## Why consider the ARM-ER® approach?

1. Assess and identify the nature of the decay.
2. Redefine the status of the affected lesion and the ongoing effect that the silver fluoride has had on the tooth.
3. Manage the future of the tooth for the individual patient.

### Education— the key to keeping your mouth and body in a health state.
You probably know already that staying healthy is not ‘one size fits all’?

Your dental practitioner will help guide you in the course of care which is best suited for each tooth.

### Review-Repeat-Restore-Rehabilitate-Re-establish

Silver fluoride for prevention – assess and control early decay between teeth before a filling is needed.

5 yr old. 1st visit – silver fluoride placed on active decay.  
Visit 2– decay is no longer active and tooth easily filled.

After the caries (decay) is treated with silver fluoride, the affected area goes black if the decay process is stopped.

### We call these ‘Black Diamonds’

#### The ARM-ER® Approach to caries management

These teeth may then be suitable for minimal intervention treatment.

### Minimal invasive treatment is:
- Less discomfort  
- Reduction in emergencies  
- Less extractions  
- Reduction in need for hospital admissions

1. Assess  
2. Redefine  
   
### Review: Repeat : Restore:

#### Rehabilitate: Re-establish

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Using silver fluorides to assess and redefine caries — then choose the management plan!

Graphics courtesy Dr J Horst. WRDC 2017

### Effective in the following way:
- Caries status is assessed  
- The lesion’s status is redefined  
- Bacterial control is established.  
- Immediate improvement of oral health status is gained

Then a management plan can be formulated:
- Remineralisation and desensitisation is expected as an ongoing effect of the silver fluoride application.
  
  - Simple, painless and safe  
- Allowing time for management plan to be formulated to address individual patient needs.
  
  - Can be used for caries status  
- Offering improved quality of care (with short and long term gains) management in patients of all ages.

### The procedure:
1. The affected area is dried.  
2. A very small amount of silver fluoride (a clear and odourless solution) is placed on the affected area for 1-3 minutes and followed by a very small application of stannous fluoride (also clear and odourless). The immediate reaction on active caries is that the area will blacken—’Black Diamonds’.
3. A ‘holding’ solution is applied.

### The Black Diamond effect!
The treated area of the tooth will turn a blackish colour, but only the area of the tooth which was decayed will stain permanently.