INFORMED CONSENT FOR SILVER DIAMINE FLUORIDE
Facts for consideration:
• Silver Diamine Fluoride (SDF) is an antibiotic liquid. We use SDF on cavities to help stop tooth decay. We also use it to treat tooth sensitivity. SDF application every 6-12 months is necessary.
• The procedure: 1) Dry the affected area, 2) Place a small amount of SDF on the affected area, 3) Allow SDF to dry for one minute.
• Treatment with SDF does not eliminate the need for dental fillings or crowns to repair function or esthetics. Additional procedures will incur a separate fee.
• Your child should not be treated with SDF if 1) they are allergic to silver 2) there are painful sores or raw areas on their gums (i.e., ulcerative gingivitis) or anywhere in their mouth (i.e., stomatitis) at the time of treatment.
Benefits of receiving SDF:
• SDF can help stop tooth decay.
• SDF can help relieve sensitivity.
Risks related to SDF include, but are not limited to:
• The affected area will stain black permanently. Healthy tooth structure will not stain. Stained tooth structure can be replaced with a filling or a crown.
• Tooth-colored fillings and crowns may also discolor if SDF is applied to them. Normally this color change is temporary and can be polished off.
• If accidentally applied to the skin or gums, a brown stain may appear that causes no harm, cannot be washed off, and will disappear in 1-3 weeks.
• Your child may notice a metallic taste. This will go away rapidly.
• If tooth decay is not arrested, the decay will progress. In that case the tooth will require further treatment, such as repeat SDF, a filling or crown, root canal treatment, or extraction.
• These side effects may not include all of the possible situations reported by the manufacturer. If you notice other effects, please contact our office.
• Every reasonable effort will be made to ensure the success of SDF treatment. There is a risk that the procedure will not stop the decay and no guarantee of success is granted or implied.
Alternatives to SDF, not limited to the following:
• No treatment, which may lead to continued deterioration of tooth structures and cosmetic appearance. Symptoms may increase in severity.
• Depending on the location and extent of the tooth decay, other treatment may include placement of fluoride varnish, a filling or crown, extraction, or referral for advanced treatment modalities.
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