Silver Diamine Fluoride (SDF): What You Need To Know

Silver Diamine Fluoride (SDF) Black Is Back in Pediatric Dentistry!

You look into your child’s mouth and notice a hole. It’s time to visit the dentist! But being concerned with your child’s behavior with medical visits (you literally have to hold them down EVERY time), you asked around and heard of a product that halts cavities called silver diamine fluoride (SDF). In this article, I will introduce you to what SDF is and prepare you with useful information prior to child’s visit to the dentist.

What is silver diamine fluoride?

SDF is a colorless liquid that helps stop dental cavities from forming. The liquid is composed of three main parts: silver, fluoride, and water.

The silver acts as an antimicrobial to fight the bacteria that cause tooth decay while the fluoride acts to strengthen (i.e. remineralize) the tooth.

On the other hand, water comprises 62% of the solution and acts as the medium for which these ingredients combine together.

How is this procedure performed?

Silver diamine fluoride is a minimally invasive way of combating tooth decay.

The tooth is first cleansed of food debris and air dried. Once dry, the SDF is applied with a brush. Soft cotton rolls can be used to keep the SDF localized to a single tooth. A thin layer of flavored fluoride varnish is often applied afterwards to mask its slightly bitter taste.

Overall, the process is quick and painless, taking only a few minutes.

How come I’ve never heard of it before? 

The use of silver to treat cavities goes back to the 1800s and has been widely used to stop cavities and reduce tooth hypersensitivity in Japan for over 40 years.

The American Academy of Pediatric Dentistry published an extensive guideline based on over 40 research papers to support its usage in cavities on baby teeth as part of a comprehensive cavity management program.

In August of 2014, the Federal Drug Administration (FDA) approved SDF to become commercially available to dental professionals.

RELATED: Baby’s First Dentist Appointment: What You Need To Know

Is silver diamine fluoride safe?

Silver diamine permanently stains cavities black. SDF does not restore tooth form or function and some teeth may require a protective covering (i.e SMART restoration) or a conventional filling to prevent food entrapment.

SDF should NOT be used in patients with metal allergies or cavities approaching the nerve of the tooth.

Overall, silver diamine fluoride is very safe and can be used on the vast majority of patients. Talk to your pediatric dentist if SDF is appropriate for your child.

Does my insurance cover this procedure?

Contact your insurance company and inquire about the CDT code D1354. There you will be provided with information on coverage amount and frequency.

If your insurance carrier does not provide SDF coverage, costs range from $30 to $100 per tooth (depending on your region).

RELATED: The Nitty Gritty Details of Dental Insurance Plans


Silver diamine is NOT a “magic bullet” or panacea for cavities. Instead, it is part of your dentist’s toolbox and will never replace the need for traditional fillings and crowns.

With that said, it is great for halting the progression of smaller cavities or cavities in pre-cooperative children who will not tolerate traditional dental treatment.

It is a minimally invasive approach that does not require shots or drilling. Also it can protect your child’s psyche until they are more behaviorally ready for fillings.

Interested in learning more about if SDF is appropriate for your child? Schedule a visit with your local pediatric dentist today!