For our latest COVID updates click here

Silver Diamine Fluoride

EPDG Now Offers Something New in Dentistry

Techniques, procedures, and for the most part, products used in the practice of dentistry have not changed much in the recent past. In October of 2016, the U.S. Food and Drug Administration approved a new treatment for (some) cavities. This is a liquid treatment used in the management of tooth decay. Silver Diamine Fluoride (SDF) contains silver, which acts as an antibacterial agent to kill bacteria and fluoride, which strengthens teeth. In the 1800s, silver was used in dentistry and then fell out of favor when local anesthesia and esthetic restorations were developed. Using Silver Diamine Fluoride will not eliminate the need for fillings and/or crowns to restore form, function, and aesthetics, but it has been effective at preventing further decay.

The application of Silver Diamine Fluoride is a treatment that has been used successfully in many parts of the world including Europe, Asia, Australia, and Japan for decades to painlessly treat tooth decay. We believe that Silver Diamine Fluoride is an excellent treatment option and can be quite successful:

  • When very young children have shallow cavities on front teeth or on the chewing surfaces of back teeth
  • When baby front teeth have deep cavities, which may fall out in a couple of years
  • When young children need more time to mature in order to tolerate dental treatment without the aid of sedative medications and/or general anesthesia
  • When young children to teens have small cavities on the flossing surfaces of their molars and premolars
  • For medically compromised and special needs patients who cannot tolerate dental treatment in the traditional setting and/or cannot tolerate sedative medications and/or general anesthesia
  • For children who have too many cavities to treat in one dental visit, Silver Diamine Fluoride can serve as a ‘stop’ to keep cavities from growing before treatment can be delivered.

The Downsides of Silver Diamine Fluoride

  • It is an unesthetic treatment option because it will turn cavities and any unhealthy or weakened enamel black. This occurs by direct application or indirect application when the patient’s spit carries Silver Diamine Fluoride throughout the mouth.
  • It does not work for all cavities; thus, some patients may still require dental treatment.
  • It does not taste great, but the taste does not last long.
  • It will stain the gums for five to seven days, the skin ten to 14 days, and clothes permanently.
  • It may require additional applications.
  • It is not ideal for large cavities.
  • It is not a covered benefit with most insurance companies.

Silver Diamine Fluoride Application

  • The teeth are isolated and dried.
  • The liquid is painted on the teeth with a small brush and, when possible, allowed to soak in for two minutes.
  • Fluoride varnish may or may not be applied.
  • We may or may not shine a blue light on the teeth.

What are the benefits of Silver Diamine Fluoride?

  • It is a non-invasive treatment.
  • It is painless and does not require anesthesia.
  • The appointment is short.
  • In most cases, it is effective only when there is a change in diet and hygiene.
  • It may stop tooth decay.
  • It may help with sensitivity.


  • No treatment. This comes with the risk of tooth pain and infection, sleepless nights, difficulty eating, missed school, and the need for more invasive treatment.
  • If behavior prevents delivery of care, the use of sedative medications and/or general anesthesia may be necessary.

It is our hope that your child never hears “you have cavities,” but because the development of cavities involves many factors (some of which include: diet, hygiene, bacteria, saliva, and yes, even your genes may play a role), we know that CAVITIES HAPPEN. We now have a non-invasive treatment that helps to stop the growth of cavities while we build a strong relationship with your child.

If you think your child has cavities, please call our office to make an appointment. We look forward to seeing you and your child.

Back to top