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Efficacy of Silver Diamine Fluoride for Arresting Caries Treatment
Journal of Dental Research , 07/30/09

Yee R et al. – Tannic acid conferred no additional benefit. ACT with 38% SDF provides an alternative when restorative treatment for primary teeth is not an option.

Exclusive Author Commentary
R. Yee, 07/31/09

Untreated dental caries is a global pandemic. Many young children are burdened with untreated dental caries from an early age, more so in low- and middle-income countries than high-income countries. Due to limited financial resources, poor access to basic oral care and high cost of restorative treatment, children of disadvantaged communities have their general health, social well being and education opportunities impacted by untreated dental caries. Due to the limitations of a curative approach in managing the problem, alternative strategies to manage caries at the individual and community level need to be considered. Arresting Caries Treatment (ACT) using 38% silver diamine fluoride (SDF) is a minimum intervention technique which has the following advantages: • Low cost: the technique requires only a small number of instruments and materials. A single drop of SDF can be applied to 5 or 6 teeth. • Atraumatic procedure: facilitates treatment of rampant caries in very young children, the handicapped and the fearful without having to resort to general anaesthesia. It reduces the risk of transmission of infections. • Non-invasive simple technique: primary health care workers and other non-dental personnel can be trained to perform the technique with minimal training time. • Portable and lightweight: allows for easy access into the community. • Meets the treatment demands of the community: Many parents do not wish to have their children’s deciduous dentition treated due to other priorities. Arresting the decay would reduce the need for extraction of the deciduous teeth and allow for the natural exfoliation of the teeth. The use of 38% SDF fits well with the Primary Health Care Approach and will allow low- and –middle income nations to meet many of the Millennium Development Goals.

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