It is very challenging for a dentist in managing childpatients because of the following limitations.
(1.) Caries process is very rapidly. (2.
) Behavior management. Because of rapidly dental caries process, theappointment in each visit dentist needs to deal with cavitated teeth as much ashe/she can by filling or do caries control. One of the ways in the present to inhibit caries process is using Silver Diamine Fluoride (SDF). SDF is acolorless liquid that contains 24.
4% to 28.8% silver and 5.0% to 5.9% fluoride.Dentists use SDF in treating cavities in children although this might be moreaccurately described as caries control and management. Fluoride and silverinteract synergistically to form fluoro-apatite and silver phosphate. Silverphosphate releases silver ions that have a high polarizing effect leading tobacterial cell death.
When applying SDFon active caries it will stains cavities black and the process of caries willbe stopped. A completely darkened cavity is a strong indicator of success.Unfortunately, in the present SDF is banned in Thailand since 2013 because ofthe problem of importing product’s process. SMART Techniquestands for a Simplified and Modified Atraumatic Restorative Treatment is amethod to remove caries and minimal cavity preparation using only handinstrument and fill it with glass ionomer cement which is the material has beenaccepted as suitable for filling with primary teeth. Because it has a chemicalbond to enamel and dentin, biocompatibility, and the ability to store andrelease fluoride over a prolonged period to the tooth and adjacent surfaces ofthe tooth.
SMART is a slow and gentle technique that is well tolerated by themost fearful of patients, especially children. It is more comfortable thanstandard techniques. After workingwith children patients about 3 years, myU1 experience told me that non-invasive treatment and cariescontrol are very important to manage their behavior and promote their growthespecially in young children (3 years old) in the Northeast of Thailand wherethere are 57 percent of children have dental caries with underweight. This has inspired me to explore and developnew dental material that hasproperties similar to SDF and GI that can be applied to SMART technique.
Notonly to develop material but also explore more depth at the level of molecularmechanism between dentin-pulp complex and material. I pledge to devote myabilities to help and elevate wellbeing of children in the rural area of theNortheast of Thailand. I am certain that during my PhD study at NiigataUniversity, I will obtain the good training experiences and capabilities for anacademic career.