Silver Diamine Fluoride (SDF) is a newer modality for cavity stabilization. SDF is a colorless liquid containing silver particles and fluoride.
- How does it work? SDF has antibacterial properties acts as a physical barrier, and the fluoride strengthens enamel
- SDF arrests caries ~ 70% of the time. It is easily applied in an outpatient dental setting without use of anesthesia. The process to apply SDF is 1-2 drops of SDF with a microbrush, wait 30-60 seconds, follow up in 1-2 weeks to assess hardness. If enamel is not sufficiently hard, reapply SDF.
- Application every 6 months is better than when it is applied annually (38% vs 12%) due to increased silver and fluoride exposure
- Disadvantage: SDF stains the treated area of the tooth black, but does not stain intact enamel. SDF may temporarily stain unprotected soft tissues.
- Silver allergy is the only known contraindication. No toxicity or adverse events associated with SDF have been reported.
- The American Academy of Pediatric Dentistry published a recommendation in 2018 that the benefits of SDF application in the target populations out-weigh its possible undesirable effects.
- As SDF use continues to gain traction in the dental community, it important that primary care providers be able to recognize signs of treated disease.