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One of the most important challenges for dentists at the moment is finding ways to reduce dental aerosols generated during procedures. It is crucial to reduce dental aerosols as much as possible as these airborne particles are capable of spreading viruses such as COVID-19 through the air and contaminating the air and surfaces of the surgery.

Not surprisingly then, there has been much discussion about aerosol generating procedures (AGPs) and the introduction of strict rules to leave fallow time after AGPs to allow resulting aerosols to settle, followed by thorough disinfection.

AGPs often involve the use of high-speed dental instruments, such as turbines, mechanised scalers and air tooth polishers. These instruments by their nature agitate tooth fragments, blood and saliva into the air which carry with them any bacteria and microorganisms present in the mouth, including viruses such as COVID-19.

It therefore has made sense to many dentists to try to find alternatives to the use of high-speed instruments in an effort to reduce dental aerosols.

When it comes to the treatment of asymptomatic carious teeth, there is a non-aerosol-producing alternative that is proving extremely effective.

What is SDF?

SDF or Silver Diamine Fluoride is a liquid treatment used to help prevent caries from forming, growing or spreading to other teeth and to reduce dentine hypersensitivity. SDF contains silver which acts as an antimicrobial agent and fluoride which strengthens teeth and prevents caries progression. It can be applied to teeth without anaesthetic or the use of high-speed instruments.

SDF is licensed for use in Europe (CE-marked) for sensitivity and as a cavity cleanser only, but a growing number of clinicians consider it suitable to be used off-licence for caries arrest too, when it is in the patient’s interest and there is no suitable alternative.

RIVA STAR for better aestheticsSDF and Riva Star

Dr Geoff Knight, dentist and pioneer of a number of innovative clinical procedures in aesthetic dentistry and the pharmacological management of caries, recommends the use of SDF for treating asymptomatic carious teeth. He chooses Riva Star because of its extra step of applying potassium iodide after SDF, which forms a silver iodide creamy white precipitate which then turns clear, for better aesthetics.

Dr Knight’s protocol for treating asymptomatic carious teeth is to then apply a glass ionomer cement (GIC) overlay to restore the tooth – ART-GIC (Atraumatic Restorative Treatment – Glass Ionomer Cement). Systematic reviews in dental literature confirm that a single surface cavity restored with this process may be considered to have a similar life expenctancy as an amalgam or composite resin restoration.

A solution in COVID-19 times

At a time when dentists are looking to reduce dental aerosols in their practice by not only finding suitable alternatives to AGPs, but also providing treatments that may help patients in the short term when some AGPs are not possible, SDF has proved to be an efficacious solution.

For asymptomatic carious teeth, it will halt the progression of caries and reduce sensitivity, as well as providing an aesthetic solution for visible teeth. It is also ideal for deciduous teeth because of its quick application and superior efficacy to sodium fluoride varnish.

Riva Star with its proven efficacy and tooth-like colour is an effective, non-aerosol-producing treatment for teeth in all areas of the mouth. It is a worthy addition to the treatment portfolio of any dentist who wishes to reduce dental aerosols in their practice.


Try Riva Star now by contacting your local SDI respresentative.