Silver Diamine Fluoride

Silver diamine fluoride (SDF) is a liquid that relies on the bacteria-destroying properties of both silver and fluoride. After being applied to places of tooth decay, SDF serves several purposes.

First, the SDF goes to work eliminating harmful bacteria. Next, it adds a protective barrier against future decay at the same site. More specifically, the silver works to inactivate and kill cavity-causing bacteria, and fluoride helps to remineralize and re-harden areas of the tooth that has been softened by the cavity. Not only can SDF stop a cavity from progressing, it can help reverse some of the damage caused by the cavity. Finally, it acts to prevent tooth sensitivity linked to decay.


Why do Dentists use SDF?

We prefer using silver diamine fluoride in cases where decay hasn’t spread very far. SDF provides an alternative to drilling and filling, making the process easier for patients. Plus, the procedure exhibits very predictable results, so it’s useful and safe. If you have any questions about the benefits and safety, feel free to contact our office directly to learn more about how and why we use SDF as a treatment method and if it may be appropriate for the patient.

Although silver diamine fluoride is a great temporary solution, it is NOT a definitive treatment option and usually requires reapplication every 3-4 months after the decay is treated or until a point when the patient can tolerate a more conclusive treatment (i.e. filling or crown).


Are you or the patient a Candidate for SDF Treatment?

Patients of all ages tolerate SDF well. However, this treatment tends to be the most widely used in pediatric dentistry or dentistry provided for those with special healthcare needs who find it difficult to sit for long periods in a dental chair.

SDF cannot be applied to areas with deep cavities, otherwise, it can cause pulp/nerve irritation and symptoms usually associated with tooth infection (throbbing, pain).

Patients are not a candidate for SDF if:

  • They have a known allergy to silver or fluoride
  • They have an oral ulcerative condition like gingivitis or lichen planus
  • They have significant cavities or do not want to have stained teeth
How Does SDF Work?

The process to receive silver diamine fluoride treatment is quite speedy. First, our team will gently clean the area of tooth decay. This helps to rid the tooth of any residual food debris or plaque that is covering the cavity surface. Once clean, our team will dry and isolate the tooth, using cotton rolls or small barriers to keep the tongue and cheeks from touching the tooth.

After air-drying the cleaned site, the dental provider brushes on the SDF liquid with a small brush. Depending on the size of the cavity, as well as patient behavior, the liquid is allowed to absorb into the tooth surface for 10-60 seconds. To prevent the SDF liquid from being washed off the tooth with saliva, a thin application of fluoride varnish is applied over the top of the SDF. This helps to seal in the SDF over the cavity and prevents it from being diluted in the saliva. The patient is allowed to eat and drink immediately following SDF application.

Depending upon the patient’s situation, two or more applications of SDF may be necessary. After applying SDF treatment, we will evaluate whether the SDF liquid is successfully halting the spread of decay and determine if any further action is necessary.


Pros and Cons to SDF

SDF is a reliable method to safely halt the spread of decay in many instances. It’s particularly beneficial for pediatric patients or patients with disabilities. Rather than resorting to invasive measures that require anesthesia and numbing agents, our dentist can address cavities in a way that makes the patient feel more comfortable.

The biggest pros about SDF: No numbing. No drilling. Minimally invasive. Fast. Effective. Affordable.

SDF is FDA-approved for tooth/root sensitivity and can be applied in some cases of recession or excessive wear.

Skin, mucosa and/or gums that come in contact with SDF will also be temporarily stained for one to two weeks. Clothing will be stained indefinitely. 

Although SDF application offers tremendous positives for patients, it does have one downside that parents and patients should consider. Once applied, silver diamine fluoride turns decayed areas dark brown or black. It does not discolor healthy enamel. This color change is permanent. For this reason, some people only opt for SDF application on teeth that don’t show when the patient smiles.