Silver diamine fluoride will only stain defects in the tooth structure, such as carious lesions and restorative margins; sound tooth structure will not be stained by silver diamine fluoride. In addition, silver diamine fluoride is very cost effective.

How does it benefit your oral hygiene?

• SDF has widely been shown to be effective to help stop cavity development after a cavity has formed. Dentists call this process caries resonance.
• SDF is for treating carious teeth without a drill at a lower cost to patients, fewer pediatric hospital visits due to dental emergencies, and improved oral health for nursing home residents.
• SDF helps kill the bacteria that break down tooth surfaces while also keeping them from spreading to other teeth.
• SDF is often suggested as a more comfortable alternative to drilling cavities. This can be helpful for children or adults who have anxiety about the dentist or may not be able to fully engage in dental procedures, such as those with special healthcare needs.
• SDF can be helpful as a cavity treatment if you’re overly sensitive to the instruments and substances used during cavity treatments.
• SDF can help keep cavities to a minimum or prevent them entirely if you feel that it’s difficult to make time for regular dental check-ups or feel uncomfortable about cavity procedures. It’s quick, requires no special equipment, and generally only needs to be done once per year.

Are there any side effects?

Few harmful or negative side effects have been found with use of SDF. SDF is widely considered by dentists to be safe, even on young children.

You shouldn’t use SDF if you have a silver allergy, oral ulcerations or canker sores, advanced gum disease, or major tooth decay that’s exposed the soft tissue of your tooth beneath the enamel. These conditions can have painful reactions with the acid or ammonia in SDF.

The only common side effect of SDF noted in hundreds of studiesTrusted Source is black staining around the area where SDF is applied. SDF can also stain surfaces that it comes into contact with when being applied, such as clothing or nearby tissues in the mouth.

What is silver diamine fluoride?

Silver diamine fluoride (SDF) is a liquid substance used to help prevent tooth cavities (or caries) from forming, growing, or spreading to other teeth.

SDF is made of:

• silver: helps kill bacteria
• water: provides a liquid base for the mixture
• fluoride: helps your teeth rebuild the materials they’re made of (known as remineralizationTrusted Source)
• ammonia: helps the solution remain concentrated so that it’s maximally effective against cavity resonance

SDF was first approved for use in Japan more than 80 years ago. SDF was approved by the U.S. Food and Drug Administration (FDA) in 2014 for use in the United States.

SDF is considered a class II medical device. This means that it only carries slight risks (for reference, condoms and pregnancy tests are also class II medical devices).

It’s sold in some stores for home use, but it’s most commonly and safely used in dental clinics.

Studies Reveal: Untreated dental caries are a significant pediatric public health problem. One in every seven U.S. children ages 2 to 8 years has untreated dental caries in primary teeth, according to National Health and Nutrition Examination Survey data (Dye BA, et al. NCHS data brief, no 191. Hyattsville, Md.; National Center for Health Statistics, 2015).

One in every seven U.S. children ages 2 to 8 years has untreated dental caries in primary teeth.

While fluoride varnish application is a well-established primary intervention for preventing dental caries, it does not restore deeper cavitated lesions. Untreated dental decay extending through the tooth’s enamel layer requires mechanical removal of decayed tissue with hand instruments or powered dental drills. Tooth structure lost during removal of the decayed lesion is restored with dental fillings or full coverage crowns.

Non-invasive, interim interventions for arresting untreated dental caries have been needed, especially in underserved populations lacking timely access to restorative dental services. Such an intervention — silver diamine fluoride (SDF) — recently was introduced in the U.S.

HISTORY OF SDF?

SDF is non-invasive medicament that is applied topically. It is 38% SDF, a silver fluoride salt made soluble in water through the addition of ammonia. SDF received Food and Drug Administration approval in 2014 as a device for treating dental hypersensitivity. Similar to its predecessor fluoride varnish, SDF has not been approved as a dental caries arrest medicament and is administered in children and adults as an off-label use.

SDF has a high LD50 value indicative of low toxicity. To date, no toxic adverse events have been reported (Horst JA, et al. J Calif Dent Assoc. 2016;44:16-28).

Is SDF effective?

SDF has been used internationally for decades to arrest dental caries in primary and permanent teeth. As reported in a recently published meta-analysis, two-thirds of all dentinal caries lesions studied (those that had progressed into the dentin) were found to be arrested after treatment with SDF .

When teeth with arrested dental decay are not subsequently restored with dental fillings or full coverage crowns, studies show it is advisable to re-apply SDF every six months

With a fluoride concentration of 44,800 parts per million, SDF is nearly twice the strength of commercially available 5% sodium fluoride varnishes used in primary care. Application of both agents on the same day is to be avoided as the fluoride dose would be additive, and its safety profile in children is unknown.

Which patients are candidates for SDF use?

SDF has clinical benefits for children and adolescents when patient cooperation for restorative dentistry is limited due to young age, situational anxiety, or intellectual and developmental disabilities.