, drink after application of SDF allows what?

A

formation of calcium fluoride in saliva

34
Q

short-term effect on gingiva after SDF application

A

transient inflammation (24 hr)

35
Q

long-term effect on gingiva after SDF application

A

reduces plaque and gingival inflammation where it is applied (antimicrobial)

36
Q

post-op effect on teeth after SDF application

A
  1. functional indicator of effectiveness

2. staining or radiolucency under restoration does not indicate active decay

37
Q

T/F: composite and glass ionomer bond strength is affected by SDF

A

false, unaffected

38
Q

if it is not necessary to remove stain from SDF, why might you need to slightly prep axial walls and/or place opaquer on pulpal floor?

A

for esthetics

39
Q

T/F: if there are no symptoms, you still need to excavate pulpally or do pulpotomy

A

FALSE, do NOT

40
Q

why would you not need to excavate pulpally or do pulpotomy post-SDF?

A

SDF causes dentin to lay down a protective layer, like an indirect pulp cap

41
Q

T/F: it is okay if there is some soft dentin below the SDF hard layer

A

true

42
Q

silver modified atraumatic restorative technique (SMART)

A

SDF + self-curing GIC

43
Q

SDF’s role in SMART

A

to arrest and remineralize

44
Q

GI’s role in SMART

A

to restore and remineralize

45
Q

T/F: etch should be used before applying GI or RMGI when using SMART

A

false, not etch but polyacrylic acid

46
Q

SDF pros

A
  1. quick and painless (non-invasive)
  2. safe
  3. affordable
  4. stops tooth decay and sensitivity, can help prevent recurrent decay
  5. may help improve trust, compliance, cooperation
  6. teeth can ALWAYS be restored later
  7. less need for LA = more volume
47
Q

SDF cons

A
  1. permanently stains cavities black
  2. does not restore form or fxn (but SMART filling does!)
  3. requires repeat applicatiosn for max effectiveness
  4. doesn’t tx teeth w/ infected pulp - dx is important
  5. not a silver bullet - SDF cannot work alone!
48
Q

who else can benefit from SDF?

A
  1. frail elderly
  2. immunocompromised
  3. Sjogren’s syndrome, polypharmacy, xerostomia
  4. methamphetamine abuse
  5. dental phobias
  6. cognitive disabilities
  7. recurrent decay at crown margins
  8. root caries
  9. or nay patient who needs a caries control phase

AU '18 - Peds III exam III (12 decks)

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