Mode of use and treatment protocols
Learn how to correctly apply your CaviGuard product.
- Treatment protocol for grade I and II caries.
- Dentinal hypersensitivity treatment protocol.
- Interproximal treatment protocol (Detection of cavities between teeth).
- SMART GIC FILLING (Self-Healing Glass Ionomer Cement Filling Material) Restoration Treatment Protocol.
- Sandwich technique filling (GIC + Composite/resin, filling protocol for best aesthetic results).
- Mechanism of action
- Bibliography
TREATMENT PROTOCOL FOR GRADE I AND II CARIES
PROPHYLAXIS: Cleaning only with a toothbrush and water.
STEP 01. Protect the patient’s eyes.
STEP 02. Assemble and prepare device 1 and device 2. (See video below)
STEP 03. Apply Vaseline to the patient’s lips and face to avoid SDF stains on the skin.
STEP 04. Isolate the treatment area with cotton.
STEP 05. Dry completely with compressed air to remove all saliva that saturates the injury.
a. Note: Not drying the lesion enough will reduce the effectiveness of the treatment.
b. Note: To avoid aerosols, dry completely with a cotton pad or place an air/water tip between the tooth and the cotton square before drying with compressed air.
STEP 6. Place the applicator tip of device 1 on the lesion, click once, paint 38% SDF on the entire lesion.
STEP 7. Immediately place the applicator tip of device 2 on the lesion, click once and apply FV 5% to cover the entire treated lesion.
STEP 8. Instruct the patient not to eat or drink for 4 hours and not to brush their teeth for 24 hours.
STEP 9. Check arrest (socket should look black and hard, DO NOT remove any tooth structure, lesion stops and remineralizes) in a second session after 48 hours. Repeat treatment protocol if necessary.
STEP 10. Once caries detection is verified, the patient can return after 48 hours to receive a restoration if necessary.
Treatment effectiveness of 96.2% after the first treatment session with Caviguard, references:
TREATMENT OF THE DENTINAL HYPERSENSITIVITY PROTOCOL
STEP 01. Protect the patient’s eyes.
STEP 02. Assemble and prepare device 1 and device 2. (See video below)
STEP 03. Apply Vaseline to the patient’s lips and face to avoid SDF stains on the skin.
STEP 04. Isolate the sensitive site with cotton.
STEP 05. Dry completely with compressed air to remove all saliva.
a. Note: To avoid aerosols, dry completely with a cotton pad or place an air/water tip between the tooth and the cotton square before drying with compressed air.
STEP 06. Place the applicator tip of device 1 on the sensitive site, click once and apply SDF.
STEP 07. Immediately place the applicator tip of device 2 on the sensitive site, click once and apply FV to cover. (If there is any demineralized tooth structure at the site of sensitivity, there may be some discoloration after treatment).
STEP 08. Schedule a follow-up treatment if the patient still experiences sensitivity.
STEP 09. If the site of tenderness is a cavity, then a filling may be done after stopping the injury and decreasing the tenderness.
INTERPROXIMAL PROTOCOL TREATMENT (STOPPING CARIES BETWEEN THE TEETH)
STEP 01. Protect the patient’s eyes.
STEP 02. Assemble and prepare device 1 and device 2. (See video below)
STEP 03. Apply Vaseline to the patient’s lips and face to avoid SDF stains on the skin.
STEP 04. Isolate the treatment area with cotton.
STEP 05. Dry completely with compressed air.
STEP 06. Place superfloss (orthodontic absorbent floss) between the teeth where the injury is located.
STEP 07. Apply SDF to the superfloss lingually and upwards over the marginal edge of the contact area.
STEP 08. Leave the superfloss saturated with SDF on the injury site for 1 minute.
STEP 09. Remove the superfloss by pulling away from the contact so that the SDF does not touch other fabrics.
STEP 10. Apply fluorine varnish to the contact area to seal the SDF and prevent contamination with saliva.
STEP 11. When necessary, fill the treated lesion at least 48 hours after final treatment.
SMART GIC FILLING RESTORATION PROTOCOL TREATMENT (glass ionomer cement filling material, self-curing)
STEP 1. Wait at least 48 hours after the final treatment with SDF+FV and confirm that the caries was stopped by the Caviguard treatment, before applying the SMART GIC FILLING restoration protocol.
Note: Applying FV will prevent the filler from adhering and liquid SDF may stain the filler materials if done on the same day.
STEP 2. Check that the lesion has stopped and is black and difficult to probe gently before filling.
STEP 3. Do not remove any of the black lesions treated with SDF, the black is a silver reservoir that provides protection over time.
STEP 4. Remove the dark enamel margin around the lesion with a handpiece of low speed or excavator bucket to prevent a dark halo from showing through the filling material.
STEP 5. Paint GIC conditioner on the stopped lesion and rinse after 10 seconds to remove the smear layer.
STEP 6. Place the tip of the GIC applicator at the base of the arrested lesion and fill from bottom to top.
STEP 7. Allow GIC to cure according to manufacturer’s recommendations.
SANDWICH TECHNIQUE FILLING (GIC + Composite/Resin, filling protocol for best aesthetic results)
STEP 1. Wait at least 48 hours after final treatment with SDF+FV before filling.
Note: Applying FV will prevent the filler from adhering and liquid SDF may stain filler materials if done on the same day.
STEP 2. Check that the lesion has stopped and is black and difficult to probe gently before filling.
STEP 3. Do not remove any black lesions treated with SDF, the black is a silver reservoir that provides protection over time.
STEP 4. Remove the dark enamel margin around the lesion with a low-speed handpiece or digging spoon to prevent a dark halo from showing through the filling material.
STEP 5. Paint GIC conditioner on the stopped lesion and rinse after 10 seconds to remove the smear layer.
STEP 6. Place the tip of the GIC applicator at the base of the arrested lesion and fill from bottom to top.
STEP 7. Allow GIC to cure according to manufacturer’s recommendations.
STEP 8. Acid etch the enamel surfaces around the lesion with phosphoric acid for 15 seconds.
STEP 9. Rinse and then dry with compressed air.
STEP 10. Apply dentin bonding agent and light-polymerize.
STEP 11. Fill the remainder of the lesion on the enamel surface with composite/resin filling material and shape it to follow the natural contours of the tooth structure.
STEP 12. Light cure for 20 seconds.
STEP 13. Check the occlusion and adjust if necessary.
CaviGuard Treatment
Glass ionomer seal
Thin layer of resin
Mechanism of action
Silver precipitation from SDF 38% in the dental structure www.smartoralhealth.com
Silver nanowires form in the dentinal tubules after treatment with 38% SDF, to provide long-term antibacterial effects and stop sensitivity. The deposition of silver stops the infection and allows the cavity to remineralize and harden, so there is no need to remove the tooth structure.
Bibliography
1. WHO breakthrough: Model List of Essential Medicines includes new section for dental preparations
2. Silver Fluoride as a Treatment for Dental Caries
3. Result of effectiveness study from the JCDA magazine of Canada
4. Joint clinical study between Univalle and the University of California Berkeley
5. Xu, Yuewen, et al. “Silver Compounds for Caries Management.” International Dental Journal, Nov 1, 2023
