 Hello, hello, Andrew Maeski here with Dental L. So let's talk about something called silver diamine fluoride. So you might have heard about this, you might have no idea what I'm talking about. I know I first heard about this probably about a year ago and somebody was talking about it and I kind of said to them, wait, what is that silver diamine fluoride? So it's a fluoride silver diamine, what is this? And they kind of looked at me like, where have you been? You've never heard of this. So this is something that has been around for years, but it has recently come to the US in 2016, I believe, and it's now starting to work its way into Canada, which is probably why I started hearing about it a little bit more. So now depending on who you are and where you are in your practice. So if you are a new dental hygienist, you're probably interested to hear about all of the newer things that people are doing in the dental office, especially when it comes to treating cavities, because that's probably the number one thing that we obviously see the most. That's the number one thing where a patient will say to you, ooh, do I have a cavity? Do I need a needle? That is something that everybody wants to try to avoid is getting a cavity because they don't want the needle. They don't want the high speed handpiece all of that, right? So we needed to come up with a way to stop that from happening. And it's so much more than simply telling a patient, well, you have to brush twice a day. You have to make sure to use the floss every day, you know, all of that, right? It is so much more than just telling them to do something because sometimes or most times it doesn't always happen. So I do understand that if you are working in a practice, this isn't something that you can just order on your own. It's something that you do have to talk to your dentist about. And I don't know about you, but the practices where I have worked at in the past, not all of them, but nine out of 10 of them, they kind of go, oh, will silver-diamond fluoride? Yeah, it looks good. It sounds good, but let's just do things how we've been doing it for the past 30 years, you know? If they've owned the practice for 30 years or more, the last thing they're going to probably want to do is to buy something else and start using a new method. You know, people are stuck in their ways quite easily. I'm the opposite where I'm always looking for something new because, you know, there are better things out there all the time. So I would like to be that person to know what's out there to help my patients as much as possible. And I'm lucky in the sense where I do own my own practice. So I can buy whatever I want. I can do what I feel is best for my patients. So silver-diamond fluoride, it comes in a bottle. I purchased it from Oral Science. I do have, I did talk about this probably a couple of months ago, I do have several videos on that too. But it's a bottle about this big and it's about don't quote me on the price, I'll have to double check again. I think it's about $300 a bottle. And what I charge for it is depending on the tooth surfaces to be treated. So typically a drop of the silver-diamond fluoride treats about one to five areas, obviously depending on how large the area is. So I treat, I charge about $25 per two to five teeth. So that's not $25 per tooth. That's $25 per two to five different teeth. Depending on, again, how large those areas are to be treated. Because if I need another drop, then I will charge another $25 on top of that. But you guys, you might be saying, ooh, $25 for up to five teeth. That's not expensive at all. Because if they were to get a composite filling in the dental office, that would be probably about $60 to $100 per tooth. Of course, depending on the larger surface area. But silver-diamond isn't meant to replace the composite. Because it's a drop of liquid that you place on the tooth. And it does turn the area black. So this, of course, is not my picture. But if you would like to see more, she has a lot on her website. She's a pedodentist. So she sees children primarily. But so you see this first picture here up at the top. So it's a drop that goes in the tooth to stop that cavity. It does turn the area this color here. So obviously, parents don't like that. Kids don't like that. Because, oh, it looks like their cavity got even worse. But it didn't. So this will actually stop that cavity from getting larger without a needle and without a high-speed handpiece. So how amazing is that? But of course, they will look at this and say, well, I don't want my kid to have this for another five years or more until those primary teeth fall out. So what can you do? So you can actually put, depending on where you live, it could be the dentist or it could be the restorative hygienist that does this. Again, depending on where you live, they can place what is called a glass ionomer in those areas. So it's not a composite. But it can go over top here so that things look normal. So doesn't the second picture look nicer? So I'll just recap that a little bit. So silver diamie is a drop or two that you put in the area first to stop those cavities from getting larger, so in the first picture here. In the second picture, so if the parent or the child obviously doesn't like that look, then take it a step further and place a glass ionomer over top. Composite, you cannot place over top because it will actually change composite that same color. So it does have to be something different. And you cannot like here either because that will oxidize the silver that's inside the tooth, changing the color even more. And the silver you put in won't have a chance to work properly. And there's many different types of, excuse me, there are many different types out there of the glass ionomer. A lot of them do have to be light cured. So you have to watch and find the one that does not have to be. Actually, I'll see if I can pull it up here for you now. And the only one that I have found is the Fuji Equia Forte. And I believe I actually learned that from this dentist from a Facebook group, I think. So this one, the Fuji Equia Forte, this is the only one as far as I know that you don't need to light cure it. So it is perfect to place on top of the silver diameter. So I'm just going to show you guys a picture of what that looks like. So here. So I had ordered this for my practice. It comes, darn it, I can't remember how many capsules. I want to say 40 or 60, something like that. It costs about $500 for the actual package. So when I'm placing this on patients, again, depending on the area, I charge about $65 per area. So if I can use a capsule for two teeth, then I will only charge $65 for that. So I guess an easier way of thinking about it is per capsule, I charge about $65. Now here in Canada, not a lot of insurance companies cover silver diamine or the glass ironware. But so I do let the parents know this. I say I don't know if your insurance will cover it. Some do and some don't. But it's still a lesser expensive option than if you had to go to get composites. And if your child's, let's say, three years old, the dentist won't be able to do that anyway. So they would probably have to put them to sleep to do all of their dental work. And then that's about $2,000 to $5,000 later, depending on the areas to be treated. So yes, insurance may not cover this, but you might be spending $300 versus $2,000 to $5,000. And it's a lot easier for your child. So that's what I tell them. But I do also like to let them know they have options, because I don't want them to think that they can only see me, right? If they go to their dental office, however, they likely don't use this. So I do ask them first if they would like to ask their dental office if they do use these materials and if they would prefer to see them instead, it is totally up to them. But I see a lot of patients where they don't want to go to the dentist because they're either nervous or they don't have the money. So then at least I can do something now so that the cavities don't become a lot worse and then cause pain. So does this make sense to everybody so far? If you have any questions, let me know. Because the main thing that I want to say too is, I want to be able to treat patients before they get cavities or before we see them and then say, yeah, we've been keeping an eye on those areas for six months. Now those cavities are a lot larger. So we have to treat them now. So let's give you a needle, the high-speed handpiece, pretty much all of that. But then after that happens, that patient will likely come back six months later and then we say, oh, you're actually getting cavities around those composites that we did the last time. So now we have to fix those months. Whereas of course that can happen anywhere but at least this is a much, it's a less expensive option plus you do not need a needle, you do not need the high-speed handpiece. So their tooth is staying the same. You do not have to take away additional enamel to put in the composite. Their tooth is staying the same. You're just simply covering it up and killing the cavities that are in there. So I prefer to treat things that way if I can. But of course this does not work for everybody. If they have this large hole in the tooth, they'll probably need a little bit more than that, right? If they're in a lot of pain, they might need more. So it's nice to catch it early enough before all of that happens. Of course this would still work if they have a large hole but it's better to catch it a lot earlier because without the X-rays, we can't see what's happening underneath. And then we might have to say at some point, ooh, now they need a root canal and nobody wants a root canal, right? So we try to avoid that from happening. We try to avoid that cavity from getting a lot larger. So let me know you guys if you have any questions. If you're a new dental hygienist, especially you might not have heard about this before but this is the new way of pretty much everything. Like this will just help so many people because they don't have to think about needles. They don't have to think about the high speed handpiece. It will take a lot less time, a lot less money. But of course it depends on the practice where you work in too. Because if you don't have this, you need to be talking to patients about the types of methods that they use in your practice. But like I said, I'm lucky in that I do have my own practice so I can do and purchase whatever I want. And this has helped so much. People are a lot happier when they hear that they don't need a needle or the high speed handpiece. So thank you guys so much for listening and let me know if you have any questions.