Silver Diamine Fluoride (SDF) FAQ for Families

What is Silver Diamine Fluoride?

Silver Diamine Fluoride (SDF) is a liquid medication used by doctors and dentists to treat cavities. It takes just a few minutes to put on teeth with cavities and can be provided by your child’s doctor as well as a dentist. 

What are the benefits of Silver Diamine Fluoride?

SDF is a quick way to help stop or slow down cavities. It can be used without shots (local anesthetic), sedation or general anesthesia. It can fix cavities without drilling. SDF is very helpful for children who are very young, experience dental anxiety, or have special behavioral or healthcare needs. It also helps relieve tooth sensitivity. 

Is Silver Diamine Fluoride safe?

Yes, SDF is safe for children and adults. 

Is Silver Diamine Fluoride the best treatment for my child?

Sometimes SDF is not recommended. 

• Children who are allergic to silver or have raw or painful sores anywhere in the mouth should not have SDF.
• Teeth that hurt on their own (toothache when the tooth is not touched), nocturnal pain (toothache that wakes the child at night), pain for more than 60 seconds after eating or brushing, or swelling of the gums or face should not receive SDF.
• Some infected teeth do not cause pain. If your child has a tooth that is infected, with or without pain, the tooth should not receive SDF. In that case, your child should be seen by a dental professional.
• There is a chance that SDF is not enough to stop the cavity from getting worse. In that case, the tooth will need more treatment. That could include another SDF treatment, a filling or crown, or extraction (pulling the tooth). 

Are there alternatives to Silver Diamine Fluoride?

Yes. You have the option of having no treatment to the tooth, but the cavity may get worse and require more involved treatment. In that case, a dentist may recommend a filling or crown, pulling the tooth, or other methods that might need sedation or general anesthesia. 

How is Silver Diamine Fluoride applied to the teeth?

SDF application is quick and painless. Your doctor or dentist will: 

1. Clean and dry the tooth with the cavity.
2. Place a small amount of SDF on the cavity.
3. Allow 10 to 60 seconds for SDF to absorb.
4. Remove remaining SDF using a gauze or cotton roll. 

How often should Silver Diamine Fluoride be applied to my child’s teeth?

For best results, SDF should be reapplied every 3, 6, or 12 months. If the cavity still progresses with the first treatment, additional applications by your doctor or dentist may be necessary. It is possible that more advanced treatment by a dentist may eventually be necessary. 

What should I remember when Silver Diamine Fluoride is applied to my child’s teeth?

• SDF will permanently stain the cavity black. For baby teeth, this will last until the tooth falls out.
• If a little SDF gets on the gums or lips, a brown or white stain may appear. It will go away in 1 to 3 weeks.
• Your child may notice a metallic taste that will go away quickly, usually by the next day.
• If your child already has tooth colored fillings or crowns, they may be temporarily discolored if SDF is applied to them. 

Other considerations

• SDF does not replace the need for a dentist (called a dental home) for regular care.
• SDF may not be enough to stop tooth decay. Your child’s doctor will schedule a follow-up appointment for 3 months from the treatment to make sure SDF was successful and to discuss any new concerns. In some cases, additional SDF application may be necessary.
• After SDF treatment, follow up with your child’s dentist as soon as you can. If you need help finding a dental home, please let your child’s doctor know so they can help you.
• Your child’s doctors and dentists want to partner with you for your child’s best oral health which is an important of your child’s overall health. They will work with you to identify oral health habits that you are able to accomplish at home. 

Confirming Arrest of Decay

Confirming arrest of tooth decay can be challenging, so it is not expected that pediatricians and other primary care professionals will be able to fully assess hardness of tooth decay to confirm or deny the success of applied SDF.