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: https://www.youtube.com/watch?v=zxlvbhUx3QE&t=4s (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)

Pros:

● 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

Cons: 

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

Technique:

● 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