SILVER DIAMINE FLUORIDE
FIGURE 4. UCSF special consent form.
UCSF Dental Center Informed Consent for Silver Diamine Fluoride
Facts for consideration:
• Silver Diamine Fluoride( SDF) is an antibiotic liquid. We use SDF on cavities to help stop tooth decay. We also use it to treat tooth sensitivity. SDF application every 6-12 months is necessary.
• The procedure: 1) Dry the affected area, 2) Place a small amount of SDF on the affected area, 3) Allow SDF to dry for one minute, 4) Rinse.
• Treatment with SDF does not eliminate the need for dental fillings or crowns to repair function or esthetics. Additional procedures will incur a separate fee.
• I should not be treated with SDF if: 1) I am allergic to silver 2) there are painful sores or raw areas on my gums( i. e., ulcerative gingivitis) or anywhere in my mouth( i. e., stomatitis).
Benefits of receiving SDF:
• SDF can help stop tooth decay.
• SDF can help relieve sensitivity.
Risks related to SDF include, but are not limited to:
• The affected area will stain black permanently. Healthy tooth structure will not stain. Stained tooth structure can be replaced with a filling or a crown.
• Tooth-colored fillings and crowns may discolor if SDF is applied to them. Color changes on the surface can normally be polished off. The edge between a tooth and filling may keep the color.
• If accidentally applied to the skin or gums, a brown or white stain may appear that causes no harm, cannot be washed off, and will disappear in 1-3 weeks.
• You may notice a metallic taste. This will go away rapidly.
• If tooth decay is not arrested, the decay will progress. In that case the tooth will require further treatment, such repeat SDF, a filling or crown, root canal treatment, or extraction.
• These side effects may not include all of the possible situations reported by the manufacturer. If you notice other effects, please contact your dental provider.
• Every reasonable effort will be made to ensure the success of SDF treatment. There is a risk that the procedure will not stop the decay and no guarantee of success is granted or implied.
Alternatives to SDF, not limited to the following:
• No treatment, which may lead to continued deterioration of tooth structures and cosmetic appearance. Symptoms may increase in severity.
• Depending on the location and extent of the tooth decay, other treatment may include placement of fluoride varnish, a filling or crown, extraction, or referral for advanced treatment modalities.
I certify that i have read and fully understand this document, and all my questions were answered:
SIGNATURE OF PATIENT
DATE
A saturated solution of potassium iodide( SSKI) is contraindicated in pregnant women and during the first six months of breastfeeding because of the concern of overloading the developing thyroid with iodide; thyroid specialists suggested a pregnancy test prior to use in women of childbearing age uncertain of their status.
Nonmedical Side Effects Silver diamine fluoride darkens carious lesions. At least for children, many parents have seen the color changes as a positive indication that the treatment was effective. 29 Application of an SSKI immediately following silver diamine fluoride treatment is thought to decrease staining( patent US6461161). This is an off-label use; potassium iodide is approved as an over-the-counter drug to facilitate mucus release to breathe more easily with chronic lung problems and to protect the thyroid from radioactive iodine in radiation emergencies. In our clinical experience, SSKI helps but does not dramatically effect stain; arrested lesions normally darken. Most stain remains at the dentin-enamel or cementum-enamel junction. However, SSKI maintains resistance to biofilm formation or activity in laboratory studies. 20 Also, SSKI maintained caries arrest efficacy in the early results of an ongoing clinical trial. 42 Meanwhile, silver diamine fluoride-treated lesions can also be covered with GIC or composite( see below for discussion on bonding).
At least for children, many parents have seen the color changes as a positive indication that the treatment was eff ective.
SIGNATURE OF WITNESS DATE
22 JANUARY / FEBRUARY 2017 | PENNSYLVANIA DENTAL JOURNAL