Drill-free caries arrest

A filling is the repair route when decayed tooth structure is removed and the space is restored with a filling material. Composite fillings are tooth-coloured, while amalgam fillings are silver-coloured.

Silver diamine fluoride is used to arrest cavitated caries in primary teeth. It is included in caries management for children and adolescents, including children with special health care needs.

These routes involve different work: a filling removes decay and rebuilds the prepared tooth, while silver diamine fluoride is applied to arrest a cavitated lesion as part of wider caries management.

Fillings and crowns do not last forever and may need replacement. With silver diamine fluoride, studies reported caries arrest at two years with once- or twice-yearly application.

A filling removes decayed structure before restoring the tooth. Silver diamine fluoride contains silver and fluoride, and it is applied within a comprehensive caries-management programme for cavitated primary-tooth lesions.

Neither treatment reverses the cause of repeated acid attacks on enamel. Early mineral loss can be repaired by saliva and fluoride, but once enamel breaks down into a cavity, the tooth needs a repair or caries-arrest plan.

The decision begins with the treatment aim: remove decayed tissue and restore the tooth, or arrest a cavitated lesion without drilling. The amount of decay and the child’s wider caries-management needs shape that choice.