Toddler teeth black from silver diamine fluoride cavity treatment

  • My family has had horrible teeth for generations.
  • My daughter had three cavities in her front teeth when she was only 1.
  • Her dentist suggested treatment to prevent more cavities, but she ended up with black teeth.

My family has terrible teeth. They have chompers with crowns and fillings, and silver smiles back when they open their mouths. I am convinced that a small community of dentists have remained in business because my family name keeps appearing on their calendars.

Don’t get me wrong: we brush and floss like the best, but our teeth are just soft and delicate, with crevices that welcome clinging sugar granules and bits of flesh. I’ve gotten the least of this “family curse,” with only a handful of refills so far. But I’m afraid my toddler, Elle, has the worst.

As a baby, she took a nap in my arms while I sat on the couch, a time I often used to wipe food stains from her cheeks and lightly brush her few teeth with a rubber baby toothbrush. When Elle was about 1 year old, I started brushing what I thought was plaque on her front teeth, but it wouldn’t come off.

“Oh, no,” I thought, “cavities.”

I took Elle for her first dental visit soon after – and a tall, kind-eyed dentist confirmed that she had small cavities in three of her front teeth.

I felt like a failure for letting my 1 year old’s teeth get so bad. I was also nervous and wondered if this meant Elle would get more holes. Our dentist offered to put silver diamine fluoride on my daughter’s front teeth to stop the growth of cavities until she’s old enough to sit down for fillings without a general anesthetic, or until her baby teeth fell out.

Silver diamine fluoride is safe and effective

My daughter’s dentist explained that SDF was safe, painless and cost a fraction of fillings. Still, with safety as the number one priority, I wanted to do my own research. I had to make sure I wasn’t skipping anesthesia risks in favor of a worse list of side effects.

Lynn Gargano, the clinical director of pediatric dentistry at the Family Health Centers at NYU Langone, confirmed that SDF was safe.

“Scientific reviews and clinical trials report no side effects or serious side effects in children or adults,” she said, adding that the only known side effects were minor nuisance, such as short-term gum irritation or a metallic taste.

“SDF has been proven to stop decay up to 80% of the time,” Gargano said. “In my practice, SDF is a viable alternative in very young children and patients with special management considerations.”

After discussing it with my husband, we decided that SDF would be the best choice, and the following week Elle’s dentist brushed the tops of her teeth with what appeared to be a small plastic stick. We were in and out of the office in a matter of minutes.

Her teeth turned black from the treatment

Before applying SDF, the dentist warned me – a few times – that the solution would permanently stain the decay, meaning parts of Elle’s teeth would remain black unless we decided to do the fillings later. He said some parents weren’t happy about this, but I brushed off his warning.

Yet SDF as a cavity treatment is relatively new in the US. It has been used for oral care in Japan for over 50 years, but the Food and Drug Administration only approved it for dental use in 2014. people don’t know what it is.

“Does she eat Oreos?” other parents have asked after seeing my daughter laughing on the playground.

Sometimes I just nod and smile, blaming the dark area for cream-filled cookies. But usually I have to explain that my daughter has cavities and that this was the alternative to general anesthesia. I’ve gotten some raised eyebrows, but usually other parents sympathize with a difficult decision. In addition, they are often interested to learn that fillings are not the only option. I am happy to tell them about our experience.

When my pediatric dentist warned about the SDF stains, I knew he was concerned that Elle’s teeth wouldn’t look their best. But my daughter doesn’t mind her stained teeth, and I don’t mind the look at all. In fact, I like it. This makes her more like my side of the family.

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