Silver Diamine Fluoride (SDF) is a non-surgical alternative to fillings offered at Shady Grove Pediatric Dentistry. Dr. Ball can apply this medication to your child’s area(s) of tooth decay and destroy the bacteria that caused the cavity, thereby addressing the decay without doing anything invasive.
SDF is a liquid substance composed of silver, fluoride, ammonia and water and is applied via a microbrush. Depending on the size and location of the cavity, further treatment may be required later on, but SDF is a great tool to “press pause” and determine the next steps in how to best treat the cavity definitively.
SDF is also a great desensitizing agent and can be used to treat the severe hypersensitivy some kids experience from hypoplastic or hypomineralized molars. SDF is a perfect option for treating teeth on very young or highly anxious kids. It can also be considered in cases where there is a cavity on a tooth that is expected to fall out within the next year. In this case, a filling may be excessive, but we can use SDF to stabilize the cavity until the tooth is lost.
The main drawback is the dark staining of the area of decay. However, in most cases, the pros outweigh the cons. Dr. Ball will assess your child’s circumstances and help you make the right decision for your child.
Silver Modified Atraumatic Restorative Technique (SMART) is an evidence-based method to effectively treat cavities without the need for needles or sedation. Children who are young, fearful, or unable to handle “traditional” dental fillings for whatever reason could be great candidates for SMART fillings. In this technique, Dr. Ball would first apply SDF (see section above) to stop progression of decay and kill the cavity-causing bacteria. This step is often completed at the same appointment as the exam and cleaning visit. When your child returns for the filling appointment, the decay has been arrested, and the tooth has been desensitized, which means the cavity can be filled without requiring local anesthesia (injection) and without the use of the dreaded high speed drill. This option is not appropriate for all types of cavities, but Shady Grove Pediatric Dentistry is happy to offer SMART fillings as a minimally-invasive treatment modality under suitable circumstances.
Laughing gas is always available in cases where a parent wishes for their child to have added comfort and relaxation while in the dental chair, though it’s often not needed when providing minimally invasive care.
Hall crowns are used to restore decayed molars (back teeth). This treatment uses a pre-formed stainless steel crown and involves no drilling or removal of part of the tooth, compared to traditional crown placement. The crown is simply chosen based on the size of your child’s tooth, and it’s bonded in place using a special fluoride-containing dental cement. The entire tooth is protected by this “helmet”. The metal crowns are made of medical grade stainless steel and contain no mercury.
Compared to fillings, crowns have better long-term outcomes and require less time in the dental chair. Even though a crown may sound more involved than a filling, that’s not the case. Crowns done using the Hall Technique are well-tolerated even by anxious little ones, and parents have peace of mind that this treatment will hold up well over time. For large cavities, stainless steel crowns are considered the standard of care in pediatric dentistry.
If your child is unable or unwilling to cooperate with getting a filling or a crown, Dr. Ball may recommend active surveillance to start. This means that your child will visit us about every 3 months for a re-evaluation of their tooth decay, and we can work towards an eventual path for treatment tolerance while monitoring the situation and applying fluoride varnish treatments more frequently.
This approach works well if your little one is pre-cooperative (typically under 3) and has non-urgent treatment needs that we would like to address, but when waiting until they are sufficiently cooperative for minimally-invasive care is acceptable.
Do you have questions about minimally invasive dentistry? Get the answers you need.
In cases where serious tooth decay or damage has occurred, a traditional filling or crown may be better than minimally invasive dentistry. A tooth that is beyond restoring may even require removal. Contact Dr. Bana Ball to learn more, and see what treatment may be right for your child.