Informed Consent for Fluoride Treatment

Why dental caries are a problem

• People are living longer now and most still have most of their own teeth.
• In older age groups, most people are taking a range of different prescription medicines, which can create a dry mouth as a side effect. Our saliva is so essential to controlling tooth decay and gum disease, and a dry mouth means less saliva, 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 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.

What does fluoride treatment 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 becomes 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.
• Root decay areas, even when filled, are hard to maintain and the decay process tends to encircle the root of the tooth over time, making it very weak and fragile. Once the decayed area is treated this way, it becomes hard again, even if the colour is quite noticeable. In most situations, it is out of sight.
• The process does need to be repeated in this group of people approximately every 3 to 4 months, but the fees for this are under $40 per tooth for each application and the process is simple and painless.
• Areas that have been repeated problems can be better treated with this method and it preserves sound healthy tooth structure previously under threat by the softened root around it.
• Areas that were previously sensitive are very effectively desensitised with this technique.
• In some situations, we may still advise the treated areas to have a filling, but the good news is that the filling can usually be done painlessly without any needles because of the strong desensitisation.
• The majority of people, once given the choices of conventional dental treatment or this newer option, are happy to accept that the previously decayed areas will turn dark in colour rather than go through the more traditional forms of continuing to fill these decay-prone areas.
• Some patients will still opt to have traditional forms of treatment.

Advantages of treatment using the Silver Fluoride/Stannous Fluoride or Silver Diamine 

• The active decay process is arrested, and this softened area becomes hard again.
• The sensitivity of the area is eliminated.
• The desensitised area can be painlessly filled conventionally after about 2 weeks without using needles.
• More sound tooth structure is preserved in the event that we do advise the tooth be filled after treatment.
• The processes of treating active decay are quick, painless and at a fraction of the fee for conventional fillings.
• Numerous teeth can be treated in a single visit if required.
• Areas of gum disease around these decayed root areas are similarly shown to become less inflamed and bleed less.
• Emergency visits are cut down by about 80%.
• People are helped to keep their teeth through life, and it is shown that having few or no teeth is associated with a shorter life expectancy and lower quality of life.

Disadvantages of treatment using the Silver Fluoride/Stannous Fluoride or Silver Diamine

• The process usually requires to be redone usually every 3-4 months in this group of people.
• The areas treated for active decay become darkly discoloured which, to some people, is not acceptable.
• A very small minority of people are opposed to the use of Fluoride in any form. Unfortunately, this means the greater need for traditional fillings and more teeth that will ultimately be lost.

Informed Consent for fluoride treatment