Tools of the trade: Riva Star Aqua


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silver fluoride desensitising agent

by Dr Emma Wainwright, Rosewood Dental, QLD

Riva Star Aqua is a silver fluoride aqueous formulation used for desensitising teeth while also providing an application of fluoride.

What’s good about it

I use it routinely to stabilise dentitions of patients at high risk of caries. This might be elderly patients with exposed roots and root caries. It can be used with medically compromised patients with xerostomia and with patients who struggle to maintain adequate oral hygiene. 

Other silver fluoride products stain terribly or contain ammonia which has an unpleasant odour and a tendency to irritate the gums. Riva Star Aqua is an improved product that causes minimal staining. Patients have reported reduced sensitivity two years after application. 

With patients who have a high amount of plaque and root caries, it’s very evident that it has an inhibitory effect on biofilm. When the patient returns for review, there’s much less plaque in the same areas, less gingivitis and demineralised enamel appears glossy and stronger.

Some patients with enamel hypoplasia get no relief from sensitivity even when using sensitive toothpaste. They often find scaling with water and ultrasonics unpleasant. Riva Star Aqua can be a great help in those cases. When I’m dealing with a patient that needs a lot of work across multiple visits, this product can be used to slow down the decay in open cavities until they can be treated. 

What’s not so good

You must discuss with your patient the risk of staining. Any part of the tooth already damaged may turn grey or black. You need to check for any contraindications medically as it contains iodine. 

Dentist and staff should change gloves immediately after usage because it’s very easy to have accidental contamination of surfaces. As the liquid oxidises over time, it will leave a stain.

Where did you get it

Henry Schein

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