Minimally Invasive Dentistry in Coppell, TX

Silver Diamine Fluoride is a fairly new and revolutionary treatment option for the management of cavities in the US.  Silver Diamine Fluoride is an antimicrobial liquid that is able to treat cavities in a non-invasive, painless, fast and affordable way.

Not every patient with tooth decay may be a candidate for this alternative treatment, Dr. Karen evaluates this option and will present it to you if needed.

Minimally Invasive Dentistry in Coppell, TX

Silver Diamine Fluoride is a fairly new and revolutionary treatment option for the management of cavities in the US.  Silver Diamine Fluoride is an antimicrobial liquid that is able to treat cavities in a non-invasive, painless, fast and affordable way.

Not every patient with tooth decay may be a candidate for this alternative treatment, Dr. Karen evaluates this option and will present it to you if needed.

Coppell Pediatric Dentistry Icon

What is Silver Diamine Fluoride?

Untreated decay in young children remains a challenge, in the U.S. and worldwide.  Untreated, it can create significant poor health and quality of life, impacting children and their families.

Surgical-restorative work in young children and those individuals with special health care needs often requires advanced pharmacologic usage for behavior management such as sedation or general anesthesia.  In some cases, these alternatives are not available, nor recommended. SDF is an antimicrobial and remineralizing, liquid that is simply brushed onto the cavity that can stop current decay, prevent new decay in the future and decreases dental sensitivity.

Compared to a traditional filling that requires shots of local anesthetic and drilling of tooth structure, this treatment is non-invasive and more comfortable for the patient. It buys time until the patient gains trust and becomes more comfortable in the dental chair.

SDF Increases access to care, improves dental health and reduces cost.  Keep in mind that SDF does not restore form, nor function.  Teeth may still need a restoration/filling to restore function and esthetics.

Is Silver Diamine fluoride a new medication?

No, Silver Diamine Fluoride has been used extensively around the globe for decades. Advantage Arrest silver diamine fluoride 38% provides another alternative to treatment for young apprehensive patients, teens and even elderly patients.

Silver Diamine Fluoride Teeth

How does Silver diamine fluoride work?

  • Provides immediate relief from dentinal hypersensitivity
  • Kills pathogenic organisms
  • Hardens softened dentin making it more acid and abrasion-resistant
  • Does not stain sound dentin or enamel
  • Can provide important clinical feedback due to its potential to stain visible or hidden lesions

Silver diamine fluoride 38% is indicated for the treatment of dentinal hypersensitivity.

BENEFITS

  • Can stop the grow of cavities up to 80 % or higher
  • Painless
  • Non-invasive
  • Affordable
  • Can stop tooth decay and help prevent recurrent decay.
  • SDF has very low toxicity
  • It is quick a quick procedure
  • Prevents the adherence of plaque
  • It buys time until treatment can be completed safely and possibly avoiding sedation.

DISADVANTAGES

  • SDF permanently stains cavities black (not healthy tooth structure)
  • SDF does not restore tooth form or function, so large holes that trap food may still eventually require traditional restorations.
  • SDF requires repeat application for maximum efficacy. (Dr. Karen will let you know how often needs to be reapplied)
  • SDF can not be used in the presence of infection or decay into the nerve.
  • 20 % of cavities can still grow: Proper oral hygiene and healthy eating habits are necessary for success.
  • SDF stains gums and skin temporarily if apply inadvertently touches

Is Silver Diamine Fluoride FDA approved?

Advantage Arrest is an FDA regulated prescription medical device and is only available for purchase and administration by a licensed healthcare professional.  ELEVATE ORAL CARE

FDA cleared the use of SDF in August of 2014, SDF became commercially available to dental professionals in April of 2015 as Advantage Arrest by Elevate Oral Care.  

Why use Silver diamine fluoride?

Tooth decay remains the number one most common disease of childhood, five times more common than asthma.  Drinking bottled water without fluoride, infrequent or delayed trips to the dentist have all contributed to children having a cavity by age three or earlier.  More than half of children have experienced a cavity by kindergarten.  This problem is not unique to our country and has prompted forward-thinking dentists to rethink our approach to managing tooth decay.

This technique is very exciting for young, fearful or pre-cooperative children, special needs patients, and medically compromised individuals who may otherwise require sedation for traditional dental restorations such as fillings or crowns.  It is also a great option for nursing home elderly patients, those that lack access to care, and those individuals without dental insurance or the funds to afford traditional dental restorations.

IMPORTANT:
Once this treatment is recommended the consumption of unhealthy snacks, frequent consumption of sugary and acidic beverages is highly recommended to change as it will not be as successful.

Thank you to Dr. Matthew Pingel, from Granville Pediatric Dentistry
for facilitating and sharing his amazing work and knowledge in SDF and minimally invasive dentistry.

RESIN INFILTRATION OF WHITE-SPOT LESIONS

WHAT IS ICON? Resin infiltration is a minimally invasive restorative treatment for post-ortho white-spot lesions (WSLs) and certain congenital hypocalcified enamel lesions (“hypo” spots). WSLs are associated with subsurface enamel porosities caused by a cyclical imbalance between demineralization and remineralization of the enamel, resulting from poor hygiene and associated plaque, bacteria and acids. With time, reminerlization at the outer surface of the tooth decreases the access of calcium and other ions to deeper portions of the enamel, eventually arresting the lesion. The lesions look white because there is a scattering of light at the subsurface of the demineralized enamel. Hypo spots, or enamel bruising, are congenital enamel defects often caused by trauma or infection involving the primary teeth.

First described 40 years ago
· Low viscosity, unfilled resin
· Penetrates demineralized enamel and fades the appearance of WSLs and hypo spots
· Optical properties similar to those of natural enamel, so it matches the natural shade of the tooth

THE PROCEDURE

  • One visit
  • No “shots” or numbing
  • No drilling
  • Plain pumice is used to clean the teeth
  • Lesions etched 3×2 minutes – this removes the outer remineralized layer of enamel that had previously been blocking calcium and other ions from entering the tooth
  • Finishing bur on any surfaces that do not indicate an improved appearance
  • Application of drying agent (ethanol)
  • Application of the resin infiltrant
  • Material soaks in for 3 minutes (allowing for capillary action)
  • Remove excess material with cotton rolls, micro-brushes & floss
  • Light cure the material
  • Material added again for 1 minute, excess removed, and cured
  • Finish with polishing discs or burs
  • Temporary blanching of gums can occur in lesions close to the gumline
    * total process takes approximately 45 minutes to 1 hour *

BENEFITS

  • Much less invasive and less expensive than the alternatives of fillings or veneers.
  • Can be done sooner than other cosmetic options like veneers that you have to wait until growth is complete..
  • Untreated hypo spots often look worse after bleaching. Hypo spots treated with Icon will whiten similarly to the natural tooth enamel.
  •  

DOES IT WORK? DOES IT LAST?

Unlike whitening products, Icon resin infiltration is considering to be a long term treatment solution. Research shows stability for at least 2 years.   That being said, we have many patients with stable results for 6+ years.

Key talking point * This is a treatment we offer to help fade the appearance of WSLs & hypo spots. We can not guarantee the spot will disappear completely, but in most cases it provides a significant cosmetic improvement in one simple, painless visit. Worse case scenario – there’s no change in appearance, but at least nothing irreversible or invasive has been done to the tooth.

Curodont Repair Plus Fluoride with CUROLOX technology

Is a non-invasive treatment for non-cavitated caries lesions (porous, not chipped open), that promotes natural remineralization by formation of hydroxyapatite crystals within the enamel. It is good for white spot lesions, decalcification, and demineralization. The 5 minute procedure is simple, painless, and non-staining. Over time, Curodont can facilitate reinforcement of porous enamel to help arrest and reverse early lesions, helping to prolong the life-span of the natural dentition. The product comes from Switzerland, where it has received innovation and technology awards for the CURODONT active ingredient.

How it Works

Curodont Repair Fluoride Plus is applied directly onto the cleaned surface of the early carious lesion and allowed to dry for five minutes. After one application, Curodont Repair Fluoride Plus acts where it is needed. It's that simple. Over the course of weeks, the unique formulation and the application procedure help minerals, like calcium and phosphate found in saliva, to penetrate the enamel surface. Lost enamel is remineralized and re-hardened.

Visual results are usually seen at 90 days, though the enamel begins to repair and reharden much earlier.

Curodont in action

cor

Smooth Surface

Oclusal Surface

Ortho

Interproximal

HALL TECHINIQUE

(HT) is a minimally invasive restorative option for primary teeth with severe decay and/or hypomineralization without numbing (shots), tooth preparation (drilling), or sedation (general anesthesia/IV deep sedation). HT is an evidence based procedure with 5 randomized control trials, with clinical efficacy equivalent to the conventional surgical approach to stainless steel crown (SSC) placement. It originated in Scotland in the 1990’s where general practitioner, Dr. Norna Hall, accidentally discovered that when she sealed her pediatric patient’s carious lesions within a glass ionomer cement under a SSC, the lesions became arrested (inactive) once starved of the carbohydrate substrate necessary to get worse/deeper. Sealing the lesions allows the vital pulp to lay down reparative dentin and retreat/wall itself off from the carious lesion. The procedure is well tolerated by most pediatric patients and is a welcome alternative to the more invasive surgical approach.

INDICATIONS

  • Decayed primary teeth
  • Asymptomatic or reversible pulpitis
  • Clear band of dentin between the carious lesion and the pulp on a radiograph
  • Newly erupted first permanent molars with severe molar incisor hypomineralization (MIH)

CONTRAINDICATIONS

  • Decay extends into the nerve
  • Pain or infection (Irreversible pulpitis)
  • Unrestorable teeth
  • Patients where the airways cannot be protected due to very poor cooperation (will not open mouth, cannot stay still for placement of the crown, will not tolerate anything being placed into the mouth like a mirror, gauze, etc.)

Minimally Invasive Dentistry Near Me

Contact Coppell Pediatric Dentistry to learn more about minimally invasive dentistry. Dr. Karen and her team look forward to working alongside you to ensure your child enjoys a lifetime of healthy smiles. Call us and schedule your child's appointment today!

SOURCES OF INFORMATION

- Silver Diamine fluoride in caries prevention and arrest: a systematic literature review

Dr. Violeta Contreras, DDS, Dr. Milagros J. Toro, DDS, MSD, PhD, Dr. Augusto R. Elías-Boneta, DMD, MSD, DHC, and Ms. Angeliz Encarnación-Burgos. Author manuscript; available in PMC 2017 Jul 31.

Gen Dent. 2017 May-Jun; 65(3): 22–29. 

- Evidence-Based Dentistry Update on Silver Diamine Fluoride.

Crystal YO1, Niederman R2. Dent Clin North Am. 2019 Jan;63(1):45-68. doi: 10.1016/j.cden.2018.08.011.

Use of Silver Diamine Fluoride for Dental Caries Management in Children and Adolescents,

Including Those with Special Health Care Needs

Yasmi O. Crystal, DMD, MSc, FAAPD1 • Abdullah A. Marghalani, BDS, MSD, DrPH2 • Steven D. Ureles, DMD, MS3 • John Timothy Wright, DMD, MS4 • Rosalyn Sulyanto, DMD, MS5 • Kimon Divaris, DDS, PhD6 • Margherita Fontana, DDS, PhD7 • Laurel Graham, MLS8

E-ffectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Arresting Dentin Caries in Chinese Pre-school Children C.H. Chu1, E.C.M. Lo1*, and H.C. Lin2 Faculty of Dentistry, The University of Hong Kong, 34 Hospital Road, Hong Kong, China; and 2Department of Preventive Dentistry, Sun Yat-sen University of Medical Sciences, Guangzhou, China; *corresponding author, edward-lo@hku.hk J Dent Res 81(11):767-770, 2002

  1. Dye BA, Thornton-Evans G, Li X, Iafolla TJ. Dental caries and sealant prevalence in children and adolescents in the United States, 2011–2012. NCHS data brief, no 191. Hyattsville, Md.: National Center for Health Stat- istics. 2015. Available at: “https://www.cdc.gov/nchs/ products/databriefs/db191.htm”. Accessed September 6, 2017. (Archived in WebCite® at: “http://www.webcita tion.org/6tX0D6qO1”)

Gao SS, Zhang S, Mei ML, Lo EC, Chu CH. Caries remineralisation and arresting effect in children by professionally applied fluoride treatment – A systematic review. BMC Oral Health 2016;16:12.

 Duangthip D, Jiang M, Chu CH, Lo EC. Restorative approaches to treat dentin caries in preschool children: Systematic review. Eur J Paediatr Dent 2016;17(2): 113-21.

Crystal YO, Niederman R. Silver diamine fluoride treat- ment considerations in children’s caries management: Brief communication and commentary. Pediatr Dent 2016;38(7):466-71.

Fung M, Duangthip D, Wong M, Lo E, Chu C. Arresting dentine caries with different concentration and perio- dicity of silver diamine fluoride. JDR Clin Transl Res 2016;1(2):143-52.

Llodra JC, Rodriguez A, Ferrer B, Menardia V, Ramos T, Morato M. Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial. J Dent Res 2005;84(8):721-4.

Zhi QH, Lo ECM, Lin HC. Randomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children. J Dent 2012;40(11):962-7.