Silver diamine fluoride is a non-invasive, cavity-fighting liquid medication that can be used to halt the progression of cavities. Originally approved by the FDA for tooth sensitivity, silver diamine fluoride is also useful for the treatment of tooth decay. The active ingredient in this treatment is silver, which is well known for its powerful antimicrobial properties, and is very effective at eliminating the bacteria known to cause tooth decay. The application of silver diamine fluoride is a conservative approach for the treatment of active decay.

Tooth decay and treatment in children

According to the CDC, almost 20% of children aged 2-19 have untreated cavities. Children who are on the younger end of that spectrum may not be mature enough to handle routine restorative dental care. Silver diamine fluoride is applied to the teeth with a brush. The application takes less than a minute, and there is no noise,  drilling, or numbing. This makes it an excellent choice for very small or anxious children. It can also be used on baby teeth that may be close to falling out, sparing the patient more invasive dental treatment while still protecting the teeth from harmful bacteria.

Silver diamine fluoride treatment is a simple process.

  • The tooth will be dried
  • Using a microbrush, the dentist will apply a small amount of 38% silver diamine fluoride to any teeth with visible cavities
  • A second application may be scheduled for 4-6 weeks after the initial application
  • During both applications, a 5% sodium fluoride varnish will be used to seal the silver diamine fluoride onto the treated tooth to arrest the progress of the decay
  • These procedures may be followed up with home fluoride therapy, such as an ACT rinse

Using silver diamine fluoride to treat tooth decay in very young children will result in a dark discoloration of the decayed area. Healthy tooth surfaces remain undisturbed, but the tooth decay, which is usually already brown in color, turns very dark after application. The dark discoloration is the main criterion checked during follow-up appointments in order to know that the treatment was effective.

The use of silver diamine fluoride does not mean a patient will not ever need dental fillings or crowns in order to restore function or appearance. In many cases, we are able to use silver diamine fluoride when children are very young, and then focus on restoring the teeth with more conventional treatment at a later date. The use of silver diamine fluoride buys the patient some time until more traditional dental methods can be utilized.