The SMART technique (Silver Modified Atraumatic Restorative Technique) is a minimally invasive and innovative approach in pediatric dentistry.
📌 Recommended Article :
Video 🔽 Use of Silver Diamine Fluoride (SDF) - General Guide on its application ... It offers several advantages such as its easy application, low cost, it avoids the use of dental anesthetics, and it can be applied in places that do not have dental equipment.
It combines the application of 38% silver diamine fluoride (SDF) with atraumatic restorative treatment (ART), offering effective caries control in children without the need for anesthesia or extensive drilling.
Advertisement
✅
Introduction
Dental caries remain one of the most common chronic diseases in childhood, especially in underserved populations. In this context, the SMART technique has emerged as an accessible and effective option for managing carious lesions, particularly in pediatric patients.
✅
What is the SMART technique?
The SMART technique integrates two approaches:
1. Application of 38% silver diamine fluoride (SDF): halts caries progression and provides an antimicrobial effect.
2. Atraumatic Restorative Treatment (ART): sealing the lesion with glass ionomer cement, which releases fluoride and reinforces tooth structure.
This approach does not require anesthesia or rotary instruments, making it a cost-effective and well-accepted technique in community pediatric dentistry.
📌 Recommended Article :
Dental Article 🔽 Glass Ionomer Cement in Pediatric Dentistry: Benefits, Uses, and Step-by-Step Application Guide ... This article explores its characteristics, advantages, disadvantages, clinical applications, and a step-by-step guide for proper use.
✅
Benefits of the SMART technique
° Effective caries arrest in primary teeth.
° Reduces pain and anxiety in pediatric patients.
° Low-cost and suitable for underserved populations.
° Preserves tooth structure and prolongs tooth survival.
° Minimally invasive and conservative.
✅
Drawbacks of the SMART technique
° Permanent black staining of carious lesions due to SDF.
° Potential parental concerns about esthetics.
° Limited effectiveness in deep caries with pulpal involvement.
° Requires regular clinical follow-up.
📌 Recommended Article :
Dental Article 🔽 Top Benefits of Chemical Caries Removal in Children and Patients with Dental Anxiety ... Modern dentistry increasingly embraces minimally invasive approaches that prioritize preserving healthy tooth structure and enhancing the patient experience.
✅
Comparative table: SMART vs. ART
| Aspect |
SMART |
ART |
| Caries control |
High, due to SDF antimicrobial effect |
Moderate, depends on seal quality |
| Esthetics |
Limited, black staining occurs |
Better, no dark discoloration |
| Application |
Simple, no anesthesia or drill |
Simple, no anesthesia or drill |
| Cost |
Low |
Low |
💬 Discussion
The SMART technique has shown high effectiveness in controlling caries in pediatric patients, especially in underserved communities with limited access to dental services. Its main limitation is esthetics due to black staining, which can cause parental concerns. However, its efficacy, affordability, and minimally invasive nature make it a valuable tool in modern pediatric dentistry.
📌 Recommended Article :
Video 🔽 Atraumatic Restorative Treatment - Indications, Advantages and Disadvantages ... This technique is very useful when it is necessary to attend to oral health needs in hard-to-reach areas. The pediatric patient also generates less anxiety and stress.
✍️ Conclusions
The SMART technique is a safe, effective, and accessible clinical option for managing caries in children. It offers significant benefits in public health dentistry, particularly in resource-limited settings, though its esthetic limitations and follow-up requirements must be considered.
📚 References
✔ Crystal, Y. O., & Niederman, R. (2019). Evidence-Based Dentistry Update on Silver Diamine Fluoride. Dental Clinics of North America, 63(1), 45–68. https://doi.org/10.1016/j.cden.2018.08.011
✔ Horst, J. A., Ellenikiotis, H., & Milgrom, P. L. (2016). UCSF Protocol for Caries Arrest Using Silver Diamine Fluoride: Rationale, Indications, and Consent. Journal of the California Dental Association, 44(1), 16–28. PMID: 26897901
✔ Seifo, N., Robertson, M., MacLean, J., Blain, K., Grosse, S., Milne, R., Seeballuck, C., & Innes, N. P. T. (2020). The use of silver diamine fluoride (SDF) in dental practice. British Dental Journal, 228, 75–81. https://doi.org/10.1038/s41415-020-1203-9
📌 More Recommended Items
►
Webinar: Minimally Invasive Dentistry - Dra. Aisha Mohamed
►
Chemical Caries Removal: Drill-Free Technique, Materials, and Clinical Application
►
Severe early childhood caries: an integral approach
