Recently the American Association of Pediatric Dentists (AAPD) released a study on the use of Silver Diamine Fluoride (SDF) and how it may be used to treat hypersensitivity and decay in children and patients with special needs. It is important to note that the preferred method to treat and arrest decay is by removing the decay and taking restorative measures such as fillings or crowns, but it may be the case that these standard methods are not always readily available or viable. In these cases, SDF provides an alternative solution to slowing or stopping decay in its tracks.

Since you may be hearing of this as a treatment option, we thought it would be helpful to provide some background to improve your grasp on what it is and how and why it may be used.

What Is Silver Diamine Fluoride?

SDF is a liquid solution comprised of silver, water, ammonia, and fluoride. The silver in the solution serves to strengthen and protect the dentin layer of a patient’s teeth, while the fluoride treats decay and prevents further deterioration from progressing. SDF is colorless and is sometimes reported to have a slightly metallic taste during treatment.

This anti-microbial liquid has been in use for years to treat hypersensitivity, but only recently did we have abundant, detailed studies available on the successful use to treat and arrest decay in children, special needs patients, and the elderly.

How Does It Work?

After the patient’s teeth are cleaned and dried, SDF is applied to teeth with a small brush one drop at a time and left to cure for roughly two minutes. The solution is applied directly to areas affected by decay and kills harmful bacteria to stop or severely slow cavities from growing and minimize further decay from progressing. This also reduces hypersensitivity by allowing the silver to add strength and protection to any exposed dentin, which is most often the cause of hypersensitivity.

Is It Right For My Child?

To date, SDF is reported as a safe, although temporary, treatment method that comes with no reported health risks or severe adverse effects. It is most often recommended for use in children who have severe early childhood caries (SECC) but is also a valid non-invasive option for patients who are unable to physically cooperate fully during treatment. SDF is not a permanent solution, as SECC typically (and ultimately) requires attention through restorative procedures. However, SDF can halt the spread of decay until more invasive treatment can take place.

There are many benefits from the use of SDF:

• SDF treatment is a very simple, cost-effective, and fast process.
• It is painless and non-invasive
• It is effective at stopping and/or severely slowing the spread of decay and also relieves sensitivity in a patient’s teeth.

There are also some drawbacks with SDF treatments:

• Decayed areas of teeth treated with SDF will have permanent black or brown staining. This is caused by a reaction with the silver in the compound and is evidence that it is killing the bacteria causing the decay. Only the decaying areas will appear brown/black, not the entire tooth.
• SDF has been reported to have a slightly metallic taste and ammonia smell that fades rapidly after treatment.
• Patients with mouth ulcers or silver allergies should avoid SDF and discuss alternative options with their clinicians.
• Again, while SDF can arrest the spread of decay, it is not a permanent solution, and your child should ultimately receive restorative treatment from his/her pediatric dentist.

As with any dental procedure, you should discuss treatment options with your pediatric dentist to ensure you fully understand the potential benefits and risks. Regardless of the method of treatment applied, your best defense against decay is to remove risk by favoring healthy nutritional and dental habits.

Sources: AAPD SDF Guidelines, ADA Science in the News, and the National Center for Biotechnology Information