Anyone who loves going to the dentist for a filling please raise your hand.


We get it. Sometimes shots stink! But now there is a new cavity treatment called silver diamine fluoride (SDF). SDF is an FDA-approved liquid used to treat cavities without an injection or drilling. This new treatment can be great for young children, special needs/medically compromised patients, or anyone fearful of dental treatment.

So, what is a cavity anyway?

A cavity is a localized bacterial infection in a tooth that causes a hole, or “cavity.” Traditionally, dentists would need to drill out the infection and place a filling to restore the lost tooth structure. Now, with SDF, we can stop the infection instead of drilling it out.

I’m listening. What is the procedure?

The procedure is simple and painless. First, the teeth are cleaned with a toothbrush or polishing paste. Then, SDF is applied to the cavity with a small paintbrush. That is it! We repeat this procedure approximately three times, or until the cavity is fully healed. If the original cavity was large, or if there is still a hole in the tooth, we can place a white filling over the healed cavity to restore the tooth to its original shape.

Sounds like magic! How does it work?

The two main ingredients in SDF are silver and fluoride. Silver has long been known to be an effective antibacterial agent, killing bacteria and even preventing new bacterial growth. Fluoride is used daily in the dental field to help rebuild weakened tooth structure. Together, they are a one-two punch against cavities! SDF was recently approved by the FDA in the United States as a tooth desensitizer, but has also been used internationally for decades in countries such as Japan, China, Argentina, Australia, Brazil, and many others.

Ok, what is the catch? Are there any downsides to SDF?

Great news: there are no documented adverse reactions to SDF. The most common side effect of SDF use is that as the infection is healing, the cavity will turn a dark color; that is how we know it is working. SDF will only darken a cavity and will not discolor any healthy tooth structure. After the cavity is healed, we can place a white filling or sealant to mask any discoloration. If some SDF touches the gums, lips, or tongue, it may turn a dark color, but this will go away in a few days. We do not recommend SDF for any patients with a silver allergy.

Are you interested in learning more?

*Hands now go up*

Ask your dentist at the Samuels Sinclair Dental Center if this new cavity treatment option is right for your child (or even you).

Sara DiNardo, DMD

Dr. Sara DiNardo is a dentist at Rhode Island Hospital’s Samuels Sinclair Dental Center. She is also the assistant director of the Joseph S. Sinclair General Practice Residency Program and a clinical instructor of surgery at the Warren Alpert Medical School of Brown University.