The silver bullet

The Silver Bullet

Wondering if this is about the latest action/thriller movie hitting the cinemas this weekend? No, it is not about a feared, underworld don either. It is about something less fearsome perhaps, silver diamine fluoride, fondly called the silver bullet.

Silver diamine fluoride (SDF) is a colourless liquid, tried and tested by dental surgeons in Japan, since the past 40 years, to “arrest” cavities. It is also highly effective for the treatment of hypersensitivity.

The silver content helps in combating the bacteria responsible for deepening cavities. Together with fluoride from toothpastes, it converts “active” lesions (those that have a tendency to worsen) to “inactive” caries lesions (those that remain static for a long time). It is so much more effective than simple fluoride formulations! It is easy to apply too.

The only disadvantage, possibly, is that it causes staining of the cavity and turns it black due to the deposition of silver. However, a tooth-coloured filling material can be placed on top once the cavity is rendered inactive!

So, in which cases do we prescribe SDF?

1. Very young children with lots of cavities, who cannot cooperate for treatments of long duration.
2. Adults, to deal with sensitivity due to caries/ fractures/ tooth erosions
3. Children, prior to placing a filling material so that unnecessary deep cutting of tooth is avoided.