Widely accepted silver diamine fluoride in the United States

Non-surgical caries treatments, particularly with silver diamine fluoride (SDF) and Hall crowns, offer alternative options for populations facing barriers to traditional treatment. The researchers wanted to know to what extent these treatment options are gaining attention in pediatric oral health education in the United States.

To this end, a 29-question online survey was conducted among university departments of pediatric dentistry. The data was compared to the results of a similar survey conducted in 2015 to identify trends, report protocols, identify barriers to use, and potential reasons for changes.

Respondents from 82 study programs completed the surveys (89% responses). While only 26% of respondents reported using SDF in 2015, this percentage had risen sharply to reach 100% in 2020 (p <0.001).

Hall’s crowns were part of 90% of educational programs, and 69.5% of respondents used the method at least sporadically in their own clinic. Long wait times for anesthetic treatment (4 weeks – 14 months) and sedation (1 week – 12 months) motivated increased use of SDF, provisional restorations and Hall crowns. Guidelines supporting the use of SDF have also led to increased use of this caries inhibitor. These changes were likely caused by various barriers to the delivery of traditional restorative care. The rapid increase in the learning and use of minimally invasive treatments offers clinicians more options for the management of caries in patients with barriers to the application of traditional treatment.

Conclusion. American educational institutions have widely adopted SDF to slow down decay in temporary dentition, and this trend appears to be spreading to other non-surgical methods of caries treatment.

Source

Crystal YO, Janal MN, Yim S, Nelson TJ. Teaching and Use of Silver Diamine Fluoride and Hall Style Crowns in U.S. Pediatric Dentistry Residency Programs. Am Dent Assoc 2020; 151: 755-763.