CDA Essentials 2017 • Volume 4 • Issue 6

19 Issue 8 | 2017 | N ews and E vents  Who are you using SDF on at the community health clinic? I use it on about a quarter of my patients, for a variety of reasons. It’s rare for us to see patients who are caries free. SDF is phenomenal in arresting the early decay we see in kids under age 3. We also use it as a first defense in arresting some areas for older children who have incipient carious lesions, for example, on the 6-year molars. In adults, we use it to stabilize those who have had quite significant amounts of decay—they often have not just 1, 5, or 10 cavities, they have 20! So SDF has been very effective where we have removed the soft caries, treated the area with SDF and then covered the area with an interim glass ionomer material. This helps to quickly remove the pain associated with eating and cold air and gets them settled down and able to start caring for their teeth.  What has been the response from patients? The great thing about SDF is that it’s very well received by children. There is no Chairside Perspective: USING SDF INACOMMUNITY HEALTHCLINIC Dr. Aaron Burry is CDA’s new associate director, professional affairs. Dr. Aaron Burry Throughout his career as a senior executive in the municipal sector, Dr. Burry kept his hand in private practice and dental public health. For 6 months this year, he practised in community health clinics (CHCs) addressing patients who were referred primarily from hospital emergency departments for dental pain, and he continues to practise one day a week at a CHC in Cornwall, Ontario. Patients at that CHC were likely some of the first in Canada to be treated with silver diamine fluoride (SDF). needle involved. For a nervous child, once they understand how it works, there’s nothing better than saying, “I’m going to paint something on your teeth and then we’re going to count together.” Many of our patients are referred from hospital and they’re in extreme pain. Their visits often involve removing a tooth. SDF works very effectively in treating other open, painful cavities and making their dental visit a more positive experience from the outset, especially for patients who are very nervous and haven’t had good experiences at the dentist. We typically do three applications for young children on the carious areas. It gives you repeated opportunities to assess that the caries are arrested, have motivational discussions with patients and parents, and helps your patients develop a positive relationship with the CHC. A lot of the adult patients we see are not brushing because it hurts so much just to put the toothbrush near their teeth. With SDF, they feel relief immediately, which allows them to start brushing again, which then buys us time for them to take control of their daily care and create an environment where we can then address their restorative and cosmetic needs. Fluoride varnish will slow down the decay process, but SDF actually stops it. For us, it’s a game changer. Theviewsexpressedarethoseoftheauthor anddonotnecessarilyreflecttheopinions orofficialpoliciesoftheCanadianDental Association.