If the tooth is vital and there has
been no history of pain the tooth to be treated is isolated with cotton rolls
Any obvious food debris is removed with an excavator. No caries is removed.
The CSDS silver fluoride preparation is applied on a microbrush and the site is kept wet with the solution for at least one minute (ideally 3 minutes).
After the silver fluoride application period the CSDS 10% stannous fluoride is applied as a reducing agent to turn the surface of the lesion black.
The treated site is temporarily covered with Orabase Protective Paste (Convatec). Experienced operators may prefer to use a piece of Stomahesive Wafer (Convatec).
Ideally, a few days later the surface of the lesion is examined to see if the entire surface has a black mat appearance. If it does not, the nonpigmented area is inspected to ensure it is not a pulp exposure. If this is not the case, repeat the above steps.
