Every now and then, I have a patient who is not a perfect candidate for dental work. Usually, there is a cavity that needs to be filled but the patient can’t sit still long enough to have a filling done. These patients are either very young (under the age of 5) or considerably aged. Either way there are compliance issues and they can’t cooperate enough to have a filling completed.
Standard protocol would usually require for the dental work to be done under general anesthesia (most likely in a hospital setting). As many of you may be aware, general anesthesia can have many adverse side effects, some which can be deadly.
For non-cooperative or medically compromised patients, silver diamine fluoride (see our post here) has been one option and is a minimally invasive treatment to arrest decay. However, the only negative with this product is that it contains fluoride. In the holistic community, fluoride is taboo. (see our many posts on fluoride here.)
Teeth Stained from Silver Nitrate
For the holistically minded, there is another option for treatment. Silver nitrate can be used instead of silver diamine fluoride to totally stop decay in deciduous (baby) teeth. It is also a good option for the elderly who are not cooperative for dental work due to mental or physical challenges. Silver nitrate will prevent further damage from the decay and ultimately buy some time until the deciduous tooth exfoliates in the young child or the patient can be more compliant.
Silver nitrate has all the advantages of silver diamine fluoride but none of the neurotoxicity that is associated with fluoride. Here is a list of advantages in using silver nitrate on dental cavities:
• effective to help stop cavity development after a cavity has formed.
• helps kill the bacteria that break down tooth surfaces while also keeping them from spreading to other teeth.
• often suggested as a more comfortable alternative to drilling cavities. This can be helpful for children or adults who have anxiety about the dentist or may not be able to fully engage in dental procedures, such as those with special healthcare needs.
• helpful as a cavity treatment if you’re overly sensitive to the instruments and substances used during cavity treatments.
• help keep cavities to a minimum or prevent them entirely if you feel that it’s difficult to make time for regular dental check-ups or feel uncomfortable about cavity procedures. It’s quick, requires no special equipment, and generally only needs to be done once per year.
The downside of using silver nitrate (as well as silver diamine fluoride) is it will turn the tooth black, permanently. Not a problem for posterior teeth or baby teeth, but can be unsightly on front teeth. Also silver nitrate can stain more than just teeth. It can also stain soft tissues, restoration margins, fingernails, skin and clothing. So special care must be used to prevent this. For the skin, the stain will dissipate in about 2 weeks. It will take longer for everything else, and may even remain permanently discolored. The extent of staining and the length of staining vary significantly among individuals.
Silver nitrate is a safe, painless alternative to traditional cavity drilling procedures. It may stop the cavity from spreading, but will not fill the hole created by decay. It is a good interim procedure when a restoration is not possible.
We may not recommend silver nitrate in every case of cavities. But it has been proven to be highly successful in stopping the development and spread of cavities. A great choice for young children and the elderly.
If you like this post, you may also like: Silver Diamine Fluoride in Caries Management