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Silver diamine for your patients’ golden years

Caring for the teeth of your older patients requires an awareness of the issues and conditions that can affect the oral health of this older population. Dental conditions associated with aging include dry mouth (xerostomia), root and coronal caries, and periodontitis.

Additionally, patients may show increased sensitivity to drugs used in dentistry, including local anesthetics and analgesics.

If you are a dentist who treats an older population, read on.

Applying silver diamine fluoride to exposed root surfaces of teeth in older adults can be an effective way to prevent cavities, according to the August issue of The Journal of the American Dental Association.

Authors of the long-term study, “Controlling Caries in Exposed Root Surfaces With Silver Diamine Fluoride: A Systematic Review With Meta-Analysis,” examined over 1,000 articles (wow!) to identify high-quality randomized controlled, human clinical trials that critically looked at and evaluated the preventive effect of silver diamine fluoride on root surface caries in older adult patients.

They found that 38 percent silver diamine fluoride applications to exposed root surfaces applied annually “are a simple, inexpensive and effective way of preventing caries initiation and progression,” according to the article’s abstract.

“Silver diamine fluoride application to root surfaces presenting dental caries also appears to be very safe,” said one of the article’s authors, Dr. Branca Heloisa Oliveira, a dentist who also holds a Ph.D. “The only known potentially relevant side effect would be the discoloration of the treated caries lesions,” said Dr. Oliveira.

Because of this, dentists should be prepared to address patients’ concerns regarding the blackening of the decayed tooth surfaces after silver diamine fluoride applications. But it should be noted that complaints about black staining of the carious lesions by a silver fluoride application were rare among older adults in all cases of the study.

But what about your younger patients? According to this study,there is limited evidence suggesting silver diamine fluoride may arrest dental caries in children.

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