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The Silver Bulletin®

Vol. 5, September 13, 2018


Data continues to be released providing more clarity on how SDF works in numerous clinical applications. The recently published cover story in JADA, August 2018, states that, "Yearly 38% SDF applications to exposed root surfaces of older adults are a simple, inexpensive, and effective way of preventing caries initiation and progression." Not only will it arrest lesions (D1354), it can prevent lesion formation. If you have a subscription to JADA you can view the full text article here, or find the abstract here.

Independent Research on Riva Star

The recent introduction of Riva Star has created questions about the application process and efficacy of a two-step, SDF and potassium iodide product. There are published peer-reviewed independent research articles on the product that show its pro's and cons. Three of these articles can be found at the links below.

  • “SDF + KI treatment inhibited development of secondary caries on GIC restorations, but was not as effective as SDF treatment alone. Moreover, SDF + KI treatment caused a perceptible staining at the restoration margin, but the intensity was less than that with purely SDF treatment.” Zhao et al 2017 Abstract
  • “In the long term, blackening of arrested root caries is not reduced by immediate application of KI after the application of SDF.” Li et al 2016 Abstract
  • Effect of a silver diamine fluoride and potassium iodide-based desensitizing and cavity cleaning agent on bond strength to dentine Koizumi et al 2016 Abstract
Arizona AGD Continuing Education SDF Summit

Interested in learning about SDF, glass ionomer cement and SMART from the leading clinicians, researchers and professors? Here's your chance! Join the SDF front runners and the Arizona AGD for the first ever SDF and SMART Summit, Saturday, January 12, 2019, in Scottsdale AZ. Drs. Steve Duffin, John Frachella, Jeremy Horst, Jeanette MacLean, and Doug Young will lead a full day SDF and SMART course including hands-on instruction. This comprehensive SMART, SDF course is perfect for both private practitioners and public health and will help you improve oral health and access to care from pediatric to elder care. This course is an Academy of General Dentistry PACE program worth 8 CE hours through the Arizona Academy of General Dentistry. You can register for the event here.

Be sure to review the other informative silver diamine fluoride information these clinicians have published on Youtube by searching for their names.

We're Changing Our Applicators

Some good things come to an end, and unfortunately our SDF applicators are doing just that. The company that manufactures these silicone-tipped applicators is no longer producing them for us and is discontinuing the line. We estimate our current supply will run out at the end of October 2018, then we'll be changing to flock-tipped applicators in the same two sizes we've provided all along.

The noticeable difference in these applicators is that the tip will start to darken when dipped in SDF (the previous applicators did not darken). In the picture to the left, the applicators on the outside edges are the old applicators, and the new applicators are in the middle.

If you liked the silicone-tipped applicators that we've sold over the past three years, now is your chance to buy a final supply. Click here to purchase.

Podcasts and Webinars on SDF

There have been numerous webinars and PodCasts regarding silver diamine fluoride over the past few months. We've collected several and linked them here for your convenience. If you're questioning how best to use SDF in your practice, please take a moment and watch these.

The first webinar is conducted by Dr. Ryan Quock and Dr. Mike Helgeson. Dr. Quock is a Professor and interim chair at UT Houston while Dr. Michael Helgeson is CEO at Apple Tree Dental. Both clinicians have extensive experience in Silver Diamine Fluoride use. The webinar was hosted by Oral Health America.

The PodCast below features Dr. Jeanette MacLean discussing the uses of SDF in her practice with moderator Dr. Joel Berg. It was recorded at the AAPD Annual Session in Honolulu HI.

DentalTown has also posted a few PodCasts regarding SDF featuring Dr. Jeanette MacLean and Dr. Steve Duffin. Both are leaders in silver diamine fluoride use, and have great perspective on its use and potential expansion in the future. You can view both parts of Dr. MacLean's PodCast here.

Part One of Two:

Part Two of Two:

Dr. Steve Duffin's DentalTown PodCast can be viewed here.

Finally, Dr. Margherita Fontana and Dr. Amir Moursi took time to release the following Webinar on SDF. They are the Primary Investigator and Site Director for the Advantage Arrest SDF Phase 3 clinical trial for the Breakthrough Therapy Designation for Caries Arrest. You can read more about their work here, and watch the webinar below that was hosted by the American Academy of Pediatrics.

Medicaid Coverage for SDF Continues to Expand

Approximately 28 states have begun covering CDT Code D1354 at various rates and frequencies. The ADA has recently released a table showing 16 states that provided responses when asked about D1354 coverage. The chart can be found here

Elevate Oral Care and several other organizations are actively assembling lists of coverage which we will share in future Silver Bulletins.

Introducing Just Right 5000 Metered Dose Prescription Dentifrice

Elevate Oral Care continues to deliver industry firsts. This time with the Just Right 5000 Metered Dose Pump which provides 6 months of therapy. Moderate (D0602) and High (D0603) Caries risk pediatric patients need help managing their fluoride ingestion, and even more so when they are prescribed a high-strength toothpaste.

Just Right 5000 is the first 1.1% NaF Dentifrice delivered in a metered dosing system that always provides the optimal amount of toothpaste, a pea-sized dose (~0.25g). Minimize the risk of ingestion while providing the highest level of fluoride possible, with a great Bubble Mint Flavor.

While supplies last, we're giving away 24 free pediatric toothbrushes with every case purchased. The time has never been better to strengthen caries prevention programs for moderate to high caries risk pediatric patients safely. Click here to order now.

Previous versions of the silver bulletin can be seen here: Each will open in a new window.