Nobody looks forward to using a cavity drilled and filled by a dentist. Now there’s a different: an antimicrobial liquid that can be brushed on cavities to halt tooth decay – painlessly.

The liquid is called silver diamine fluoride, or S.D.F. It’s been utilized for decades in Japan, but it’s been accessible in the United States, under the manufacturer Advantage Arrest, for almost a year.

The meals and Drug Administration cleared silver diamine fluoride for usage like a tooth desensitizer for adults 21 and older. But studies show it may halt the advancement of cavities which will help prevent them, and dentists are increasingly using it off-label for all those purposes.

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

Silver diamine fluoride is already found in numerous dental offices. Medicaid patients in Oregon increasingly becoming the treatment, and at least 18 dental schools have begun teaching the next generation of pediatric dentists utilizing it.

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

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

The principle downside is aesthetic: Silver diamine fluoride blackens the brownish decay on a tooth. That may not matter on a back molar or perhaps a baby tooth that will fall out, however, many patients are apt to be deterred with the prospect of an dark i’m all over this 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 pleased to pay $25 to get Dr. Jeanette MacLean, a pediatric dentist in Glendale, Ariz., paint on the cavity that her son Knox, 4, had recently developed.

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

The noninvasive treatment might be perfect for the indigent, elderly care residents and others who’ve trouble finding care. And a lot of anxious dental patients need to dodge the drill.

But the liquid might be especially useful for children. Nearly a quarter 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 within a hospital under general anesthesia, though it may pose risks on the developing brain.

“S.D.F. gives us a chance to decrease the amount of toddlers with cavities coming to the O.R.,” said Dr. Arwa Owais, an associate 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 trip to the operating room.

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

Alejandra Bujeiro, 32, was delighted that her 3-year-old daughter, Natalia, didn’t require 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 for the decay.

Two front teeth, however, were drilled. The very next time, Ms. Bujeiro said, she’d select silver diamine fluoride. “I would apply it in baby teeth even if it’s in-front,” she said. When it comes to discoloration? “You can’t notice excessive.”

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

“S.D.F. decreases the incidence of recent caries and advancement of current caries by about 80 percent,” said Dr. Niederman, that’s updating an evidence overview of silver diamine fluoride published during 2009.

Fillings, by contrast, usually do not cure an oral infection.

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

That’s why some children must have baby teeth under anesthesia twice.

Microbe infections also cause acne, but a “dermatologist doesn’t require 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 has a Facebook page called SDF Action, where dentists can discuss individual cases.
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