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Writer's pictureDr. Peter - Pediatric Dentist in Arlington, Virginia

What is Silver Diamine Fluoride (SDF) and Does My Child Need It?

By: Dr. Peter Markov, Owner and Kids Dentist at VK Pediatric Dentistry in Arlington, VA



Silver diamine fluoride (SDF) is a safe and effective cavity treatment option that is starting to gain popularity, especially with pediatric dentists. This medicament has been used safely in Europe and Asia for over 80 years but is now finally finding it's way to the United States of America after being approved by the FDA in 2014.


What is it?

SDF is a liquid that can be painted onto a cavity on a child’s tooth to slow down or stop decay. It contains silver, water, fluoride, and ammonia and works to kill bacteria and remineralize the areas that are broken down. SDF is a topical solution (which means it's painted directly onto the surface of the teeth), generally with 38% solution, and can be applied multiple times.


How its used:

1) Cotton or gauze is used to dry the teeth and prevent saliva from moistening the affected tooth.

2) Air from a dental unit is used to dry the tooth.

3) SDF is applied directly to the cavity with a microbrush and dried.

4) If behavior allows, multiple applications may be applied at the same visit.


How it works:

When applied correctly, SDF hardens the softened, cavitated tooth structure and kills the bacteria, allowing for caries arrest. This can be especially effective on cavities that are on the occlusal (or tops) of kids teeth. If your child is very young or has special needs, SDF treatment can help delay or prevent more extensive or difficult procedures such as numbing, drilling, or sedation.

  • SDF has been shown to be effective in stopping cavity development after a cavity has formed (also known as caries resonance)

  • SDF helps kill bacteria that can cause cavities and also limit the spread to other teeth.

  • SDF, when correctly used, can be a more comfortable and more tolerated procedure than conventional fillings in children. Children that have anxiety or that may not fully cooperate for dental procedures may benefit from SDF application.

Are there risks?

There are few negative side effects documented with the use of SDF. One of the biggest downsides of SDF is that it darkens any area that is cavitated and leaves it permanently discolored. Though, it will not stain healthy tooth structure. There are options to mask the discoloration including crowns, glass ionomer, or resin modified glass ionomer composites, though these may depend on the behavior and acceptance of the child. If the cavity is in on a baby tooth that will eventually fall out or if the tooth is in the back of the mouth, SDF may be the least invasive, best option for some children.


How much does it cost?

On average, SDF costs $75 for a single treatment. It can be applied to multiple teeth at the same time. Insurance may or may not cover treatment with SDF, though a large number of state legislation is proposing adding SDF coverage to healthcare plans.


VK Pediatric Dentistry is proud to offer Silver Diamine Fluoride (SDF) as a conservative approach to manage decay in certain situations. SDF can be a very useful tool for providing dental care for your children that may have challenges to receiving traditional treatment because of age, behavior, or medical conditions.


VK Pediatric Dentistry

5001 Langston Blvd, Arlington VA 22207



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