The ARM-ER® Approach to Caries/Sensitivity Management in Permanent Teeth

After silver fluoride application. The dark area indicates arrested decay.

Black ‘callus’ is cleaned and hard, sound dentine is revealed.

White ‘base material’ placed.

White filling is placed .

In patients, where cleaning is difficult or the mouth is drier, silver fluoride may need to be re-applied every six months.

Graphics - Dr Alan Deutsch

Surface staining is temporary and only decay is permanently stained - this indicates it has been arrested.

Using Silver Fluorides to:

• 2 weeks after application—remineralized, desensitized and only the decay is stained.
• Gum health is also improved when the silver continues to inhibit plaque formation.

Assess ….Arrest?

Redefine…..Remineralise?

Manage —

• Black Diamonds Rock!!

Þ Review? Þ Repeat? Þ Restore? Þ Rehabilitate? Þ Re-establish?

How Does It Work? When Can It Be Used? Why Is It Beneficial?

Silver and fluoride ions are absorbed into the affected part of the tooth and continue to protect against ongoing bacterial activity on a hardened tooth surface.

Graphic courtesy Dr Jeremy Horst. WRDC 2017

The use of silver fluorides to address and assess the status of decay in an affected tooth is an easy, safe and very effective method of managing the plans for ongoing treatment for a single tooth or several teeth. It often means that treatment recommendations can be planned without compromising the teeth until the patient is able to have further treatment if this is recommended.

In the adult patient it is ideal when the patient is:

• very anxious
• medically compromised
• needs more time to access care
• unable to have treatment completed in one visit

ARM-ER® ~ Assess : Redefine: Manage - Educate & Review? Repeat? Restore? Rehabilitate? Re-establish?