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Silver Diamine Fluoride (SDF) Cavity Treatment

Woman getting a Silver Diamine Fluoride (SDF) Cavity TreatmentSilver diamine fluoride, or SDF, is a topical method for treating and preventing dental cavities that uses a colorless liquid to keep cavities from progressing and even arresting the cavity without removing tooth structure. Already widely used in New Zealand, China, and Japan for more than 50 years, SDF was approved by the FDA in 2014, first as an option for treating tooth sensitivity in adults then as an effective treatment for cavities in pediatric patients and patients with severe dental anxiety or special needs.

When applied to a tooth with a cavity, the silver in SDF kills the bacteria causing the decay and remineralizes the enamel of the treated tooth, slowing or even stopping the progression of decay and strengthening the tooth. SDF is painless, non-invasive, and ideal for patients who can’t or are unable to tolerate traditional restorative procedures like fillings.

Norman Smile Center, led by Drs. Kristen Campbell and Donna Sparks, is proud to offer silver diamine fluoride (SDF) as part of our preventative services for pediatric patients. The health of your child’s teeth is critical for everything from their eating and sleeping habits to their social development, school performance, and self-esteem, and treating problems like cavities early—even in baby teeth—can help set your child up for a lifetime of good dental health.

Benefits of Silver Diamine Fluoride (SDF)

Silver diamine fluoride offers an easy, non-invasive alternative for treating cavities. Although it is not a substitution for removing and filling cavities as a long-term solution, SDF helps keep decay at bay in pediatric patients until their baby teeth fall out or until the child is old enough or ready for fillings, stopping around 80% of cavities and proving 89% more effective than other treatments at stopping cavities over a 12-month period. It can also help prevent recurring decay.

Because SDF doesn’t require any drilling, filling, or other tooth modification to physically remove decay, there is no need for anesthetic or sedation.

Other benefits of SDF include:

  • No adverse health effects or reactions
  • Affordable, serving as a cost-effective option to traditional filling procedures
  • No additional restorations, since SDF is strong enough on its own to prevent most cavities from spreading

SDF is best for cavities in their early stages, before they have gone too deep into the tooth and caused extensive damage.

The SDF Application Process

First, the tooth or teeth to be treated are cleaned, then isolated and kept dry with a piece of gauze or cotton. Dr. Campbell or Dr. Sparks will use a micro brush to apply the SDF liquid to the area of decay, then rub it in for one minute. The tooth will be covered with an additional coat of fluoride varnish to seal in the SDF.

In addition to routine cleanings and exams, your child will likely be scheduled for a follow-up visit after the initial SDF application to make sure the cavity was completely and successfully treated, and because SDF is most effective with repeat applications, which can be done after two to four weeks.

Special Considerations for SDF Treatment

While simple and effective, SDF treatment is not for everyone, and it does come with some limitations and special considerations.

  • SDF does not restore tooth form or function, so extensive damage or decay, as well as large holes, may still require a filling or other restoration in the future.
  • For maximum efficacy and optimal results, SDF should be reapplied every six to 12 months.
  • SDF cannot be used on very deep cavities or if there is existing decay or infection in the nerves.
  • SDF should be avoided in patients with an allergy to silver or who have lesions or tooth decay that have exposed the dental pulp inside the tooth. Using SDF on this soft tissue can cause the infection to spread to surrounding areas of the tooth.
While there are some minor side effects, such as a temporary metallic taste or initial gum irritation, the most notable drawback of SDF is the tendency of the liquid to stain the treatment area black. These stains are permanent to the tooth treated but, if it is a baby tooth, will not affect the adult tooth below it, and the extent of the staining depends on the extent of the decay. For this reason, SDF should not be used in cases where staining or discoloration is a significant concern.

SDF Treatment from Norman Smile Center

For more than 30 years, Drs. Campbell and Sparks, along with their team at Norman Smile Center, have been providing exceptional dental care to patients in and around the Norman area, including specialized dental services for our pediatric patients and patients with special needs.

At Norman Smile Center, we combine our experience and expertise in pediatric dentistry with a warm, comfortable, and welcoming environment designed to make your child’s visit with us a positive one. We are committed to providing the best possible dental care for your child, from protecting baby teeth to polishing brand-new adult teeth and everything in between. We strive to stay at the forefront of the latest in dental treatments, techniques, and procedures to help ensure your child is receiving quality, comprehensive care that makes sense.

Whether your child’s due for a cleaning, developing a cavity, or has never even been to the dentist before, Norman Smile Center can help. Schedule an appointment today to find out if SDF treatment is right for your child and put them on the path to better dental health!


SDF is a great option for people who don’t want or can’t tolerate traditional restorative treatment for mild to moderate cavities and decay, such as children and patients with special needs or severe dental anxiety.

Because it is fast, non-invasive, and highly effective, SDF is best for:

  • Children, babies, and toddlers aged two to eight
  • Primary teeth, especially the front teeth
  • Special needs patients
  • Pediatric patients at a higher risk of cavities because of genetic predisposition
  • Small, early-stage cavities and decay
  • Patients with cavities that are hard to treat or who have too many cavities to treat at once with traditional restorations
Fear of needles, drills, and sedation, as well as concerns about challenging behavior, can make dental treatments difficult and keep children and their parents from seeking the dental care needed to address problems like cavities, allowing decay to worsen. For cases like these, SDF would likely be recommended as a way to help preserve the patient’s dental health until other options like sedation or traditional restorations can be pursued.

Untreated cavities in baby teeth can be just as detrimental to your child as cavities in their adult teeth, if not more. In the short term, cavities in baby teeth can cause pain and sensitivity that makes eating and sleeping difficult or uncomfortable, leading to poor sleep and eating habits.

They can also impact things like speech development and articulation and contribute to infections in other parts of the body such as the ears and sinuses.

Over time, untreated decay and infections can damage emerging permanent teeth that are still developing, and there is considerable evidence that having cavities at a young age increases the risk of poor dental health outcomes in the future.

For treating mild to moderate tooth decay in certain patients, the benefits of SDF far outweigh those of traditional restorative procedures. A traditional filling entails at least an hour-long appointment with anesthetics and drilling and requires significant cooperation from the patient. The sounds of the drill and the sensations of numbing and sedation can simply be too much for young or special needs patients to tolerate, keeping them and their parents or guardians from seeking prompt dental care.

SDF is fast, painless, and simple to apply while providing effective results, making it easier for dentists to treat cavities in children with extensive decay requiring multiple visits and treatments or who have intellectual, behavioral, or developmental disabilities that keep them from sitting still or cooperating with dental staff. With SDF, your child’s cavities can be treated quickly and effectively, reducing the stress on both you and your child.

Staining is one of the primary concerns of SDF treatment. SDF is that it will cause permanent black stains on the area of decay being treated, but the extent of the staining depends on the extent of the decay. SDF is typically recommended only in cases where the treatment will not result in an excessive blackening of the tooth; if a cavity or area of decay is too large, the dentist will suggest a traditional filling or removing the tooth entirely.

Moreover, SDF applied to a primary (baby) tooth will not affect the permanent tooth below it, so the black stain will fall out with the baby tooth. If the aesthetics pose a significant problem to a patient, any staining can be covered with white filling material.

SDF can cause temporary brown or white stains anywhere the liquid has come in contact with the skin, lips, or gums, which typically disappear within 3 weeks or so. For many patients and their parents, however, the minimal staining caused by SDF is less of a concern than leaving a cavity untreated. Most cavities recommended for SDF are so small, the stain is virtually unnoticeable and never becomes an issue. If you are concerned about the effects of staining from SDF, be sure to discuss your worries with Dr. Campbell or Dr. Sparks, who can go over other treatment or remediation options with you.