Nobody looks forward to creating a cavity drilled and filled by a dentist. Now there’s a different: an antimicrobial liquid that could be brushed on cavities to stop dental cairies – painlessly.

The liquid is known as silver diamine fluoride, or S.D.F. It’s been used for decades in Japan, but it’s been accessible in the usa, underneath the name Advantage Arrest, for nearly 12 months.

The Food and Drug Administration cleared silver diamine fluoride to be used as a tooth desensitizer for adults 21 and older. But research shows it might halt the continuing development of cavities preventing them, and dentists are increasingly using it off-label for the people purposes.

“The upside, the truly amazing one, is that you don’t must drill and you also don’t require an injection,” said Dr. Margherita Fontana, a professor of cariology with the University of Michigan.

Silver diamine fluoride is already used in countless dental practices. Medicaid patients in Oregon are receiving the procedure, and a minimum of 18 dental schools have begun teaching generation x of pediatric dentists using it.

Dr. Richard Niederman, the chairman with the epidemiology and health promotion department with the New York University College of Dentistry, said, “Being capable to paint it on in Half a minute without having 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 with a tooth. That will not matter with a back molar or a baby tooth that may drop totally out, but a majority of patients are likely to be deterred through the prospect of a dark just right an apparent tooth.

Until more insurers buy it, patients also need to cover the charge. Still, it’s affordable. Dr. Michelle Urschel, an anesthesiologist, was thrilled to pay $25 to have 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 be drilled cost $151. The liquid “was very reasonable,” Dr. Urschel said.

The noninvasive treatment might be well suited for the indigent, nursing home residents among others who may have trouble finding care. And lots of anxious dental patients want to dodge the drill.

However the liquid might be especially a good choice for children. Nearly 1 / 4 of 2- to 5-year-olds have cavities, according to the Centers for Disease Control and Prevention.

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

“S.D.F. provides an opportunity to slow up the amount of toddlers with cavities going to the O.R.,” said Dr. Arwa Owais, a part professor of pediatric dentistry with 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 holiday to a operating room.

Dr. MacLean said, “People assume that parents will reject it due to poor aesthetics.” But “if it implies preventing a child from having to be sedated or having their tooth drilled and filled, there are several parents that like S.D.F.,” she added.

Alejandra Bujeiro, 32, was delighted that her 3-year-old daughter, Natalia, didn’t need 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. The next occasion, Ms. Bujeiro said, she’d go for silver diamine fluoride. “I would use it in baby teeth even if it’s in the front,” she said. As for the discoloration? “You can’t see it an excessive amount of.”

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

“S.D.F. reduces the incidence of recent caries and continuing development of current caries by about 80 %,” said Dr. Niederman, who’s updating an evidence overview of silver diamine fluoride published last year.

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

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

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

Transmissions also cause acne, however a “dermatologist doesn’t take 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 features a Facebook page called SDF Action, where dentists can discuss individual cases.
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