SDF caries prevention in children

My basic position on using SDF for prevention in a patient that has no current signs of disease, is to target the highest risk areas. Place the SDF at the sites where you would expect to see new carious lesions in 6 months. For 12 months olds whose older siblings are missing their upper incisors from extractions following caries, I place on the upper anteriors. For teen agers who walk in with a 2 liter of mountain dew or worse, I place on the posterior interproximals. For elders, I place on restoration margins and exposed root surfaces. For 6 year olds, newly erupted first molars. Etc. Full mouth application is a bit much. It would probably be safe but very unpleasant.

My clinical protocol for apply SDF for prevention is the same as for treatment, but I do not need to re-dip. I want to see the surfaces go from being dry to being moist. Isolate with cotton, air dry (if at all possible) until desiccated, moisten the entire lesion / target area with SDF, wait 2-10 seconds, wipe excess with 2x2, place Fluoride varnish or vaseline over the areas.

Also, Iodine before Fluoride varnish 4x/year increases the preventive effect of FV alone to that of SDF 1x/year.

All that said, if you simply treat the caries lesions, there will be less new lesions. Yet, for example, if there are lesions in 3 posterior quads, I will also treat the 4th.

This figure will stay updated to the latest high quality clinical randomized trials on the use of Silver Fluoride for arresting dental caries lesions (cavities).

Use it as you like!