Silver Diamine Fluoride

Silver Diamine Fluoride

What is Silver Diamine Fluoride (SDF)?

While the ideal way to treat teeth with decay (caries) is by removing the decay and placing a restoration (filling or crown), there is an alternative, non-invasive treatment that has FDA approval, Silver Diamine Fluoride (SDF). SDF is a clinically applied treatment that controls active dental caries (cavities) and aids in preventing further progression of the disease. SDF has a dual mechanism of action resulting from the combination of its ingredients. The silver component acts as an anti-microbial agent killing bacteria and preventing the formation of new biofilm, while the fluoride acts to prevent further demineralization of tooth structure.

Video on SDF Treatment: (Shown with permission by Dr. Jeanette MacLean)

Indications for SDF Treatment:

● Young children who have difficulty cooperating for treatment
● Children with excessive decay who are not candidates for oral or IV sedation
● Special needs patients
● For those patients who need a low cost alternative to traditional restorative procedures
● For patients with multiple cavities starting in between the teeth

Contraindications for SDF Treatment:

● Individuals with a silver allergy
● Ulcerative gingivitis (painful, bleeding gums)
● Stomatitis (sores in the mouth)


● Quick, easy, painless
● Helps relieve tooth sensitivity
● Helps remineralize natural tooth structure
● Helps prevent biofilm adhesion
● Helps avoid or delay more invasive treatment
● Arrests 80% of cavities when applied twice yearly


● Permanently stains cavities black
● Cavities (holes) that trap food may still require a restoration
● Not an option for deep cavities or teeth with infection
● 20% of cavities continue to grow
● SDF is a treatment for cavities not a cure


● Vaseline is placed on the lips and skin around the mouth
● The carious teeth are isolated, dried, and all excess debris is removed
● A small brush is dipped ina drop of SDF and placed on the lesion(s)
● The excess SDF is removed and patients are instructed not to eat or drink for one hour and are encouraged to avoid brushing their teeth for 24 hours after treatment
● Re-application is usually recommended biannually until the cavity is restored or arrested or the tooth is lost

Proper diet and oral hygiene, including daily flossing, are critical for long-term success

The following are potential candidates for this treatment:

This technique can be combined with Hall Crown Treatment for full coverage of the tooth with large cavities or SMART Treatment for teeth with smaller cavities

Description of Silver Diamine Fluoride

Silver Diamine Fluoride - Chairside Guide

Dr. Sabbadini's Article in the Journal of the California Dental Association on Silver Diamine Fluoride

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