Fact Check: How does Silver Diamine Fluoride work?

Cavities are usually treated by drilling out the decay and using a dental filling, which can be an unpleasant experience. But what if a drill and needle weren’t needed? Silver Diamine Fluoride may be the answer.

What is Silver Diamine Fluoride?

Silver Diamine Fluoride (SDF) is a liquid substance made of four parts: silver, water, fluoride, and ammonia. It’s applied directly to the surface of the tooth. Studies show it can stop emerging cavities and prevent other cavities from forming.

While SDF has been used for decades outside of the United States, it was approved by the Food & Drug Administration in 2014.  In 2017, the American Academy of Pediatric Dentistry (AAPD) guidelines recommended SDF to treat cavities in children and adolescents. In 2018, the Journal of the American Dental Association noted it as an effective treatment for older adults too.

Are there any side effects to SDF?

Once SDF is applied, the decay turns black permanently. If not applied carefully, the surrounding tissue may also temporarily turn black.  It also has a metallic taste but it goes away quickly after application.

However, when used on a child’s baby teeth or on a molar (the color is not much different from an amalgam filling), the positive results outweigh the discoloration because it is noninvasive, painless, and relatively quick to apply.

As a newer treatment, SDF may not be available at every dental office.  SDF may also not be the right treatment for everyone. If there is an infection or if the decay is too severe, SDF can’t be used.

Who is a good candidate for SDF treatment?

Because there are no drills, no needles, and takes less time than a traditional filling procedure, SDF is especially useful for kids, people with special healthcare needs like cancer patients, and the elderly. 

SDF is also often used as a stopgap for patients needing oral surgery or other more extensive treatments that take time to complete.

Is SDF different from fluoride varnish or a sealant?

SDF is different from both a fluoride varnish and a dental sealant, even though all three are applied in a similar way.

While fluoride varnish helps keep your tooth enamel hard to resist cavities, it does not have the same ability to stop tooth decay in progress like SDF.

A sealant prevents cavities from forming because it coats the chewing surface of molars to prevent food from getting stuck, which can lead to the bacteria that cause tooth decay.  Sealants are best for kids aged six to 14 when permanent molars are coming in.

Is SDF right for me?

Talk to your dentist if you’re interested in SDF as a treatment for tooth decay. It’s quick, painless, and has a high success rate of stopping decay and preventing new decay from forming.

A follow-up visit is recommended within a month after the first application to ensure the decay has stopped. Additional SDF treatments can be done at the follow-up or other future visits.

SDF treatment is covered by Delta Dental of South Dakota plans, subject to some limitations.

You can work with your dentist on a pre-treatment estimate to know exactly what’s covered.

*Updated February 2023