Unfortunately, tooth decay remains the number one most common disease of childhood, five times more common than asthma. Readily available snacks, frequent consumption of sugary and acidic beverages, bottled water without fluoride, infrequent or delayed trips to the dentist have all contributed.
Some patients who have active tooth decay may be eligible for an alternative treatment that uses Silver Diamine Fluoride. FDA approved in August of 2014, SDF became commercially available to dental professionals in April of 2015 as Advantage Arrest by Elevate Oral Care. 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 is a liquid that is easily brushed on to the cavity that can stop current decay and also prevent new decay in the future.
Pros: SDF has very low toxicity, it is quick, painless, non-invasive, affordable, and can stop tooth decay and help prevent recurrent decay.
Cons: SDF permanently stains cavities black. SDF does not restore tooth form or function, so large holes that trap food may still eventually require a SMART filling or traditional restorations. SDF requires repeat application for maximum efficacy. SDF cannot be used in the presence of infection or decay into the nerve.