Nobody looks forward to using a cavity drilled and filled with a dentist. Now there’s an alternate: an antimicrobial liquid that could be brushed on cavities to halt cavities – painlessly.

The liquid is termed silver diamine fluoride, or S.D.F. It’s been useful for decades in Japan, but it’s been for sale in the United States, under the manufacturer Advantage Arrest, for just about per year.

The foodstuff and Drug Administration cleared silver diamine fluoride to be used like a tooth desensitizer for adults 21 and older. But research has shown it may halt the continuing development of cavities and stop them, and dentists are increasingly making use of it off-label for the people purposes.

“The upside, the truly amazing one, is basically that you don’t need to drill and also 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 hundreds of dental offices. Medicaid patients in Oregon are receiving treatments, and a minimum of 18 dental schools have started teaching the next generation of pediatric dentists how to use it.

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

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

The key bad thing is aesthetic: Silver diamine fluoride blackens the brownish decay on a tooth. That will not matter on a back molar or possibly a baby tooth which will drop totally out, but a majority of people are probably be deterred from the prospect of the dark spot on an apparent tooth.

Until more insurers buy it, patients also need to cover the price. Still, it’s relatively inexpensive. Dr. Michelle Urschel, an anesthesiologist, was happy to pay $25 to have Dr. Jeanette MacLean, a pediatric dentist in Glendale, Ariz., paint over a cavity that her son Knox, 4, had recently developed.

A cavity which in fact had to get drilled cost $151. The liquid “was very affordable,” Dr. Urschel said.

The noninvasive treatment might be ideal for the indigent, nursing home residents and others who’ve trouble finding care. And lots of anxious dental patients want to dodge the drill.

However the liquid might be especially ideal for children. Nearly a quarter of 2- to 5-year-olds have cavities, in line with the Cdc and Prevention.

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

“S.D.F. provides for us a chance to decrease the amount of toddlers with cavities exploring 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 wanted to delay a vacation to the operating room.

Dr. MacLean said, “People believe that parents will reject it as a consequence of poor aesthetics.” But “if it means preventing a kid from the need to be sedated or having their tooth drilled and filled, there are several parents who enjoy S.D.F.,” she added.

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

Two front teeth, however, were drilled. The next occasion, Ms. Bujeiro said, she’d go for silver diamine fluoride. “I would put it to use in baby teeth even when it’s in front,” she said. Are you aware that discoloration? “You can’t see it excessive.”

Silver diamine fluoride has an additional benefit over traditional treatment: It kills the bacteria that cause decay. Another treatment applied six to 18 months following your first markedly arrests cavities, research has shown.

“S.D.F. cuts down on the incidence of the latest caries and continuing development of current caries by about Eighty percent,” said Dr. Niederman, that is updating an evidence writeup on silver diamine fluoride published in ’09.

Fillings, in comparison, do not cure a dental infection.

“There’s nothing which goes on in a operating room that treats the actual problem,” said Dr. Peter Milgrom, a professor of pediatric dentistry in the University of Washington who was simply instrumental in receiving F.D.A. clearance for silver diamine fluoride and it has a monetary stake in Advantage Arrest.

That’s why some children should have braces dental trauma under anesthesia twice.

Bacterial infections also cause acne, but a “dermatologist doesn’t require a scalpel and stop your pimples,” said Dr. Jason Hirsch, a pediatric dentist in Royal Palm Beach, Fla. Yet “that’s how dentistry has approached cavities.” Dr. Hirsch carries a Facebook page called SDF Action, where dentists can discuss individual cases.
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