Oral Science is pleased to once again share with Canadian dental professionals that the World Health Organization (WHO) has added, for the first time in 2021, dental caries medications to the Essential Medicines List (EML and EMLc). Section 30 of the released document defines fluoride toothpaste, silver diamine fluoride and glass ionomers as essential drugs.
This designation is a huge step for dentistry and the fight for medical treatment of dental caries. It will likely lead to policy changes in many countries and coverage of these products in various payment systems. You can see the entire post here.
The report states the following. “The committee also recommended the inclusion of glass ionomer cement and silver diamine fluoride preparations in the core list of EMLs and EMLcs for the prevention and treatment of dental caries. The Committee noted that these products offer relevant benefits and can be used in non-traumatic rehabilitation treatment techniques and in non-specialist settings in line with WHO guidelines for oral health interventions.’
Advantage Arrest: 38% Silver Diamine Fluoride
Launched in 2017 as the first Silver Diamine Fluoride treatment, Advantage Arrest® received FDA’s 1st breakthrough therapy designation for an oral care product.
Since then, Advantage Arrest® continues to be the leader of SDF treatment as the only one indicated by Health Canada to help stop the progression of an already formed caries into permanent and primary dentition.
In addition, the formulation of 38% silver diamine fluoride without potassium iodide (KI) offers multiple benefits for dental professionals:
- SDF + KI treatment inhibited secondary caries development in GIC restorations, but was not as effective as SDF treatment alone. In addition, SDF + KI treatment induced noticeable staining in the repair margin, but the intensity was less than that with pure SDF treatment alone. [1],[2]
- As stated, KI is only indicated for use in vital permanent posterior dentition (KI is not indicated for pediatric/primary dentition). [3]
- Storage requires refrigeration and shelf life 2 years compared to 3 years for Silver Diamine Fluoride (Advantage Arrest®).
- Several steps are required to complete the application.
Sources
[1] Turton, B., Horn, R., Durward, C. (2020). Caries arrest and lesion onset using two different silver fluoride treatments in primary teeth with and without potassium iodide: 12-month results. Clinical and Experimental Dental Research, page 1 – 11.
[2] Zhao, I., et al. (2017). Effect of silver diamine fluoride and potassium iodide treatment on the prevention of secondary caries and tooth discoloration in cervical glass ionomer cement restoration. International Journal of Molecular Science, Volume 18, Number 340, pages 1-12.
[3] Riva Star – SDI retrieved from
