Info on Silver Diamine Fluoride (SDF)

Information

  • SDF is an antibiotic and tooth remineralizing liquid/medication.
  • Studies show it can:
    • Prevent over 75% of cavities from getting larger
    • Prevent new cavities from forming
    • Decrease tooth sensitivity
  • SDF treatment does not replace the need for fillings or crowns to restore lost tooth structure and function.
  • Procedure:
    1. Dry the affected area
    2. Apply SDF solution with a small brush
    3. Allow to dry
    4. Multiple applications may be needed
  • Do not use if patient has:
    • Allergy to silver
    • Painful sores in mouth or gums

Benefits

  • Temporary stabilization/arrest of decay and prevention of new decay
  • Allows time for emotional or physical maturity before more definitive treatment (fillings or crowns)
  • Ideal for:
    • Young or fearful patients
    • Those with special healthcare needs
    • Patients wishing to avoid sedation
  • FDA-approved for reducing tooth sensitivity

Risks

  • Turns decayed areas of treated teeth dark black (can be covered later with a filling or crown)
  • Surrounding skin/gum tissue may turn brown or white temporarily (harmless but cannot be washed off)
  • Decay may still progress; tooth could require more extensive treatment later (crowns, root canals, extractions)
  • No guarantee of success
  • May not be covered by insurance, or may share frequency limits with restorations

Alternatives to SDF

  • No treatment — risk of worsening decay, pain, infection, abscess
  • Fluoride varnish — less effective than SDF (about 3× less effective) but no tooth discoloration
  • SDF + temporary filling — improves success and restores some function/appearance
  • Definitive treatment — fillings, crowns, or extractions with sedation if needed