Hygiene Atlas

Atlas · Plate XV · Caries and Preventive Agents · 09

SDF, xylitol and other agents

38% silver diamine fluoride (about 44,800 ppm) arrests cavitated lesions but stains them black; avoid it with silver allergy, ulcerative gingivitis or pulp involvement. Xylitol cannot be fermented by S. mutans and is used at 6-10 g a day. CPP-ACP supports remineralization but is ruled out by milk protein allergy, and chlorhexidine lowers mutans counts.

High-yield facts · 7

  1. Silver diamine fluoride 38%: about 44,800 ppm F; arrests cavitated lesions; stains the lesion black; usually reapplied every 6-12 months.S37
  2. SDF contraindications: silver allergy, ulcerative gingivitis or stomatitis, and pulpal involvement.S37
  3. Xylitol: 5-carbon sugar alcohol that S. mutans cannot ferment; 6-10 g/day in 3-5 doses; large amounts cause diarrhea; toxic to dogs.S48
  4. CPP-ACP (casein phosphopeptide-amorphous calcium phosphate) supports remineralization; avoid with milk protein allergy.S37
  5. Chlorhexidine varnish and rinse lower mutans streptococci in high-risk patients.S31
  6. Calcium phosphate and arginine products help remineralization and dentin sensitivity.T2
  7. Povidone-iodine has been used in early childhood caries programs; avoid with iodine allergy.S37

Facts are written in our own words; each tag links to its source. Values marked "sources vary" differ between references, so check the one your program uses.