Cutting Edge Therapy for Caries
My purpose in presenting an arresting and reversing decay concept as a case study was to show that evidence-based clinical practice guidelines on nonrestorative treatment for carious lesions , as put forth recently by the ADA Center for Evidence-Based Dentistry , may be further researched . The goal would be to consider applying SDF to both non-cavitated AND cavitated lesions . Currently , the standard differentiates those two and recommends different treatments . Also , the professional members who have adopted using SDF in their practices are probably following the same path I did 4-5 years ago . They may timidly apply SDF to some pediatric patients and some elderly patients who may have multiple or rampant root decay , often around previously pristinely restored posterior teeth with Gold Crowns and multi-unit Bridges . Both types of cases tend to break the heart of any caring and compassionate dentist . When I used to see that devastation , I wondered what I could do . Now I have found the solution .
I am blessed that I have been allowed to practice and continue to learn these 45 years . But even more satisfying to me , at the end of my practice days , is to have come across such a treatment that solves over 80 % of those aforementioned tragedies . There are studies that back that up . My hope is dentists who read how my approach evolved are emboldened to at least begin to give a try using SDF in your practices . Slow starts are fine , build your confidence , document your results , and go from there . My process started almost five years ago and has brought me to where I am today .
Where am I today ? With the findings of this documented case study and my experience with literally hundreds of other patients in my practice , I can confidently say that every dentist should be using SDF every day in their own practice and even discovering new uses for it to end the scourge of the worldwide pandemic … of tooth decay . My plan is to begin applying SDF to inter-proximal areas of all posterior teeth and then covering that with a fluoride varnish . This will be standard protocol for all recall patients we classify as Moderate to High risk for future decay , or anyone else who wants to do all they can to prevent future tooth breakdown due to decay .
HOW TO REACH DR . PARRETT drp @ cvdc . com ( 717 ) 263-3123 Cumberland Valley Dental Care 99 St Paul Dr . Chambersburg , PA 17201
About the Author Dr . Parrett received a BS from Bowling Green State University in 1974 and graduated from The Ohio State University College of Dentistry in 1976 . He is a fellow of the Academy of General Dentistry . He remains active in the dental community as a member of the Cumberland Valley Dental Society ( Past President ), the Fifth District Dental Society ( Past President ) as well as serving in various positions with the American Dental Association and the Pennsylvania Dental Association . He is on staff at Chambersburg Hospital and has served with the Academy of Laser Dentistry . He has practiced in Chambersburg , PA , for over 40 years .
SOURCES
1 . Jeremy A . Horst , DDS , PhD ; Hellene Ellenikiotis , DDS ; and Peter M . Milgrom , DDS , UCSF Protocol for Caries Arrest Using Silver Diamine Fluoride : Rationale , Indications and Consent . ( 2016 ) California Dental Association Journal , VOL 44 ( No 1 ).
2 . Yamaga , et al , ( 1972 ) Journal of Osaka University Dental School , VOL 12 , 1-20 .
3 . Sylvie Martel , RDH , DipDH , Teaching Certificate NDHCB , Silver Diamine Fluoride : NEW in North America ! ( 2017 ) Oral Health Group , ( July 2017 ) https :// www . oralhealthgroup . com / features / silver-diamine-fluoride-new-north-america /.
4 . Jeremy A . Horst , DDS , PhD , et al , Silver Microwires from treating tooth decay with silver diamine fluoride , ( 2017 ), BioRxiv-beta , this article is a preprint and has not been peer reviewed , Jun . 19 , 2017 , https :// doi . org / 10.1101 / 152199 .
5 . Steve Duffin , DDS , The Medical Management of Caries : A Paradigm Shift , ( 2014 ) The Lund Report / Oregon , Guest Opinion , 10-1-2014 .
6 . R . Li , E . C . M . Lo , B . Y . Liu , M . C . M . Wong , C . H . Chu , Randomized clinical trial on arresting dental root caries through silver diamine fluoride applications in community-dwelling elders , ( 2016 ) Journal of Dentistry 51 , 15-20 .
7 . Jason Hirsch , DMD , MPH , Silver Diamine Fluoride An option for more effective dental care , ( 2017 ) Inside Dental Hygiene , VOL 13 ( No9 ) Special Issue 1 .
Author ’ s Note : At www . elevateoralcare . com there is a very lengthy scientific literature review that would be helpful to anyone wanting to learn more about SDF . http :// www . email . elevateoralcare . com / site / images / SDFoff050515 . pdf ? promocode =& promocodeaction = overwrite
26 JANUARY / FEBRUARY 2021 | PENNSYLVANIA DENTAL JOURNAL