Silver Diamine Flouride (SDF)

We have a new option to treat cavities in children who may be too young for traditional fillings or as an alternative to sedation in order to buy time until the baby tooth is naturally lost. We can apply a medicine called silver diamine fluoride to your child’s cavity and it will kill the bacteria and remineralize your child's natural tooth structure.


Silver diamine fluoride (SDF) is a liquid medication that’s applied topically to the teeth with a small brush or a special type of floss. The silver fluoride formula is 38 percent silver fluoride salt, which is made water-soluble by the addition of small amounts of ammonia.  It’s been used in other countries in Europe, Japan, Australia, etc., for a long time. The FDA approved it for use in 2014, and it became commercially available in 2015.


Cavities are caused by bacteria (S. mutans) in the mouth. The bacteria feed on simple carbohydrates and release acids that eat away at teeth. Brushing and flossing help clean away the bacteria and prevent them from causing decay to your teeth. Silver diamine fluoride can stop current decay, harden the soft areas of the tooth, desensitize the tooth, and help prevent further decay.


Traditionally, when a dentist finds a cavity, they treat it surgically by placing a filling. SDF is a new way of treating these cavities medicinally AND in a minimally invasive way. The American Dental Association now says that non-restorative treatment options for cavities are the standard of care.


Pros of SDF:

  • Easy, painless, and fast
  • No need for local anesthetic (shots)
  • Affordable
  • Very safe→ very low toxicity
  • Desensitizes teeth
  • Stops cavities from progressing and prevents future cavities from forming
  • Alternative to sedations or general anesthesia


Cons of SDF:

  • Metallic taste
  • May require multiple applications
  • Permanently stains the decayed part of the tooth black
  • May require a traditional filling or a SMART filling to restore the form and function of a tooth or to cover the black staining
  • Cannot be used if there is an infection in the nerve of the tooth


While we love using SDF, it is not a “silver bullet” for every cavity and every tooth. Please call our office and ask for a consultation. We would love to evaluate your child and see if he/she is a good candidate for this exciting and innovative alternative to traditional dental treatment.