“You’re going to need to get a root canal.” For years, those words have sent children and adults alike into a panic, with images of numbing needles, bright lights and oral drills flashing through their heads. Perhaps no other dental procedure is so heavily associated with pain in the public’s eye, according to Jessica Calabrese, the dental operations director at the Community Health Center of Franklin County.
“The root canal, in itself, is really not that complicated, but it sounds awful and it’s got really bad press — it’s the thing every movie threatens people with. It’s even in ‘Finding Nemo,’” she said.
But a new treatment being offered by the center’s dental practice is designed to make those procedures easier and less painful — and can help people avoid them all together.
The center has recently begun applying the new medication, called silver diamine flouride, to patients. The treatment is applied with a microbrush and allowed to set in for one minute before being rinsed. The area will harden over the next two days and prevents the decay from progressing any further.
The silver in the mixture has anti-bacterial properties that protect against any new infection of the area, Calabrese said, while the flouride hardens the tooth.
The treatment has been in use for nearly 80 years in Japan, where it was invented, f and in Europe for decades, Calabrese said. It was approved for use in the United States by the federal Food and Drug Administration in 2014, but dentists did not receive a billing code for it until Jan
“Now we’ve got a solid six months in of using this as a treatment here, and we’ve got really good success. It’s been really useful,” she said.
The medicine stops cavities from progressing — it doesn’t do anything to repair the damage that’s already been done, but it will prevent any further damage from occurring, Calabrese said.
It’s quite useful for very young children who can’t sit through traditional restorative work or for people with dental phobia. For people without insurance coverage for major dental work, it can suspend the decay when they can’t afford a crown.
The treatment is $50 per application, while crowns are at least $1,000 each, Calabrese said.
“This has become an option for them,” she said. “We treat the decay, we arrest it and they keep their tooth.”
Silver diamine flouride is also useful as a precursor to more extensive procedures by hardening the tooth before filling a cavity or doing a root canal.
“We’ve had several cases where we thought it would end up in a root canal, but it didn’t,” she said. “This stopped it, and we were able to just fill the tooth.”
The treatment can be used for patients who are undergoing much more serious treatment for cancer or heart disease, who need dental clearance to begin their treatments but can’t afford to wait to have any oral problems fixed. Applying silver diamine flouride can protect their wounds enough to begin chemotherapy or other treatments that would weaken their immune systems, she said.
At least two of the clinic’s patients have used it in that manner.
Calabrese said it’s also great for patients with transportation challenges whom the clinic’s staff goes out to visit — it can be applied to buy time until they’re able to get to the clinic for further treatment.
So far, the clinic has applied the treatment in at least 50 cases, Calabrese said. Those will be monitored for effectiveness over time, typically every six months.
Calabrese said there have been almost no demonstrable adverse reactions over the 80 years the technique has been used, although people with silver allergies can not use it and the substance stains the area where it’s applied.
The staining can be temperized, to make it white again, she said.
“It’s one simple product that addresses everything we’ve been trying to do,” she said.
You can reach Tom Relihan at: 413-772-0261 ext 264, or trelihan@recorder.com. On Twitter@RecorderTom