Toddler’s Teeth Turned Black with Silver-Diamine-Fluoride Cavity Treatment

  • My family has had terrible teeth for generations.
  • When my daughter was 1 year old, she had 3 cavities in her front teeth.
  • Her dentist suggested a treatment to prevent more cavities, but it turned her teeth black instead.

My family has terrible teeth. They have chewers lined with crowns and stuffing, and when they open their mouths, a silvery smile returns. I believe a small group of dentists have been in business because my last name has been on their calendars.

Don’t get me wrong: We brush and floss just like the best of them, but our teeth are soft and delicate, and the crevices welcome clinging sugar grains and morsels of flesh. I’ve had the least amount of this “family curse” I’ve had, so far, with a small amount of filler. But I fear the worst for my toddler Elle.

As a child, she would nap in my arms while I sat on the couch, and I would often use this time to wipe food stains off her cheeks and lightly brush a few of her 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 didn’t come off.

“Oh no,” I thought, “tooth decay.”

Shortly thereafter, I took Elle to her first dental appointment—a tall, kind-eyed dentist confirmed that she had small cavities on her three front teeth.

I feel like a failure for making my 1 year old’s teeth so bad. I was also nervous and wondered if that meant Elle was going to get more cavities. Our dentist offered to coat my daughter’s front teeth with silver diamine fluoride to stop cavities from growing until she was old enough to sit down for fillings without general anesthesia, or until her baby teeth fell out.

Silver diamine fluoride is safe and effective

My daughter’s dentist explained that SDF is safe, painless and a fraction of the cost of fillings. Still, safety is my number one priority and I wanted to do my own research. I need to make sure I don’t skip the risk of anesthesia for worse side effects.

Lynn Gargano, clinical director of pediatric dentistry at the NYU Langone Center for Family Health, confirmed that SDF is safe.

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

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

After talking with my husband, we decided that SDF was the best option, and the next week Elle’s dentist brushed her teeth with what looked like a little plastic stick. We are in and out of the office within minutes.

Her teeth turned black after treatment

Before applying SDF, I was warned several times by the dentist that the solution would permanently stain areas of decay, which meant that parts of Elle’s teeth would remain black unless we decided to have a filling later. He mentioned that some parents were not happy with this, but I ignored his warning.

Still, SDF is relatively new in the United States as a cavity treatment. It’s been used in oral care in Japan for more than 50 years, but the Food and Drug Administration didn’t approve it for dental use until 2014. So while Gargano says SDF is gaining popularity in the US, I find that most people don’t know what it is.

“Is she eating Oreos?” other parents asked after seeing my daughter laughing in the playground.

Sometimes I just nod and smile and blame the creamy biscuits for the dark spots. But most of the time, I have to explain that my daughter has cavities and this is an alternative to general anesthesia. I was a little surprised, but most of the time, other parents were sympathetic to the difficult decision. Plus, they’re often interested to hear that filler isn’t the only option. I’m happy to be able to tell them about our experience.

When my pediatric dentist warned me about SDF stains, I knew he was concerned that I didn’t like Elle’s teeth. But my daughter doesn’t care about her teeth, and I don’t mind how she looks. In fact, I kind of like it. It makes her seem more like family on my side.

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