SMART stands for Silver Modified Atraumatic Restorative Technique. It is a minimally invasive way of managing tooth decay that combines two treatments: silver diamine fluoride (SDF), which helps stop decay from progressing, and a tooth-coloured glass ionomer filling, which seals and restores the tooth. In most cases it is done without drilling or local anaesthetic.
At Lumi Dental, SMART is provided by our Oral Health Therapist team, who focus on preventive and minimally invasive care for children and adults.
Key takeaways
- SMART combines silver fluoride with a glass ionomer filling.
- SDF stops the decay, and the filling seals the tooth and restores its shape.
- It usually needs no drilling or local anaesthetic.
- It is often used for young children, anxious patients and people who find longer appointments difficult.
- At Lumi Dental, SMART is provided by our Oral Health Therapists over more than one appointment.
How SMART works
- The tooth is cleaned and kept dry.
- Silver fluoride is applied to the decayed area. At Lumi Dental we use Riva Star, which includes a potassium iodide step to help reduce staining.
- At a follow-up appointment, a tooth-coloured glass ionomer filling is placed over the treated area.
SDF on its own stops decay but leaves a cavity in the tooth, where food can collect. The glass ionomer filling closes that cavity, which makes the tooth easier to clean and chew with. Glass ionomer also releases small amounts of fluoride over time. Our article on silver diamine fluoride (SDF) covers the first stage in more detail.
Who may SMART suit?
SMART is often used for:
- Young children who may find conventional fillings difficult
- Anxious patients
- Patients who have difficulty sitting for longer appointments
- Patients with additional needs
- Early to moderate decay where the tooth has no signs of nerve involvement
A clinical examination is needed to confirm whether SMART is suitable for a particular tooth.
SMART compared with other options
| Feature | SDF alone | SMART | Traditional filling |
|---|---|---|---|
| Drilling needed | No | Usually no | Yes |
| Local anaesthetic | No | Usually no | Often |
| Stops decay | Yes | Yes | Yes, by removing it |
| Restores tooth shape | No | Yes | Yes |
| Appearance | Treated area darkens | Staining partly covered | Tooth-coloured or metal |
Things to consider
- The treated decay darkens. The glass ionomer covers some of this, but some discolouration may remain visible.
- Glass ionomer fillings may wear over time and can need repair or replacement.
- SDF may need to be reapplied at later visits.
- SMART is not suitable for teeth with ongoing pain, swelling or infection, or for patients with a silver allergy.
- Regular reviews are needed to monitor the treated teeth.
For children, prevention continues at home. Our guides on how much fluoride toothpaste children need and fluoride varnish for children cover the everyday side.
SMART at Lumi Dental
SDF and SMART are provided by our Oral Health Therapist team. Oral Health Therapists are registered dental practitioners who focus on prevention and on treating children and adults with minimally invasive techniques. Treatment is usually completed over more than one appointment, with silver fluoride applied first and the glass ionomer filling placed at a follow-up visit.
To book, please contact our team and ask for an appointment with one of our Oral Health Therapists. Current offers are on the current deals page.
Frequently asked questions
Does SMART hurt?
Most patients find it comfortable. The silver fluoride is brushed on, and the filling is usually placed without drilling or an injection.
How many appointments are needed?
Usually more than one. Silver fluoride is applied first, and the glass ionomer filling is placed at a follow-up visit. Your Oral Health Therapist will explain the plan for your child or yourself.
Will the tooth still look dark?
The filling covers some of the treated area, and Riva Star includes a step to help reduce staining. Some discolouration may still be visible, particularly around the edges.
Is SMART only for children?
No. It is commonly used for children, but it can also suit adults, including anxious patients and those with additional needs.
Who do I book with?
Please ask for an appointment with one of our Oral Health Therapists, who provide SDF and SMART at Lumi Dental.
This article is general information and not a substitute for personalised advice. A clinical examination is needed to confirm whether SMART is suitable.
