Nobody looks forward to having a cavity drilled and filled by a dentist. Now there’s an alternative solution: an antimicrobial liquid that may be brushed on cavities to prevent tooth decay – painlessly.

The liquid is named silver diamine fluoride, or S.D.F. It’s been useful for decades in Japan, but it’s been for sale in the us, beneath the brand Advantage Arrest, for just about annually.

The meals and Drug Administration cleared silver diamine fluoride for usage as being a tooth desensitizer for adults 21 and older. But research has shown it might halt the growth of cavities preventing them, and dentists are increasingly using it off-label for anyone purposes.

“The upside, the truly great one, is that you don’t need to drill and you don’t need an injection,” said Dr. Margherita Fontana, a professor of cariology in the University of Michigan.

Silver diamine fluoride has already been used in a huge selection of dental practices. Medicaid patients in Oregon are experiencing the treatment, and at least 18 dental schools have started teaching generation x of pediatric dentists utilizing it.

Dr. Richard Niederman, the chairman from the epidemiology and health promotion department in the Ny University College of Dentistry, said, “Being in a position to paint it on in Thirty seconds without any noise, no drilling, is best, faster, cheaper.”

“I would encourage parents to request it,” he added. “It’s less trauma to the kid.”

The primary bad thing is aesthetic: Silver diamine fluoride blackens the brownish decay on the tooth. That will not matter on the back molar or a baby tooth that will drop out, however, many patients are likely to end up deterred from the prospect of your dark right an evident tooth.

Until more insurers get it, patients also need to cover the cost. Still, it’s pretty cheap. Dr. Michelle Urschel, an anesthesiologist, was thrilled to pay $25 to get Dr. Jeanette MacLean, a pediatric dentist in Glendale, Ariz., paint more than a cavity that her son Knox, 4, had recently developed.

A cavity that had to become drilled cost $151. The liquid “was very inexpensive,” Dr. Urschel said.

The noninvasive treatment might be suitable for the indigent, elderly care residents yet others who’ve trouble finding care. And several anxious dental patients wish to dodge the drill.

However the liquid might be especially useful for children. Nearly one fourth of 2- to 5-year-olds have cavities, in accordance with the Centers for disease control and Prevention.

Some preschoolers with severe cavities must be treated in the hospital under general anesthesia, even though it may pose risks for the developing brain.

“S.D.F. provides for us an opportunity to decrease the number of toddlers with cavities coming to the O.R.,” said Dr. Arwa Owais, an associate at work professor of pediatric dentistry in the University of Iowa.

Dr. Laurence Hyacinthe, a pediatric dentist in Harlem, used silver diamine fluoride on eight uncooperative children whose parents wished to delay a holiday to a operating room.

Dr. MacLean said, “People feel that parents will reject it because of poor aesthetics.” But “if this means preventing a young child from being forced to be sedated or having their tooth drilled and filled, there are many parents that like S.D.F.,” she added.

Alejandra Bujeiro, 32, was delighted that her 3-year-old daughter, Natalia, didn’t have to have two cavities filled in the back of her mouth. Instead Dr. Eyal Simchi, a pediatric dentist in Elmwood Park, N.J., brushed silver diamine fluoride about the decay.

Two front teeth, however, were drilled. Next time, Ms. Bujeiro said, she’d select silver diamine fluoride. “I would use it in baby teeth regardless of whether it’s in-front,” she said. When it comes to discoloration? “You can’t see it a lot of.”

Silver diamine fluoride has an additional over traditional treatment: It kills the bacteria that can cause decay. An extra treatment applied six to 18 months following your first markedly arrests cavities, studies show.

“S.D.F. reduces the incidence of recent caries and growth of current caries by about 80 %,” said Dr. Niederman, who is updating an evidence review of silver diamine fluoride published in ’09.

Fillings, by comparison, don’t cure a dental infection.

“There’s nothing which goes on within an operating room that treats the actual problem,” said Dr. Peter Milgrom, a professor of pediatric dentistry in the University of Washington who had previously been instrumental in receiving F.D.A. clearance for silver diamine fluoride and possesses a fiscal stake in Advantage Arrest.

That’s why some children must have dental care under anesthesia twice.

Attacks also cause acne, however a “dermatologist doesn’t please take a scalpel and cut-off your pimples,” said Dr. Jason Hirsch, a pediatric dentist in Royal Palm Beach, Fla. Yet “that’s how dentistry has approached cavities.” Dr. Hirsch includes a Facebook page called SDF Action, where dentists can discuss individual cases.
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