What to Know About Silver Diamine Fluoride

The discovery of cavities in a child can be heart-breaking news for everyone involved.  The conventional treatment of drilling and filling of cavities is a process that most parents and children want to avoid due to the limited cooperation of most young children.

Silver diamine fluoride (SDF) is an alternative treatment that many parents and dentists are opting for to treat cavities in children.  SDF was approved for use in Canada in 2017 but has been used in many other countries with great success for much longer.  As with any emerging type of treatment, there are questions and concerns about SDF.  Understanding more about this conservative and minimally-invasive treatment where needles and drilling are not required is the first step to deciding whether it’s right for your child’s teeth.

What is Silver Diamine Fluoride?

Silver diamine fluoride is a liquid antibiotic medication used to help prevent cavities from forming, progressing, or spreading to other teeth.  

SDF is made of:

  • Silver: helps to kill bacteria
  • Fluoride: helps to strengthen tooth structure

How is Silver Diamine Fluoride Applied?

SDF is applied topically to the teeth using a small brush or special type of floss in a matter of seconds.

  • Teeth should be as clean as possible to ensure maximum contact between SDF and the cavity
  • Soft tissue is susceptible to staining; Vaseline and cotton gauze may be used
  • The tooth is air dried prior to applying SDF with a small brush
  • Fluoride varnish is applied to seal in the SDF over the cavity


A follow-up visit 2-4 weeks after the initial treatment is recommended to check on the effectiveness of SDF.  At this time, it is expected that the SDF-treated cavity has turned dark and hard.  A single application of SDF has been shown to be highly effective, and reapplication may be required to sustain arrest.  Re-evaluation every six months is recommended.

What are the Advantages / Disadvantages of Silver Diamine Fluoride?


  • Quick and easy: literally seconds to apply
  • Minimally-invasive: no needles or drills required
  • Very cost effective compared to dental restorations (e.g. filling or crown)


  • Esthetics: SDF-treated cavities turn dark in colour
  • Should be avoided in patients with silver allergy

Which Patients May Benefit from SDF?

The following are some specific situations in which SDF may be beneficial:

  • Infants and toddlers: SDF can arrest the cavity until definitive treatment is possible (e.g. filling or crown) or until the tooth falls out

  • Medically compromised patients: SDF can treat the cavities in a minimally-invasive manner in patients with behavioural or medical management challenges

  • Older children: SDF can prevent a cavity on a primary (baby) tooth from spreading to adjacent permanent (adult) tooth

  • Patients with difficult to treat cavities

  • Patients without access or has difficulty accessing dental care

Why is it Important to Keep Teeth Healthy?

Cavities in children are very common and problematic.  Some of the short-term issues include:

  • Pain
  • Infection
  • Poor speech
  • Poor school performance
  • Poor sleep habits
  • Lowered self-esteem
  • Difficulty chewing

Talk to a Pediatric Dentist about Silver Diamine Fluoride

Silver diamine fluoride is a valuable treatment option which may be included as part of a dental cavity management plan for young children, especially when treatment options are limited due to patient cooperation.  Talking to your pediatric dentist about SDF will help determine if it is a good option for your child.

Request a Free Consultation

Our Certified Specialists in Orthodontics will help you determine which treatment option is right for you.

Request an Appointment