IDRR APRIL -MAY -JUNE 2020 - Flipbook - Page 40
PROSTHODONTICS
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Prevent secondary caries
Arrests root caries
Desensitize sensitive teeth
Treat infective root canals
ADVANTAGES
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Cost effective
Non-invasive procedure
Immediate caries/infection control
No special armamentarium required
Does not stain healthy tooth structure
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Pulp capping agent
Agent for ART – SMART
ADDITIONAL ADVANTAGES
CRITERIA FOR TOOTH SELECTION
• No clinical signs of pulpal inflammation or history
of spontaneous pain.
• Cavitated caries lesions that are not encroaching
on the pulp. use radiographs if in doubt.
• Cavitated caries lesions on any surface as long as
they are accessible with a brush for applying SDF.
(Orthodontic separators, interdental brush or floss may
be used to help gain access to proximal lesions.)
• SDF can be used prior to restoration placement
and as part of caries control therapy.
• Informed consent, particularly highlighting expected staining of treated lesions, potential staining
of skin and clothes, and need for reapplication for disease control, is recommended.
CLINICAL TECHNIQUE
DISADVANTAGES
• Potent discoloration of the teeth
• Loss of esthetics
• Staining of soft tissue
• Difficult to convince parents
• May lead to poor results if patient’s fails to maintain
a follow up
INDICATIONS
• Early childhood caries or children with high caries
risk
• Children presenting with behavioural challenges
• Multiple cavitated caries lesions that may not all
be treated in one visit
• With dental caries lesions that are difficult to treat
• Without access to or with difficulty accessing
dental care
• Dentinal hypersensitivity
• Children with special needs
• Xerostomia
CONTRAINDICATIONS
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Irreversible pulpitis
Silver allergy
Oral ulcers/lesions
July-August-September 2019
• Case selection is critical
• Dispense SDF in to Dappen Dish – in terms of drops
• One drop approximately treats 5 surfaces
• Application of Vaseline on oral n peri oral areas
• Clean and make sure that no plaque or food remanents are there
• Isolate the lesion with gauze or cotton rolls and air
dry the area
• Immerse the micro brush in to a dappen dish and
apply it all over the lesion
• Allow the drying for 1-3 min to soak in and react
• Apply fluoride varnish post SDF application and let
it dry
Modified Clinical Techniques
• SDF can be used to treat proximal caries with the
help of SDF soaked dental floss
FOLLOW UP
• Reapplication and follow ups are necessary
• The first follow up should be done after a week so
that the hardness of lesion can be assessed and
checked if the lesion is arrested or if reapplication is
required
• Post assessment SDF can be are most effectively
implemented, if applied biannually.
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