Silver diamine fluoride (SDF) has been used for caries management in other countries for more than 80 years, gained acceptance by the US Food and Drug Administration in 2014, and was approved by Health Canada in 2017.

Facts for Consideration:

• Silver diamine fluoride (SDF) is an antibiotic liquid. We use SDF on cavities to help stop tooth decay. We also use it to treat tooth sensitivity. SDF application every six to 12 months is necessary.
• The procedure is as follows: 1. Dry the affected area. 2. Place a small amount of SDF on the affected area. 3. Allow SDF to dry for one minute. 4. Rinse.
• Treatment with SDF does not eliminate the need for dental fillings or crowns to repair function or esthetics. Additional procedures will incur a separate fee.
• Patients should not be treated with SDF if: 1. The patient has a silver allergy. 2. There are painful sores or raw areas on the gums (example: ulcerative gingivitis) or anywhere in the mouth.

Benefits of Receiving SDF:

• SDF can help stop tooth decay.
• SDF can help relieve sensitivity.

Risks related to SDF include but are not limited to the following:

• The affected area will stain black permanently. Healthy tooth structure will not stain. Stained tooth structure can be replaced with a filling or a crown.
• Tooth-coloured fillings and crowns may discolour if SDF is applied to them. Colour changes on the surface can normally be polished off. The edge between a tooth and a filling may keep the colour.
• If accidentally applied to the skin or gums, a brown or white stain may appear that causes no harm, cannot be washed off and will disappear in one to three weeks.
• A metallic taste may be noticed after use. This will go away rapidly.
• If tooth decay is not arrested, the decay will progress. In that case, the tooth will require further treatment, such as repeat SDF, a filling or crown, root canal treatment or extraction.
• These side effects may not include all of the possible situations reported by the manufacturer. If you notice other effects, please contact your dental provider.
• Every reasonable effort will be made to ensure that success of SDF treatment. There is a risk that the procedure will not stop the decay and no guarantee of success is granted or implied.

Alternative to SDF, not limited to the following:

• No treatment, which may lead to continued deterioration of tooth structures and cosmetic appearance. Symptoms may increase in severity, with tooth nerve involvement.
• Depending on the location and extent of the tooth decay, other treatment may include placement of fluoride varnish, a filling or crown, extraction of referral for advanced treatment modalities.