Early Childhood Dental Caries (Decay)

Why has it been suggested to you to have your child’s teeth managed using Silver Fluoride and Stannous Fluoride products?

Tooth decay in young children is very difficult to manage by conventional dental methods because: –

• Young children are often very apprehensive, and this affects their ability to be cooperative enough to be able to do a conventional filling or even tooth removal painlessly and well.
• It can be psychologically traumatic to the child, parent/carer and the dental team, attempting to treat several decayed teeth or even just one.
• A young child, irrespective of how well behaved, can usually not sit still while being given a local anaesthetic injection. Forcing the issue and holding a child down is something we have never done, nor would we ever do.

Often, the only way to do conventional fillings and tooth removal is under heavy sedation or a General Anaesthetic (GA). Sedation of a child is risky and hard to manage.

GAs are not without risks and it has been demonstrated that doing long or repeated GAs for a child under 3 may result in permanent brain damage. GAs are very hard to book and are very expensive because there are Anaesthetist fees and Theatre fees on top of the dental fees which include a loading fee for working under GA.

If a child has had a bad dental experience, the effects can be life-long and result in a dental phobia. With this technique, most children lose their fear of dental treatment and become more easily managed. Over 80% of teeth treated this way have the decay fully arrested. Emergency dental visits are reduced by 80%.

For a few decades there has been a far simpler solution, and this is now available again in Australia. Future Dental is, to our knowledge, the only practice in Cairns offering this simpler technique.

What does it involve?

Instead of giving needles and using the drill or sending children for Sedation or a GA, to have their dental fillings and extractions done, we now offer the use of Silver Fluoride and Stannous Fluoride, which, when applied to areas of active tooth decay, arrest the decay process. This is far more powerful and effective than any other ways of using Fluoride.

The quantities used are minute and the product is extremely safe.

Furthermore, the sensitivity a child may have been experiencing from the tooth decay is also arrested. No needles and instead, a painless application of these 2 products and the problem is solved. Do they need a filling subsequently? Sometimes it may be advised, but since the decay is mainly in the baby teeth, we just need to keep the teeth in place until the child is old enough to have the teeth come out naturally, as all baby teeth do. This helps prevent crowded teeth and future orthodontic treatment often.

Is one application per tooth enough? 

No. Usually in children it needs to be reapplied after 2-3 weeks after the first application, and then repeated every 6 months or so. If we advise a filling is wise, or if you as a parent/carer, decide you want a filling in the treated tooth, the tooth is so effectively desensitised, that the filling can usually be done without any needles and without any pain.

How does Silver Fluoride and Stannous Fluoride work?

Firstly, we apply it directly to the decayed area. The effect is the decay turns black. This is instantaneous and you need to be aware that this is going to happen. Any other soft tissues or clothing will stain too, so we are very careful in the application. The silver kills the decay bacteria and the fluoride remineralises the tooth structure. The arrested decay turns shiny hard in about 10-14 days and by then the complete desensitization has occurred.

Won’t it be very noticeable? 

Yes, if we use it around the front teeth. Only the decay turns dark, not the remaining tooth structure. Surrounding gum and healthy tooth structure will stain for a few days, but after will only affect areas of active decay on teeth.

Most parents/carers, once they realise the psychological and monetary cost of having to do conventional dentistry, especially if the only sensible way is with a GA, are happy to accept this in baby teeth. We tell the children that the arrested decay which becomes shiny black and very hard, is their black diamond.

Does Medicare under the Child Dental Benefit Scheme cover the cost of this? 

Unfortunately, not yet, but the cost is a small fraction of the cost of conventional dental treatment, at $40 per tooth, per application. If you have private dental health insurance, your health fund may cover some of the cost. With this technique, often 3 or more teeth can be treated in a single session.

Can all decayed baby teeth be treated this way? 

No, unfortunately. If a tooth has already developed a severe toothache or an abscess, it is too late for this technique. Extremely deep decay may not be possible to treat this way. If parents/carers refuse to accept the Black Diamond look of arrested decay, conventional dentistry, and likely referral for a GA may be the only option. Some parents are opposed to the use of fluoride. Regrettably this leaves their children needing conventional dental care whatever that may necessitate.

Dental Caries management in senior citizens 

Dental Caries management in senior citizens and those who have a reduced capacity to manage their oral health. Tooth root caries (decay) is the most common issue.

Why is this a problem?

People are living longer now and most still have most of their own teeth. In this age group, most are taking a range of different prescription medicines, the result of which is a dry mouth. Our saliva is so essential to control decay and gum disease, and a dry mouth means more decay and more gum disease.

At this age, the roots of the teeth are exposed, and this part of the tooth is much more sensitive, more prone to decay and is much softer and more difficult to clean and manage. Most of us in this age group have gone a few decades with low dental expenses, and suddenly they are piling up again for all the above reasons, and usually by this time, we are on a fixed income and can little afford a mouth-full of expensive dental repairs.

There is now a far simpler and cheaper solution, and we believe so far, we are the only dental practice in Cairns offering this technique.

What does it involve?

Caries (tooth decay) can now be arrested and stopped from progressing by the application of Silver Fluoride followed by Stannous Fluoride, or the use of Silver Diamine Fluoride. Once active decay is treated this way, the bacteria that cause the decay are destroyed and the previously softened decayed tooth structure become firm and hard again. Active decayed areas turn a very dark brown or black colour, which does not change the colour of remaining tooth structure around it.