Home | Pediatric Dentist Blog @ West Cary
Silver Daimine Fluoride
Silver diamine fluoride (SDF), is a clear liquid that combines the antibacterial effects of silver and the re-mineralizing effects of fluoride, is a promising therapeutic agent for managing caries lesions in young children and those with special care needs. The fluoride component strengthens the tooth structure under attack by the acid byproducts of bacterial metabolism, decreasing its solubility, but SDF may also interfere with the biofilm, killing bacteria that cause the local environmental imbalance that demineralizes dental tissues. 
The benefits of SDF are:
  1. Safe—clinical trials that have used it in more than 3800 individuals have reported no serious adverse events 
  2. Effective—arrests approximately 80% of treated lesions
  3. Efficient—can be applied by health professionals in different health and community settings with minimal preparation in less than 1 minute
  4. Timely—its ease of application can allow its use as an intervention agent as soon as the problem is diagnosed
  5. Patient centered—is minimally invasive and painless
  6. Equitable—its application is equally effective and affordable
The only apparent drawback is that as the caries lesions become arrested, the precipitation of silver byproducts in the dental tissues stain the lesions black, which can be a deterrent for its use in esthetic areas. The other side effect is staining of the oral tissues which is temporary as it does not penetrate deeper layers of skin and it improves as the mucosa sheds. 


The concept of Minimally Invasive dentistry has evolved as a consequence of our increased understanding of the caries process and the development of adhesive restorative materials. MID aims to preserve original tissue and conserve healthy tooth structure. The philosophy or early detection of caries and treating the cause of caries to prevent the disease is an important part of minimally invasive dentistry. 
The important aspects of minimally invasive dentistry are.
  • Accurate diagnosis of the risk of disease and lesions
  • Primary prevention
  • Just in time, restoration – early diagnosis and intervention
  • Less invasive operative procedures 
  • Secondary prevention
In pediatric dentistry the MID helps in building a more positive relationship between the dental visits and the child. It reduces their anxiety and enhances comfort and helps children become more confident and relaxed during their dental visits. The treatment is performed with minimal or no drilling. The most important aspect is early diagnosis, every 6 months dental visit is very important (it is covered by a100% with most insurances, please use your benefits).
The key components of MID are:
  • Fluoride varnish – Children receiving fluoride varnish applications have 37%-43% reduction in dental caries 
  • Sealants – It offers up to 76% protection from pit and fissure caries
  • Silver Diamine Fluoride – it can arrest upto80% of the treated lesions
  • Resin infiltration technique – It can re-mineralize the proximal non cavitated lesions and coupled with fluoride can reduce the progress of proximal lesion (23%)
  • SMART restorations – Use of glass ionomer restorative material after arresting with SDF and involving no or minimal drill use
  • Hall Crown – Hall technique is use of stainless-steel crowns to restore the primary back teeth after arresting with SDF and no drilling. 


The coronavirus pandemic has affected everyone globally in their day-to-day activities – even when it comes to what was once a simple visit to the dentist. People find themselves questioning if their actions are safe.

“Insider” (9/18, Michelson) said, “Yes, it’s safe to go to the dentist.” The article explained that “there has been no evidence of coronavirus transmission in dental offices since many reopened in May,” and dental offices have safety precautions in place to help prevent the transmission of COVID-19 and other infectious diseases. “Our first job is to be sure that our patients are safe,” ADA President Chad P. Gehani told Insider. “If we did not think that the patients were safe, we simply would not go to the office at all. We would not have even done the emergency care in the months of March, April, and May.”

In an opinion piece for the Bangor Daily News (9/22), Dr. Jonathan Shenkin, a former ADA vice president and past president of the Maine Dental Association, said that since the coronavirus pandemic began, “there still isn’t a single known case of transmission of coronavirus in a dental setting between a patient and dental staff member,” which he attributes “to adherence to strict infection control guidelines that have long been in place in dental offices.” Dr. Shenkin added that “dental offices are one of the safest health care facilities for the public to be, and dental care should remain an essential health care service as the pandemic continues.”

The Daily Targum (NJ) (9/22, Chung) reported that dental visits are safe during the pandemic due to the safety protocols in place, said Dr. Cecile Feldman, dean of Rutgers School of Dental Medicine. “For decades, we’ve been very particular with regard to the personal protective equipment that we use,” Dr. Feldman said. “And all the evidence shows that if you’re using the right protective equipment, people are protected.” Dr. Feldman also emphasized the importance of continuing to receive dental care at this time.

An October 2020 report published in Journal of American Dental Association found that fewer than one percent of dentists nationwide were found to be COVID-19 positive and 99 percent of dentists were using enhanced infection control procedures such as screening protocols and enhanced disinfection practices when treating patients. The ADA has developed science-based guidance to dentists on extra steps they can take


Our team is committed for your safety


Protecting You During the Pandemic is Our Priority

In the Waiting Area

  • Daily Temperature checks for every staff and patients
  • Covid 19 Screening and monitoring
  • All the high touch surfaces are wiped more frequently (after every patient)
  • Spacious waiting area and all seating and wall toys wiped after every patient
  • Safe scheduling of patients with no or minimal overlap between two patients/families
  • Social distancing in schedule and in the waiting area
  • Wearing mask is required for everyone entering the clinic including staff – It is our top priority to keep you, your child, other patients and our staff safe from the minute you walk in the door. With this in mind, we require all staff, patients and visitors to wear masks to help prevent any airborne germs from spreading. 
  • HEPA and UV air filters in waiting area and the clinic
  • Clean hands are also important. That is why we provide a hand sanitizer station in our lobby and at various locations in the office. 

In the Clinic

  • At Pediatric Dentist at West Cary, our dental staff is supplied with personal protective equipment (commonly referred to as PPE), which consists of different equipment that dental care providers wear to protect them from germs spread through blood, saliva or airborne particles. For some treatments, face shields may also be worn. Most of these items are disposable, used for only one patient and thrown away after use.
  • Control of aerosol with high vacuum suction and air circulation with HEPA filters in the treatment rooms.
  • Hand sanitizing stations throughout the clinic
  • All surfaces in the treatment area, like chairs, countertops, and light handles, are disinfected between patients.

Behind the Scenes

  • Rest assured; any instruments used during your treatment is autoclaved
  • Even the quality of the water used during your dental treatment must be monitored. Water from the dental unit must be the same quality as drinking water and we use DentaPure for clean water

Ready to Book Your Child’s Visit With Us? 

We want you to know at Pediatric Care at West Cary, safety is our first priority and we want you and your child to feel comfortable visiting us and are happy to answer any questions you may have.

Book your appointment online, or call (919) 617-7878 today!

This information has been gathered from the following resources.