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

The liquid is called silver diamine fluoride, or S.D.F. It’s been employed for decades in Japan, but it’s been available in the United States, beneath the manufacturer Advantage Arrest, for just about a year.

The meals and Drug Administration cleared silver diamine fluoride to be used like a tooth desensitizer for adults 21 and older. But research has shown it may halt the growth of cavities and stop them, and dentists are increasingly using it off-label for those purposes.

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

Silver diamine fluoride is definitely employed in hundreds of 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 with the epidemiology and health promotion department in the New York University College of Dentistry, said, “Being in a position to paint it on in A few seconds without any noise, no drilling, is better, faster, cheaper.”

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

The primary downside is aesthetic: Silver diamine fluoride blackens the brownish decay on a tooth. That may not matter on a back molar or even a baby tooth that may drop out, however, many patients are probably be deterred through the prospect of an dark just right an obvious tooth.

Until more insurers get it, patients also have to cover the cost. Still, it’s comparatively cheap. Dr. Michelle Urschel, an anesthesiologist, was pleased to pay $25 to possess Dr. Jeanette MacLean, a pediatric dentist in Glendale, Ariz., paint over a cavity that her son Knox, 4, had recently developed.

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

The noninvasive treatment could possibly be suitable for the indigent, elderly care facility residents while others who may have trouble finding care. And lots of anxious dental patients need to dodge the drill.

But the liquid could possibly be especially ideal for children. Nearly a quarter of 2- to 5-year-olds have cavities, based on the Cdc and Prevention.

Some preschoolers with severe cavities must be treated in the hospital under general anesthesia, even though it may pose risks for the developing brain.

“S.D.F. provides us a chance to limit the variety of toddlers with cavities going to the O.R.,” said Dr. Arwa Owais, a part 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 think that parents will reject it due to poor aesthetics.” But “if it indicates preventing a youngster from being forced to be sedated or having their tooth drilled and filled, there are many 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 completed the back of her mouth. Instead Dr. Eyal Simchi, a pediatric dentist in Elmwood Park, N.J., brushed silver diamine fluoride around the decay.

Two front teeth, however, were drilled. The very next time, Ms. Bujeiro said, she’d select silver diamine fluoride. “I would put it to use in baby teeth even when it’s right in front,” she said. Are you aware that discoloration? “You can’t view it an excessive amount of.”

Silver diamine fluoride has another advantage over traditional treatment: It kills the bacteria that can cause decay. A second treatment applied six to Eighteen months following your first markedly arrests cavities, studies have shown.

“S.D.F. cuts down on incidence of latest caries and growth of current caries by about Eighty percent,” said Dr. Niederman, who is updating an evidence writeup on silver diamine fluoride published during 2009.

Fillings, by comparison, tend not to cure a verbal infection.

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

That’s why some children have to have braces dental trauma under anesthesia twice.

Transmissions also cause acne, but a “dermatologist doesn’t have 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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