Silver Diamine Fluoride (SDF) is an alternative to fillings for cavities in baby teeth. It uses a blend of silver, ammonia, water, and fluoride that kills bacteria and seals your child’s tooth, preventing further decay and keeping the tooth healthy until it falls out naturally. It’s only used in baby teeth because it will permanently stain the treated area black.
Silver nitrate has been successfully used by dentists since the 1800’s.
Your dentist will begin by determining that your child is a good candidate for SDF treatment. SDF is usually a good option for very young children or children with special needs as it helps to stabilize the cavity until the child is older and can receive treatment without sedation.
After your child is approved for SFD treatment, your dentist will clean the tooth or teeth to be treated, dry the teeth with air, and then apply the silver diamine fluoride. It will be left in place for about a minute and then rinsed away. It is as simple as that! No numbing or drilling needed.
SFD is not a permanent solution. For best results, we usually recommend coming back in for reapplication twice per year to keep the decay at bay. We can continue to maintain the tooth until it falls out naturally or your child is ready to receive a dental filling.
Because the silver diamine fluoride will simply be painted onto the tooth or teeth being treated, this is a completely non-invasive treatment. Plus, it only takes a small amount of the silver diamine fluoride liquid to treat several teeth. In fact, SDF is so concentrated, one drop of SDF can treat up to 5 teeth. Your child will not have to sit with a large amount of fluid in their mouth, making it a convenient and comfortable treatment, even for wiggly little ones.
SDF is helpful for some children who may have a sensitivity to certain types of sedation. By postponing treatment until they are older, it may be possible for your child to avoid the need to be sedated during a dental filling procedure, or avoid the filling procedure altogether (if it is a baby tooth that will naturally fall out on its own.) SDF treatment does expose your child to a small amount of fluoride, but it is less than the amount of fluoride in preventive topical fluoride applications and contains about the amount of fluoride present in one liter of fluoridated water.
It is important to bring your child in for dental care from an early age to ensure their teeth are healthy and to set them up for long term dental success. However, if those early dental visits are filled with intimidating restorative procedures, your child may end up developing dental anxiety. To avoid this, we put an emphasis on creating positive dental experiences early on. By using silver diamine fluoride, which is a painless, easy treatment, we can slowly build trust with your child and show them that coming to the dentist doesn't have to be painful or scary.
The FDA has approved silver diamine fluoride as a safe and effective treatment method. While SDF contains silver, ammonia, water, and fluoride, the two active ingredients are silver and fluoride. The silver effectively kills the bacteria present in the cavities. Silver ions are small enough to penetrate the weak parts of the tooth and work to plug up the microscopic holes in the enamel or dentin surface. Since fluoride is a naturally occurring mineral, it is completely safe and actually helps to improve your child’s oral health. It does this by “remineralizing” and strengthening tooth enamel that has been affected by minor decay. Together silver and fluoride work to safely keep your child's tooth healthy.
SDF can prevent cavity growth with a success rate of up to 80% when applied biannually.
While some insurance policies are begging to cover silver diamine fluoride, many still do not. It is important to check with your provider to ensure you understand your dental insurance benefits and coverage before proceeding with treatment. Oftentimes, SDF can be a more cost-effective treatment than many other restorative procedures, so even if it is not covered by your dental insurance plan, it may be a good idea to invest in your child’s teeth upfront in order to avoid more costly procedures down the line.
With regular reapplications and proper at-home oral care, it may be possible for your child to avoid additional treatment if the silver diamine fluoride is being applied to a baby tooth. Ideally, the SDF would halt the progression of the tooth decay until the baby tooth can fall out naturally on its own. This is usually the case, but sometimes if a cavity is too deep or too far advanced, SDF may not be enough.
If SDF is being used on an adult tooth, it is likely that it is just being used as a preventive measure to hold off additional restorative treatment, such as a dental filling or root canal, until your child is old enough to undergo treatment without the need of sedation.
No, SDF treatment does not hurt. Since silver diamine fluoride requires no removal of the enamel, it is not usually painful. If any of the SDF liquid comes in contact with the gums, tongue, or lips your child may experience a slight tingling sensation. However, when SDF is carefully applied by an experienced dentist, this is unlikely. At our office, we use small brushes to ensure precise application.
By painting SDF onto your child’s tooth, your doctor can effectively stop the progression of tooth decay. SDF does this by simultaneously killing bacteria and remineralizing the tooth. The minerals in the SDF solution (silver and fluoride) penetrate the tooth structure and “fill in” the gaps where the tooth enamel has been eaten away by plaque and tartar.
SDF is effective for treating teeth that have soft spots, or the beginning stages of a cavity, but it does not work on open cavities, or more severe tooth decay. This is because when the tooth has been damaged enough to create an open cavity, the tooth will need to be filled to restore the shape and structure of the tooth, which SDF can not do.
SDF can provide relief from the pain of a toothache caused by tooth decay.