World Health Organization (WHO) Recognizes Silver Diamine Fluoride as Dental Essential Medicines
Oral Science is pleased to share again with Canadian dental professionals that the World Health Organization (WHO), has for the first time in 2021, added dental caries medications to its list of Essential Medications (EML and EMLc). Section 30 of the released document defines Fluoride toothpaste, Silver Diamine Fluoride, and Glass Ionomers as Essential Medications.
This designation is a massive step for dentistry and the fight for medical treatment of caries. It will likely lead to policy changes in numerous countries and coverage of these products under various payment systems. You can see the entire publication here : https://apps.who.int/iris/bitstream/handle/10665/345554/WHO-MHP-HPS-EML-2021.01-eng.pdf
The report states the following; “The Committee also recommended inclusion of glass ionomer cement and silver diamine fluoride preparations on the core list of the EML and EMLc for the prevention and treatment of dental caries. The Committee noted that these products offer relevant benefits and can be used in atraumatic restorative treatment techniques and in non-specialized settings in alignment with WHO guidance on oral health interventions.”
Advantage Arrest: 38% Silver Diamine Fluroide
Launched in 2017 as the first Silver Diamine Fluoride treatment, Advantage Arrest® was granted the 1st breakthrough therapy designation by the FDA for an oral care product.
Since then, Advantage Arrest® continues to be the leader of SDF treatment as being the only one indicated by Health Canada to help arrest the progression of an already formed caries in permanent and primary dentition.
Additionally, it’s 38% Silver Diamine Fluoride formulation without Potassium Iodine (KI) offers multiple benefits for the dental professionals:
- SDF + KI treatment inhibited development of secondary caries on GIC restorations, but was not as effective as SDF treatment alone. Moreover, SDF + KI treatment caused a perceptible staining at the restoration margin, but the intensity was less than that with purely SDF treatment alone. [1],[2]
- As stated KI is only indicated for use in vital permanent posterior dentition (KI is not indicated for pediatric dentistry/primary dentition). [3]
- Storage requires refrigeration and shelf life of 2 years compared to 3 years for Silver Diamine Fluoride (Advantage Arrest®) .
- Multiple steps are needed to complete the application.
Sources
[1] Turton, B., Horn, R., Durward, C. (2020). Caries arrest and lesion appearance using two different silver fluoride therapies on primary teeth with and without potassium iodide: 12-month results. Clinical and Experimental Dental Research, page 1 – 11.
[2] Zhao, I., et al. (2017). Effect of Silver Diamine Fluoride and Potassium Iodide Treatment on Secondary Caries Prevention and Tooth Discoloration in Cervical Glass Ionomer Cement Restoration. International Journal of Molecular Science, Volume 18, Number 340, pages 1- 12.
[3] Riva Star – SDI retrieved from https://www.sdi.com.au/en-ca/product/rivastar/