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The law also requires them to get special training on how to use the liquid, which at least 700 hygienists from across the state have completed. Other states, including Maryland and Virginia, have no special requirements for applying the cavity treatment but require some supervision by a dentist, said Matt Crespin, president of the American Dental Hygienists' Association. In those places, hygienists apply it under the same rules that govern the application of other fluoride products. Preventing New Cavities, Too Studies show silver diamine fluoride stops decay in 60 percent to 70 percent of cases with one application. A second application six months later boosts the treatment's long-term effectiveness to more than 90 percent. In addition to killing cavity-causing bacteria, the treatment hardens tooth structure, desensitizes the tooth, and even stops new cavities from forming. Applying the liquid on the exposed root surfaces of older adults once a year is "a simple, inexpensive, and effective way" to prevent cavities, a 2018 study concluded.