What is Silver Diamine Fluoride?

Is Silver Diamine Fluoride a good idea for my child?

Silver Diamine Fluoride (also known as SDF) is the newest form of fluoride variation. SDF is approved by the FDA for use by pediatric dentists for a kids cavity. It is specifically approved for use by a pediatric dentist as a desensitizer. But that is not what has many dental professionals excited about Silver Diamine Fluoride.  Many dentists are using SDF “off-label” to arrest tooth decay and delay treatment for a child’s cavity. 

How does Silver Diamine Fluoride work?

Like other fluorides that have been around longer, Silver Diamine Fluoride will embed its mineral content into the outer layer of enamel. That makes it harder for acid (from foods or bacteria) to dissolve away and weaken the tooth's structure. What makes Silver Diamine Fluoride unique, is that the silver that it contains also has an antibacterial property. In other words, when enamel has been invaded by bacteria, and your pediatric dentist applies SDF, it will “freeze” or “kill” the bacteria. Hence, slowing down (or maybe even arresting) the progression of your child’s cavity. 

So once Silver Diamine Fluoride is placed over my child’s cavity, does the cavity have to be fixed?

Yes. The Silver Diamine Fluoride will often (at best) arrest the activity of the bacteria that it comes into contact with. Most children’s cavities can advance well beyond the surface of the tooth. Which means the SDF cannot penetrate deep enough to fully halt the process of the kids cavity. 

Also, the Silver makes the cavity dark grey or even black. Most parents will want the unsightly cavity restored esthetically. Last but not least, a cavity by definition is a hole in the tooth. So, even if all the bacteria in that hole can be killed by the silver, food particles and plaque will easily accumulate in the kid's cavity. Restoring the form and function of a SDF treated tooth most often means having your pediatric dentist fill the tooth.

In Short, Silver Diamine Fluoride is a great way to slow down the progression of a child’s early cavities. Although, there will still be the need to restore form and function to the tooth by your pediatric dentist in due time.

How is Silver Diamine Fluoride applied?

Applying SDF is a pretty quick and painless procedure. The majority of dentists follow the recommended steps outlined in the Chairside Guide by the AAPD.

  1. First the pediatric dentist will clean the area by removing any debris. Which can include plaque, food or even some of the cavity
  2. Then they will isolate the area. Since the lips and skin are susceptible to staining, a protective coating such as Vaseline can be applied to those areas. The pediatric dentist may also use cotton rolls or other methods, as well. 
  3. Once the mouth is prepped, the pediatric dentist will apply the Silver Diamine Fluoride. They will start by drying the tooth with gauze or compressed air and then apply the SDF. That is done, by simply dipping the microbrush in the solution and painting it directly onto the cavitated surface.
  4. Then the pediatric dentist may apply a gentle airflow to allow the SDF to set and the solution to dry. 
  5. A fluoride varnish is also then applied to the cavitated teeth, acting as a top coat to seal the Silver Diamine Fluoride over the portion of your child’s tooth with the cavity
  6. Follow up visits are highly recommended. And you should visit your pediatric dentist at least two to four weeks after the initial visit.

To schedule a dental appointment for your child, call (858)693-5677. You can also set up a Virtual Consultation with Dr. J  

Have a question about your child’s oral health that you would like to submit to #AskDrJ? Click here to submit your question to Dr J

J. Shahangian


Dr. J is a board certified pediatric dentist and owner of Scripps Pediatric Dentistry & Brush n Brace, pediatric dental offices located in San Diego, CA. He is not only a Diplomat with the board but now also has Fellow status with the AAPD. He is a proud father of 3 beautiful girls, a San Diego native, loves soccer and is passionate about pediatric oral health. His mission is battling the number 1 disease that he has seen take over our beloved children. #AskDrJ provides answers and solutions to parents questions & concerns regarding their children's oral health.

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