So I was at my “every so often what do you mean it’s been a couple of years” visit to the dentist.
He did the usual “cluck clucking” about that status of things, and mostly did a full “root planing” of my teeth wherein steak knives vibrating at ultrasonic speed are thrust down to the bone line and wiggled around, giving extra attention to every place there is “calcification” and bacteria and hovering especially over any place where nerves congregate… ( need I put the /sarc; tag in?…)
After that, I was informed that the roots where they meet the crown enamel in some places had pre-cavity demineralization and I was going to have a bunch of cavities that traditionally would need drilling and filling… but he had a new procedure that tends to stop them from progressing to cavities. I, of course, agreed that the new procedure sounded better, since it consisted of wiping my teeth with swabs with a couple of solutions on them…
So what is the magical solution? Silver salts.
Yes, there’s been a load of claims for silver as a sort of cure all and I talked about it some in this posting: https://chiefio.wordpress.com/2012/08/28/brass-doorknobs-flu-and-mrsa/. It does have anti-microbial activity, both as salts and as bare metal. Turns out this is another one of those “known long ago and forgotten” things, now resurrected as “new”.
When I was about 8? I went to the local doctor for something or other. He noticed I had a canker sore inside my mouth. Grabbed a bottle of silver nitrate and dabbed it with a Q-tip. I, being curious, was asking questions. The short form of the response was that “nobody knows why it works, but it kills bacteria and viruses”. (Now we know it denatures their proteins). I’d kind of kept an eye on silver nitrate ever since. But it would seem, not quite close enough…
Over the years I’ve had a load of cavities. My molars look like a metals mine. Silver, mercury, gold galore. Had I generalized a bit more from the Dr.’s treatment, I could have avoided a lot of it.
What I had done at the dentist was a Silver Solution ( I think I heard him say ‘nitrate’ to the tech getting the bottle) followed by a “fluoride varnish” topper solution. I go back in 3 or 4 months for a checkup, retreatment.
Of course, I can’t let that be the end of it. Off to DuckDuckGo for some web searches. LOTS of interesting things turn up. There’s the usual Weston Price stuff on having a diet high in Vit. D, E, and A (oil solubles) and whole wheat (germ included) along with fish and eggs as ‘restorative’. Tales of “primitive” people halting and reversing demineralization and cavities with diet. Stories of his practice doing the same with folks on a western diet by changing it. OK, nice I guess, but I was hoping for something less than a life style change. On to Silver.
I found several references to older uses of Silver Nitrate to halt cavities. It was known 100 years ago. Now it has found a resurgence. But the newer of the new is a different silver compound. Silver diamine fluoride.
This article has a reference to the ‘prior art’, bold mine:
Silver Diamine Fluoride: A Caries “Silver-Fluoride Bullet”
Thayza Christina Montenegro Stamford
The Forsyth Institute, 140 The Fenway, Boston, MA 02115, USA.
Journal of dental research (Impact Factor: 4.14). 02/2009; 88(2):116-25. DOI: 10.1177/0022034508329406
The antimicrobial use of silver compounds pivots on the 100-year-old application of silver nitrate, silver foil, and silver sutures for the prevention and treatment of ocular, surgical, and dental infections. Ag(+) kills pathogenic organisms at concentrations of <50 ppm, and current/potential anti-infective applications include: acute burn coverings, catheter linings, water purification systems, hospital gowns, and caries prevention. To distill the current best evidence relative to caries, this systematic review asked: Will silver diamine fluoride (SDF) more effectively prevent caries than fluoride varnish? A five-database search, reference review, and hand search identified 99 human clinical trials in three languages published between 1966 and 2006. Dual review for controlled clinical trials with the patient as the unit of observation, and excluding cross-sectional, animal, in vitro studies, and opinions, identified 2 studies meeting the inclusion criteria. The trials indicated that SDF’s lowest prevented fractions for caries arrest and caries prevention were 96.1% and 70.3%, respectively. In contrast, fluoride varnish’s highest prevented fractions for caries arrest and caries prevention were 21.3% and 55.7%, respectively. Similarly, SDF’s highest numbers needed to treat for caries arrest and caries prevention were 0.8 (95% CI=0.5-1.0) and 0.9 (95% CI=0.4-1.1), respectively. For fluoride varnish, the lowest numbers needed to treat for caries arrest and prevention were 3.7 (95% CI=3.4-3.9) and 1.1 (95% CI=0.7-1.4), respectively. Adverse events were monitored, with no significant differences between control and experimental groups. These promising results suggest that SDF is more effective than fluoride varnish, and may be a valuable caries-preventive intervention. As well, the availability of a safe, effective, efficient, and equitable caries-preventive agent appears to meet the criteria of both the WHO Millennium Goals and the US Institute of Medicine’s criteria for 21st century medical care.
I’ll take a 96%+ halt of cavity growth… and a 70%+ prevention. (Assuming I’ve translated that right…) So only NOW is the USA getting on board with this? Sheesh. (It does have a downside. It makes the cavity look dark metallic like a mercury filling. I’m happy with that.)
Seems lots of folks have known for a very long time that this stuff works great. So now I’m wondering why 50 years ago MY dentist wasn’t giving me a Silver wash and preventing all that drilling and filling. But I digress… Back at now. I found this link particularly interesting. It’s a PDF of a magazine, so I’m not going to cut / paste much of it. Just download it and read the thing.
Among other bits in it, there is a mention of the 100 year+ old use of Silver Nitrate for caries, that it fell from favor in the Fluoride rush, and is no longer mentioned in US dental schools (maybe now as something ‘new’?) but has been in use in Japan for 80 years. Sigh. Arrogance seems to have prevented us from looking at Japanese practice and learning a trick. (A cynic might ask if there was more profit in drilling and filling and dentures and… oh, never-mind.)
Down on page 17 is the article about Silver. (just after the one about a new gel that lets you regrow enamel…)
ABSTRACT The Food and Drug Administration recently cleared silver diamine fluoride for reducing tooth sensitivity. Clinical trials document arrest and prevention of dental caries by silver diamine fluoride. This off-label use is now permissible and appropriate under U.S. law. A CDT code was approved for caries arresting medicaments for 2016 to facilitate documentation and billing. We present a systematic review, clinical indications, clinical protocol and consent procedure to guide application for caries arrest treatment.
How nice of them to “allow” a cure… Note that down on page 22 we have:
Not a single adverse event has been reported to the Japanese authorities since they approved silver diamine fluoride (Saforide, Toyo Seiyaku Kasei Co. Ltd., Osaka, Japan) more than 80 years ago.
The manufacturer estimates that more than 2 million multi-use containers have been sold, including 41,000 units in each of the last three reporting years.
80 years behind the times… but at least now it’s “approved”… Aren’t you glad you’ve been ‘protected’ all your life from something that can prevent cavities and stop the ones you have from getting any bigger?
There’s a whole lot more interesting stuff in the article. How it works, that it can turn the cavity dark, that it’s darned easy to apply. That a filling can be put over it if desired, especially a new very cheap (and not so good) one called GIC Glass Ionomer Cement that’s very useful for small kids (going to lose the teeth anyway so a ‘few year’ fix that is fast and doesn’t need drilling is a good idea) and in places with a load of poor folks who can’t afford a lifetime of wages to get a tooth fixed. I also found this part interesting:
Fourth, some lesions are just difficult to treat. Recurrent caries at a crown margin, root caries in a furcation or the occlusal of a partially erupted wisdom tooth pose a challenge to access, isolation and cleansability necessary for restorative success.
As I’ve had a couple of those (generally resulting in tooth loss or very expensive replacement crowns – I only slightly resented the loss of the wisdom teeth…) it sure would have been nice to know a swab with some Silver Nitrate or Sliver Diamine Fluoride would have prevented all that pain and expense. Sigh, Again.
That was the fourth on the list, here’s the summary of the rest:
Following the above considerations, we developed four indications for treatment of dental caries with silver diamine fluoride:
1. Extreme caries risk (xerostomia or severe early childhood caries).
2. Treatment challenged by behavioral or medical management.
3. Patients with carious lesions that may not all be treated in one visit.
4. Difficult to treat dental carious lesions.
Finally, these indications are for our school clinics. They do not address access to care. The U.S. Department of Health and Human Services estimates 108 million Americans are without dental insurance, and there are 4,230 shortage areas with 49 million people without access to a dental health professional. Unlike fillings, failure of silver diamine fluoride treatment does not appear to create an environment that promotes caries, and thus needs to be monitored.
Thus, a final important indication is:
5. Patients without access to dental care.
I also found this patent on using a metal halogen solution (like potassium iodide) to reduce the discoloration interesting.
So looks like having a few silver coins (100% silver as in ingots or ’rounds’, not the copper / silver alloy in most government coins) and some nitric acid in your survival kit would be ‘a good thing’ or just buy a small bottle of silver nitrate on line. Not as good as the SDF, but ‘good enough’ in an emergency situation.
It also looks like maybe asking YOUR dentist about this (especially if you ‘have issues’ and they want to yank teeth or do very expensive procedures you can’t afford just right now) might be a reasonable path to explore.
The SDF looks to convert to a mix of Silver Chloride and metallic silver (thus the darkening in the cavity) over time, and the fluorine is released helping to promote ‘remineralization’. I suspect a similar advantage over plain Silver Nitrate could be had in any ‘field expedient situation’ with a high fluoride toothpaste after a Silver Nitrate treatment. While you still have the defect and it’s a bit darkened, whenever you can get to the dentist, it is not grown much bigger in the mean time and some of the area has toughened up a bit.
This also somewhat answers something I’ve wondered about: Why a new cavity didn’t just start at the border where a mercury / silver filling touched the tooth. It isn’t a molecular bond (the dentist has to drill so much to make a mechanical hold on the filling – larger in the back than the front). It’s that silver killing off the decay bugs.
In a few months or a year or so (depending on when “nothing happened” becomes significant, or “something happened”) I’ll post an update on my particular teeth and their Silver treatment. As of now they feel nicer… but that might just be the polish and cleaning ;-)
FWIW, you can also get a very dilute Silver Chloride topical antibacterial goo over the counter. I suspect it is way too dilute to do any good with a cavity in teeth, but it does exist and probably works well on things like skin sores and oral mucosa sores in an emergency.
Obligatory Disclaimer: Nothing in this article is to be construed at medical or dental advice. I’m not a medical doctor nor a dentist and I’m only reporting what happened to me at MY dentist and what I found in a web search based on that, plus some idle speculation about how that might be useful in an end of the world apocalyptic context when no dentists are to be found. Oh, and some polite snark about us not bothering to look at common practices in the rest of the world. ALWAYS go to your own doctor or dentist and hand them buckets of money for care and NEVER listen to posts on the internet for ideas how to not pay them quite so much; it can only get you killed and cause all your blackened teeth to fall out.