Aim: Introduction of Silver Modified Atraumatic Restorative Technique (SMART) as an alternative caries prevention tool advances the existing dental armamentarium.Summary: Caries management strategies have advanced far beyond simply "drilling and filling" teeth, which does nothing to halt the underlying causative disease process.Effectively treating the caries disease starts with a careful hard-tissue exam and caries risk assessment (CRA) followed by treatment intervention strategies based on the patient's individual risk status.The latest addition to the caries prevention armamentarium, silver diamine fluoride (SDF), entered the US market in 2015 shortly after it was cleared by the United States Food and Drug Administration (FDA) in 2014 to treat tooth sensitivity.It is being used off-label to treat and prevent caries, using CDT billing code D1354.The case presentation showcases a technique called Silver Modified Atraumatic Restorative Technique (SMART) in which SDF is applied and immediately restored or sealed with conventional GIC.Placement of SDF and GIC on the same appointment is especially useful when, for whatever reason, the patient will not be able to return for subsequent dental treatment and it is deemed advantageous to use a minimally invasive procedure rather than nothing at all.By placing SMART restorations you kill bacteria and cut off the nutrient source for any remaining bacteria by placing a chemically sealed restoration that will arrest and remineralize the caries lesion, preserving tooth structure and enhancing pulp vitality.The following case study showcases a different approach to using GIC material in combination with SDF.
No takes yet. Share an insight, caveat, or question.
Fa et al. (2016) studied this question.