Nobody looks forward to using a cavity drilled and filled with a dentist. Now there’s a different: an antimicrobial liquid which can be brushed on cavities to prevent cavities – painlessly.

The liquid is named silver diamine fluoride, or S.D.F. It’s been useful for decades in Japan, but it’s been accessible in the United States, within the manufacturer Advantage Arrest, for merely a year.

The Food and Drug Administration cleared silver diamine fluoride to use like a tooth desensitizer for adults 21 and older. But studies show it could halt the progression of cavities which will help prevent them, and dentists are increasingly using it off-label for the people purposes.

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

Silver diamine fluoride is already utilized in countless dental practices. Medicaid patients in Oregon are experiencing the treatment, and at least 18 dental schools have started teaching generation x of pediatric dentists using it.

Dr. Richard Niederman, the chairman of the epidemiology and health promotion department with the Nyc University College of Dentistry, said, “Being capable to paint it on in A few seconds without noise, no drilling, is much better, faster, cheaper.”

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

The principle downside is aesthetic: Silver diamine fluoride blackens the brownish decay on the tooth. That will not matter on the back molar or even a baby tooth that may drop out, however, many patients are likely to end up deterred from the prospect of an dark i’m all over this an evident tooth.

Until more insurers pay for it, patients must also cover the fee. Still, it’s pretty cheap. Dr. Michelle Urschel, an anesthesiologist, was pleased to pay $25 to own Dr. Jeanette MacLean, a pediatric dentist in Glendale, Ariz., paint on the cavity that her son Knox, 4, had recently developed.

A cavity that have to get drilled cost $151. The liquid “was very reasonable,” Dr. Urschel said.

The noninvasive treatment could be perfect for the indigent, elderly care residents and others who have trouble finding care. And many anxious dental patients wish to dodge the drill.

Nevertheless the liquid could 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 should be treated in the hospital under general anesthesia, although it may pose risks on the developing brain.

“S.D.F. provides us the opportunity to limit the quantity of toddlers with cavities visiting the O.R.,” said Dr. Arwa Owais, an associate at work 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 planned to delay a visit to the operating room.

Dr. MacLean said, “People believe that parents will reject it due to 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 they 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 rear of her mouth. Instead Dr. Eyal Simchi, a pediatric dentist in Elmwood Park, N.J., brushed silver diamine fluoride on the decay.

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

Silver diamine fluoride has an additional benefit over traditional treatment: It kills the bacteria that induce decay. A second treatment applied six to 18 months after the first markedly arrests cavities, studies have shown.

“S.D.F. decreases the incidence of new caries and progression of current caries by about 80 %,” said Dr. Niederman, who is updating an evidence report on silver diamine fluoride published in 2009.

Fillings, in comparison, tend not to cure an oral infection.

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

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

Attacks also cause acne, but a “dermatologist doesn’t require a scalpel and take 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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