What is Silver Diamine Fluoride?

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March 28th, 2024

Silver Diamine Fluoride (SDF) is a treatment used for cavity (dental caries) prevention and management. It helps to stop new cavities from forming and keeps existing cavities from worsening. The silver provides protection to the dentin layer of the tooth which can become exposed and cause sensitivity. The fluoride works to treat the cavity.

Illustration of the dental provider and child in the dental office.

SDF can be used so that the dentist does not have to remove the cavity – this allows them to avoid using drilling or needles. For children, those with special needs, people with dental anxiety or the elderly, this can be an effective alternative to other cavity treatments. SDF can also be used preventively, like other fluoride treatments. SDF is used for treatment of hypersensitive permanent teeth.

SDF treatments do result in black staining on the area of the tooth that is decaying because of a reaction in the chemical compound. The staining will not transfer to the permanent or adult teeth when they begin to grow in. A dentist can sometimes use tooth-colored filling or crowns to cover some of the staining sometime after the initial application.

Since SDF is not a permanent treatment, it will need to be reapplied about twice per year, based on your dentist’s recommendation.

Illustration of a tooth with a bottle and applicator for Silver Diamine Fluoride with SDF being applied to the tooth.


SDF was developed in the late 1960s to combine the antibacterial properties of silver ions and the well-known preventive effects of fluoride.

A 2018 expert panel of the American Dental Association recommended 38% SDF biannual application for advanced dental cavities in primary and permanent teeth for patients unable to undergo routine dental office procedures and when general anesthesia is not available or advisable to help the patients get comprehensive dental care. The use of SDF to arrest dental decay requires the diagnosis by your dentist and/or physician and monitoring by your dentist.

In 2021, the World Health Organization (WHO) included SDF in the WHO Model List of Essential Medicines for both adults and children.


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  • World Health Organization Model List of Essential Medicines – 22nd list, 2021. Geneva: World Health Organization; 2021
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  • Healthline: Silver Diamine Fluoride

This information in this post is for general educational purposes only and does not warrant or represent any information as related to health as specifically appropriate for you. It is not intended to be medical advice or replace the relationship that you have with your health care providers. You should always seek medical advice on any diagnosis or treatment from a qualified health care provider. The information is provided “as is” without any representations or warranties, express or implied.