This legislative session here in Colorado a new bill was passed that allows dental hygienists to apply silver diamine fluoride (SDF) under the supervision of a dentist.
Dr. Fred Guerra, with Guerra Dental in Colorado Springs, topical fluorides are nothing new. “Topical fluorides have been around since the 70’s, and they have evolved. From a tray and foam gel to liquid gels and now topically applied varnishes.”
Colorado HB 18-1045 says the under direct or indirect supervision of a dentist hygienists can now legally provide this treatment that can be very beneficial to certain populations.
Dr. Guerra feels it’s a great move, “Hygienists should be able to do this, either supervised by a dentist in their office, or some hygienists operate independently out in rural areas of Colorado. It’s totally within their jurisdiction and professional ability to do that.”
When applied to early tooth decay, silver diamine fluoride effectively stops a cavity in its tracks. But Dr. Guerra explains the reason this particular fluoride treatment only makes sense in a few specialized situations.
“It (SDF) has the effect of really stopping (tooth decay) and tends to remineralize (the enamel) as well, that is why it’s popular in deciduous or baby teeth even if it does cause some staining. We know that between the ages of 4 and 12 those teeth are going to be lost. The hygienist does have to let parents know if they are using this particular fluoride , it’s going to cause the teeth to stain.”
Besides people in remote or rural areas, where a trip the dentist is likely rare and difficult, and the dental care may be lacking another population that can benefit from this new bill, are the elderly says Dr. Guerra.
“For people in nursing homes, people who have Alzheimer’s and can’t take care of their teeth, (SDF) might be a tertiary measure to prevent (tooth) decay.”
While SDF is highly effective, it’s not likely to be used much in high population areas where dentists have many options when it comes to a topically applied fluoride.
Dr. Guerra says, “The big downside is the staining, and there are other products that are equally efficiently used in the dental office so most people in high population areas don’t have to resort to SDF.”
If you any questions follow up with your dentist.