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Silver Diamine Fluoride: A Case Study

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In 2014, the United States welcomed a product called silver diamine fluoride after it was approved by the Food and Drug Administration. It was with the help of Dr. Peter Milgrom, DDS., a professor at the University of Washington, who pushed through and got this fluoride approved. It was cleared as a cavity varnish for patients with hypersensitivity. It became available to dentists in 2015 and the CDT code of D1354 was created in January of 2016. Prior to this, the dentistry did not have a code to monitor this. Price per bottle of silver diamine fluoride is $129. Each bottle averages roughly 250 drops, which makes each drop of fluoride 0.52. Since its clearance for hypertension by the FDA, dentists have discovered the fluoride’s antimicrobial effects on dental caries. Silver diamine fluoride now has an off-label use to arrest dental caries while simultaneously preventing dental caries, and treating dental hypersensitivity. This is similar to that of fluoride varnish, which was created to treat hypersensitivity, but has an off-label use of preventing decay. …show more content…

Silver ions have a long history of use in both dentistry and medicine. It was known to treat tetanus before other antibiotics were created. In dentistry, one documentation of the silver nitrate dates over nine hundred years ago in Japan, where Geisha and married women used silver as a cosmetic to blacken their teeth for many months. These women were found to have little to no evidence of dental caries. Countries like Japan, Australia, Brazil, Argentina, Cuba, and China have used this product since the 1980’s or

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