Discoloration of demineralized or cavitated surface of tooth is a major drawback of SDF (Silver Diamine Fluoride). This agent permanently blackens carious enamel and dentinal lesions.
Since, it is not mandatory to excavate the infected dentin before SDF application,and there is no tooth preparation also how would the longevity and aesthetics of such restorations be?
Any studies reporting the same?
It is preferable to excavate the infected dentine and apply SDF and restore. The discoloration is more profound when the caries is not excavated and SDF applied, compared to removal of infected dentine and application. most convenient for posterior teeth , and can be restored with an adhesive restorative material. studies have evaluated and showed the caries arrest effect just after single application of 38% SDF with the time ranging from 3 weeks to 3 months. ( Clemens J, Gold J, Chaffin J. Effect and acceptance of silver diamine fluoride on dental caries in primary teeth. J Public Health Dent.2017)
I have started using SDF recently. I use GIC to mask the Black colour in Primary teeth. The far reaching benefits of SDF do not compel us to excavate discoloured dentin. A sandwich restoration of GIC+ Light cured composite helps for sure.
SDF application can be repeated as long as you get the consistency of hard arrested lesion. That can be confirmed by probing in the follow ups. Any restoration after SDF application depends on the cavity shape as well. If it is faucet shaped with no hope of mechanical retention, Crown could be the best option for the longevity. Thanks!
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