Silver Diamine Fluoride – A Cavity-Fighting Liquid

What is SDF?

In June 2016, the New York Times published an article on a new dental material called Silver Diamine Fluoride (SDF) that excited all of its readers and everyone who saw it shared on Facebook.  (New York Times article) Correction: it is not new.  SDF has been used in Japan for decades (approved by their ministry of health in the 1960’s), but it is new to the United States.

This material, which is a clear liquid that looks like water, can stop tooth decay in its tracks.  That is an exciting material!

The Food & Drug Administration has classified SDF as a fluoride treatment and has only cleared it for use as a desensitizing agent.  This means that when dentists use it to stop cavities, it is being used “off-label”.  The evidence is compelling enough that Dr. Chowning has begun offering this “caries arrest” treatment to its applicable patients.

Caries arrest, simply put, means stopping a cavity.  Caries is the scientific word for tooth decay or cavities.

Who is a candidate for SDF?

The most common application of SDF is in young children because it prevents them from having a dental appointment involving local anesthetic, drilling and filling.  It takes about 5 minutes to isolate the affected tooth and apply the colorless liquid SDF to the site.  It is also a great option for treating cavities on elderly patients with a very high risk for decay, patients with dementia or Alzheimer’s disease, and patients with special needs.  It can be used to stop the progression of decay for a patient who has need of extensive dental treatment and is unable to proceed for financial or medical reasons.

Basically, SDF can be used to buy some time when it comes to “fixing” your teeth.

What are the pros?

  • No local anesthetic = no injections
  • No drilling
  • No filling
  • Much shorter treatment (about 5 minutes compared to 30+ minutes)
  • Decreased cost (about 10% of the cost of a filling)

What are the cons?


  • The biggest con is that the silver particles in SDF stain the tooth black in areas of decay. The amount of staining depends on the amount of decay in the affected tooth.  There will be some temporary staining of the gums near the treatment area, which will resolve over a few days. The gum staining is similar to a henna tattoo, reddish brown in color and lasting for several days.
  • It tastes awful. We do our best to keep it away from your tongue, but we cannot guarantee you won’t taste it.
  • SDF is not 100% effective. There are some cavities SDF will not stop.  So it requires follow-up x-rays to confirm that the SDF did its job and that the cavities have not grown since being treated with SDF.
  • It must be reapplied at your next cleaning appointment for maximum efficacy.
  • It does not fill in any holes created by the cavity, so you still get food impaction in the treated area, which can lead to gum disease or decay on other teeth. This means it is not a good option for normal permanent teeth on a healthy adult.

Is SDF Right for You or Your Loved One?

Call our office at 940-382-1750 to set up a consultation with Dr. Chowning.  He can discuss the treatment options for each tooth, including which ones could benefit from SDF.