SDF: Pediatric Dentistry’s New Silver Bullet

Silver Diamine Fluoride (or SDF) is a non-invasive treatment option for cavities that is painted on the tooth instead of drilling and filling the cavity. The use of SDF in the United States is relatively new (approved by the FDA in 2014), but it has been used in Japan for over 40 years and in Australia and China for over 10. SDF has become very popular in pediatric dental offices across the country as an additional treatment option for cavities and tooth sensitivity in young children.

Dr. Erica offers this treatment to children with cavities who will not tolerate fillings easily, as SDF stops cavities from growing. SDF is a colorless, antimicrobial liquid made of a combination of fluoride and silver ions that kills the bacteria that causes cavities. When SDF is applied to a decayed tooth, it will stop 80% of cavities when placed twice yearly. However, not all cavities can be treated by SDF, especially if they are very deep and near the nerve. Because SDF does not fill in cavities or holes in the teeth, the cavities may need to be filled when the child is older and can tolerate traditional treatment. For many children, it is a great way to halt the progression of dental disease until they are older and can sit through a filling appointment with no fear!

One important feature of SDF is that although the medication itself is colorless, it permanently turns all decayed tooth surfaces a deep black color. The cavity itself turns black from the silver, while leaving the healthy surrounding enamel white. If the cavities are on back teeth, the discoloration is barely noticeable but obviously is more prominent on front teeth. If SDF touches the lips or skin, it can leave a grey stain for several days, so the child’s lips and surrounding skin are covered with Vaseline to help prevent staining. If the discoloration on the teeth is not esthetic, Dr. Erica can place a white filling or crown to cover the SDF when the child is older.

For the procedure, usually the child is laid on the laps of a parent and Dr. Erica and she applies SDF with a small brush. There is no need for any numbing or drilling. The application is quick (usually less than a few minutes) and completely painless. First the tooth is dried, the SDF is rubbed onto the tooth with a small brush for up to one minute, and then the area is covered with fluoride varnish to help retain the SDF and provide a better taste (the SDF itself has a metallic taste). For full arrest of the cavity, the tooth will require at least 2 applications of SDF (usually about 2 months apart) and will be checked at every wellcare visit to ensure the cavity has not worsened.

If you have any questions about SDF, don’t hesitate to reach out to our office to see if it’s a potential treatment option for your child! Here is a video on the easy application of SDF courtesy of Dr. Jeanette MacLean (find more on her website:¬†

Sweet Tooth Pediatric Dentistry
583 Saybrook Road
Middletown, CT 06457
(860) 347-4681