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Silver Diamine Fluoride and Icon Erik Harrington DDS, PhD Quick Bio: Pediatric, Family and Hospital Dentistry. Five practices in the Dallas and Kaufman county. Serve Medicaid. About 15k patient visits a year. Over a 100 offices refer their most acute cases. About 1200 hospital cases a year at Childrens Health.
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Silver Diamine Fluoride - TxOHC Diamine Fluoride and Icon_Harrington.pdf · Silver Diamine Fluoride and Icon ... SDF for us in Pedo Reducing Failure, ... 83 Spec No C: C35-38. Who

May 21, 2018

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Page 1: Silver Diamine Fluoride - TxOHC Diamine Fluoride and Icon_Harrington.pdf · Silver Diamine Fluoride and Icon ... SDF for us in Pedo Reducing Failure, ... 83 Spec No C: C35-38. Who

Silver Diamine Fluoride and Icon

Erik Harrington DDS, PhD

Quick Bio: Pediatric, Family and Hospital Dentistry. Five practices in the Dallas and Kaufman county. Serve Medicaid. About 15k patient visits a year. Over a 100 offices refer their most acute cases. About 1200 hospital cases a year at ChildrensHealth.

Page 2: Silver Diamine Fluoride - TxOHC Diamine Fluoride and Icon_Harrington.pdf · Silver Diamine Fluoride and Icon ... SDF for us in Pedo Reducing Failure, ... 83 Spec No C: C35-38. Who

Both SDF and Icon provide me/the patient with more options.

• SDF is not a silver bullet

• SDF does provide an option when others seems less plausible

• SDF does seem to be effective (AAPD Guidelines, 40y in Japan, personal)

• Same goes for Icon

Page 3: Silver Diamine Fluoride - TxOHC Diamine Fluoride and Icon_Harrington.pdf · Silver Diamine Fluoride and Icon ... SDF for us in Pedo Reducing Failure, ... 83 Spec No C: C35-38. Who

Use of SDF for insuring

successful outcome.

Another use for SDF for us in Pedo

Reducing Failure, Repeat Offenders

Page 4: Silver Diamine Fluoride - TxOHC Diamine Fluoride and Icon_Harrington.pdf · Silver Diamine Fluoride and Icon ... SDF for us in Pedo Reducing Failure, ... 83 Spec No C: C35-38. Who

After mechanical caries removal

Page 5: Silver Diamine Fluoride - TxOHC Diamine Fluoride and Icon_Harrington.pdf · Silver Diamine Fluoride and Icon ... SDF for us in Pedo Reducing Failure, ... 83 Spec No C: C35-38. Who

Treating affected Dentin

Page 6: Silver Diamine Fluoride - TxOHC Diamine Fluoride and Icon_Harrington.pdf · Silver Diamine Fluoride and Icon ... SDF for us in Pedo Reducing Failure, ... 83 Spec No C: C35-38. Who

This crown has a much

better chance for success

Page 7: Silver Diamine Fluoride - TxOHC Diamine Fluoride and Icon_Harrington.pdf · Silver Diamine Fluoride and Icon ... SDF for us in Pedo Reducing Failure, ... 83 Spec No C: C35-38. Who

IconThe Caries Infiltration Conceptand Methodology

Page 8: Silver Diamine Fluoride - TxOHC Diamine Fluoride and Icon_Harrington.pdf · Silver Diamine Fluoride and Icon ... SDF for us in Pedo Reducing Failure, ... 83 Spec No C: C35-38. Who

What is Icon?

Caries infiltration is a breakthrough microinvasive technology that treats early caries lesions without the need for anesthesia, drilling or sacrificing any tooth structure.

It will also correct white spot lesions in a single office visit and return the tooth to the look of healthy tooth structure.

1. “Radiographic lesion progression of infiltrated lesions vs. control” (Charité’- University of Medicine, Berlin;2. “Modern Detection, Assessment and Treatment of Initial Approximal Lesions” 1.Caries Research Unit UNICA, University El Bosque, Bogota, Columbia, 2. Department of Operative Dentistry and

Perio, Christian-Albrechts- University Kiel, Germany

Page 9: Silver Diamine Fluoride - TxOHC Diamine Fluoride and Icon_Harrington.pdf · Silver Diamine Fluoride and Icon ... SDF for us in Pedo Reducing Failure, ... 83 Spec No C: C35-38. Who

Icon: Changes When Treatment Begins

Healthy

tooth

End the “Watch & Wait” Approach

White spots & Incipient Lesions Restorable

with InfiltrationConventional Restoration

Kidd EA, Fejerskov O. What constitutes dental caries? Histopathology of carious enamel and dentin related to the action of cariogenic biofilms. J Dent Res 2004; 83 Spec No C: C35-38

Page 10: Silver Diamine Fluoride - TxOHC Diamine Fluoride and Icon_Harrington.pdf · Silver Diamine Fluoride and Icon ... SDF for us in Pedo Reducing Failure, ... 83 Spec No C: C35-38. Who

Who has Chart Like this? Watching

Page 11: Silver Diamine Fluoride - TxOHC Diamine Fluoride and Icon_Harrington.pdf · Silver Diamine Fluoride and Icon ... SDF for us in Pedo Reducing Failure, ... 83 Spec No C: C35-38. Who

When Is Icon Used?Lesions Treatable with Icon

• When we discover incipient caries that are beyond preventive therapies, though too early for restorative treatment, Icon offers a simple alternative to the “wait and see” approach.

Acceptable Lesion Depth Unacceptable Lesions

Page 12: Silver Diamine Fluoride - TxOHC Diamine Fluoride and Icon_Harrington.pdf · Silver Diamine Fluoride and Icon ... SDF for us in Pedo Reducing Failure, ... 83 Spec No C: C35-38. Who

Recent case of mine. 13 yo, high sensory. Needs Ortho Extractions, A few restorations, but also has 4-5 lesions that concern me.

Page 13: Silver Diamine Fluoride - TxOHC Diamine Fluoride and Icon_Harrington.pdf · Silver Diamine Fluoride and Icon ... SDF for us in Pedo Reducing Failure, ... 83 Spec No C: C35-38. Who

Both SDF and Icon (and Laser and BioActiva) provide me/the patient with more Minimally Invasive options.

• Icon is not a silver bullet

• Icon does provide an option when others seems less plausible

• Icon does seem to be effective

• Same goes for SDF