Silver Diamine Fluoride (SDF) is a clear liquid that combines the antibacterial effects of silver with the remineralization effects of fluoride.
SDF may be used in certain circumstances as a non-restorative option to stop the progression of small cavities and cavity-susceptible areas.
SDF can offer an alternative to restoration for the management of tooth decay especially in young children or patients with special needs.
- For example, our pediatric dentists might recommend SDF to postpone restorations for a very young patient that may not be cooperative enough for treatment in the office.
- When the patient is older, affected teeth can later be restored in the office after the child has matured.
Therefore, treatment with SDF does not eliminate the need for dental fillings or crowns to repair function or esthetics.
| Pros of SDF | Cons of SDF |
| Quick, easy, painless for the patient | Not a cure for caries |
| Simple to apply in an office setting | Outcome depends on oral hygiene and regular dental visits |
| Cost effective | Does not restore the form or function of decayed teeth |
| Relieves sensitivity | Deeply decayed teeth, especially with nerve involvement, are not candidates for SDF |
| Remineralizes tooth structure | Permanently stains areas of decay black and Tooth-colored fillings and crowns may discolor if SDF is applied to them |
| Arrests up to 80% of cavities when applied at least twice a year | Does not arrest decay in an estimated 20% of affected teeth |
| Avoids or delays surgical interventions | Not viable for patients with silver allergies |
Examples of suitable situations for the application of SDF to primary teeth include:
• When a patient is not able to cooperate for restorative treatment in the office (ie: such as young children with severe disease and those with special needs)
• When restorations completed under local or general anesthesia is best delayed or when there is a longer wait for hospital coordination
• When it is required to give the option for a less costly or less invasive alternative to restorations
• When minimal intervention is desired by the parent/guardian
• When patients with special needs or special situations do not allow for treatment of permanent teeth, SDF may be an appropriate option as long as parents/guardians understand the limitations.