Silver Fluoride as a Treatment for Dental Caries? – Detailed Review – 2023

Presently, Silver fluoride as a treatment for dental caries, is used in many health facilities. Medical treatment of caries is a unique area of philosophy that employs topical therapies that are minimally invasive in treating the disease.

This strategy is an alternative or supplement you can use in place of traditional care. Silver diamine fluoride (SDF) is one agent used to enable efficient non-invasive treatment.

Silver diamine fluoride (SDF) was recently approved to be used in the United States. It has been proven to be efficacious in arresting dental caries and its lesions. It is a highly valuable therapy that is included as part of the caries management routine for patients.

Dental caries treated with SDF usually turn black and become hard. Stopping the caries development in all targeted lesions may take some applications of SDF.

Reapplication may also be necessary to sustain arrest.

What is Silver Diamine Fluoride?

silver fluoride as a treatment for dental caries
Dental and health care concept with fluoride

Silver diamine fluoride (SDF) is a liquid solution that is topical, meaning it is applied on the outside surface of the teeth. A dentist often uses a small brush or a specific type of floss to apply to the affected regions. The Silver fluoride as a treatment for dental caries is 38.5% silver fluoride salt, which becomes water-soluble by the addition of minute amounts of ammonia. The fluoride in this solution protects and strengthens the enamel in the teeth, and silver fluoride as a treatment for dental caries is useful in treating decay, and cavities and preventing further breakdown.

The result is a liquid that dentists can easily rub onto teeth in seconds. SDF aids in killing bacteria, so it is a very effective treatment for cavities. However, dentists only prescribe SDF on baby teeth because it dyes the affected part of an adult tooth black or brown.

silver fluoride as a treatment for dental caries

How Does SDF Work?

Silver diamine fluoride works effectively because of its key components: silver and fluoride can reduce or limit dental caries. Silver’s antibacterial properties have been recommended for years, and its reduced toxicity makes it suitable for use in humans. Fluoride is another mineral that comes from rocks; most bodies of water have some quantity of fluoride in them naturally, although some agencies add more of this mineral for public health measures.

While using silver fluoride as a treatment for dental caries, it significantly elevates the rate at which the enamel can undergo remineralization by saliva and the same time, increases its resistance to harmful acids and substances. Fluoride has antimicrobial properties; they kill bacteria that cause caries.

Use Of SDF For Caries Arrest

The development of caries involves ingesting dietary carbohydrates, tooth mineral demineralization, bacterial metabolism, and tooth matrix degradation. The cariogenic process starts with an imbalance in the equilibrium between demineralization and remineralization. This induction is by acid-producing and acid-tolerant bacteria, which shift to a lower pH, resulting in loss of minerals in the tooth.

Therefore, it is necessary to enhance the protection, minimizing the pathologic factors associated with dental caries. Current methods for caries management focus on the individual’s risk evaluation and establishment of preventive and restorative treatments.

Caries development occurs by degradation of enamel, dentin, and organic matrix. Once the caries plaque develops, treatment options include restorative and non-restorative methods. Non-restorative approaches may be invasive, like preventive resin restoration, or non-invasive, like SDF, fluorine therapy, or sealants.

silver fluoride as a treatment for dental caries
Healthy gums and teeth coating by fluoride to protect bacterial, Prevent Tooth decay. Oral hygiene and Dental concept.

Benefits of SDF

There are benefits for silver fluoride as a treatment for dental caries; they include:

Non-invasive: Because SDF is a topical substance applied to the outside surface of one’s teeth, it is a better alternative method to fillings and other cavity treatments. It is an especially great solution for young children and adults. This is because the sound, drills, and the experience of filling cavities can lead to intense fear or more severe effects, like dentophobia.

Safe: As of now, SDF has no reported risks or reactions to health, so it is a safe treatment for unhealthy teeth. Since the dentist often use silver fluoride as a treatment for dental caries; it is safer for people who might have trouble remaining still and calm during the examination.

Cost-effective: Filling a cavity can be quite an expensive treatment option, but SDF usually comes at a lower price. While it does lead to some cosmetic alterations in the tooth, it is a reliable, approachable treatment option for ease of budget.

Quick: Getting kids to meet with a dentist can be tiring for their parents. SDF is a rapid and fast treatment measure for the removal of caries, making it a better treatment option for families with young children.

Risk Factors of SDF

Silver fluoride as a treatment for dental caries, comes with several risks related to Silver Diamine Fluoride include, but are not limited to:

  • The affected area often stains black permanently in adults, while the healthy tooth structure will not stain; stained tooth structures can be replaced with a crown or filling in the future.
  • If accidentally applied to the skin surface or gums, a brown or white stain might appear that causes no harm but will disappear in one to four weeks.
  • At the time, a child might notice a metallic taste that will go away quickly.
  • There is a high chance that the procedure may not stop the decay, and no 100% guarantee of success gets granted.
  • If dental caries are not arrested, caries will progress. In that case, the tooth will require more treatment, such as repetition of the SDF method, a crown or filling, a root canal, pulp treatment, or extraction.
  • SDF often requires repeat application for maximum effect. It cannot function in the presence of an infection of the nerve.
silver fluoride as a treatment for dental caries


1. How long does SDF last on the teeth?

Typically, the SDF treatment will be effective for 3-12 months at least, after which it will be re-applied to ensure the cavity does not grow larger.

2. How often should silver diamine fluoride be applied?

Silver fluoride as a treatment for dental caries is applied the right way, and are efficient after a single application. However, multiple usages are likely to be more impactful. For the maximum arrest of caries to be beneficial, SDF is used at six-month intervals for two years.


Evidence by top researchers shows that SDF at 38% can be a non-invasive treatment method to arrest dental caries. Among the reasons for such success is the synergistic effect of silver and fluoride ions, which inhibits bacterial or biofilm growth and supports remineralization.

Hence, silver fluoride as a treatment for dental caries has been an effective treatment option, and it is still in use today.

silver fluoride as a treatment for dental caries

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