Silver Diamine Fluoride

Silver Diamine Fluoride

SDF is a liquid substance used to help prevent tooth cavities from forming, growing or spreading to other teeth

What is Silver Diamine Fluoride?

Silver Diamine Fluoride (SDF) is a liquid substance used to help prevent tooth cavities (or caries) from forming, growing or spreading to other teeth.

SDF is made of:

Silver: helps kill bacteria

Water: provides a liquid base for the mixture

Fluoride: helps your teeth rebuild the materials they are made of (known as remineralization).

Ammonia: helps the solution remain concentrated so that it’s maximally effective against cavity resonance.

SDF was first approved for use in Japan more than 80 years ago. SDF was approved by the U.S. Food and Drug Administration (FDA) in 2014 for use in the United States.

How is it used?

Most dentists use a liquid form of SDF containing at least 38 percent of the SDF solution. It is applied topically, meaning that is applied directly to the surface of your teeth. Many dentists use the following steps:

  • Cotton or gauze is placed near the affected teeth to prevent saliva from moistening the teeth.
  • Moisture is removed from the surface of the teeth using a vacuum suction tool.
  • SDF is applied to the area affected by a cavity.

Your dentist may also use the following to mask the areas affected by cavities:

• Glass ionomer
• Opaquer
• Crowns

SDF is most commonly used on areas affected by cavities. Research shows that SDF can be just as helpful when used as a preventive measure by being applied to healthy tooth surfaces.

Research also suggests that dentists don’t need to treat cavities with fillings or tooth surface modification before using SDF. Traditionally, many dentists have used a fluoride varnish to help stop cavity development. SDF has proven to be much more successful at reducing cavity growth than varnish. SDF also requires fewer treatments over time.

There’s no set number of applications required for SDF to work. Most dentists only apply SDF every six months. Varnishes often need to be applied four or more times per year.

How does it benefit your oral hygiene?

• SDF has widely been shown to be effective to help cavity development after a cavity has formed.

• SDF helps kill the bacteria that break down tooth surfaces while also keeping them from spreading to other teeth.

• SDF is often suggested as a more comfortable alternative to drilling cavities. This can be helpful for children or adults who have anxiety about the dentist or may not be able to fully engage in dental procedures, such as those with special healthcare needs.

• SDF can be helpful as a cavity treatment if you’re overly sensitive to the instruments and substances used during cavity treatments.

• SDF can help keep cavities to a minimum or prevent them entirely if you feel that it’s difficult to make time for regular dental check-ups or feel uncomfortable about cavity procedures. It’s quick, requires no special equipment, and generally only needs to be done once per day.

• SDF can allow your dentist to treat decay that is present on a difficult to reach areas such as a root surface or second molar.

Photo of a tooth with Silver Diamine Fluoride (SDF) treatment
Photo of a tooth with Silver Diamine Fluoride (SDF) treatment

Are there any side effects?

Few harmful or negative side effects have been found with the use of SDF. SDF is widely considered by dentists to be safe, even on young children.

You shouldn’t use SDF if you have a silver allergy, oral ulcerations or canker sores, advanced gum disease, or major tooth decay that’s exposed the soft tissue of your tooth beneath the enamel. These conditions can have painful reactions with the acid or ammonia in SDF.

The only common side effect of SDF noted in hundreds of studies is black staining around the area where SDF is applied.


SDF is a safe, painless alternative to traditional cavity drilling procedures. Your dentist may not recommend SDF in every case of cavities. It’s also not yet as widely available as similar treatments, such as fluoride varnish.

But SDF has been proven to be highly successful in stopping the development and spread of cavities. Even more effective forms that leave fewer black stains continue to be tested.

SDF application is not a replacement for restoration of decayed teeth with dental fillings or crowns. Rather, it is an effective interim therapy used as part of a
comprehensive treatment plan supervised by a dentist.

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