High House Pediatric Dentistry now offers Silver Diamine Fluoride (SDF) as an alternative treatment method for very young children with cavities. Dubbed as a “magic bullet” for cavities in kids, SDF has long been used in Europe and Asia, and is now approved for use in the US. SDF provides a safe and non-invasive way to stop cavities from progressing, and, in some cases, may be an alternative to sedation or general anesthesia.

Who should use SDF?

The primary purpose of SDF is to stop cavities from progressing. SDF does NOT restore tooth structure- so if there is a hole in a tooth, SDF can keep the cavity from getting bigger, but cannot prevent further breakage, nor can it improve function in the tooth.

Silver Diamine Fluoride is safe for toddlers and children.

High House Pediatric Dentistry uses SDF as a holdover medicament to delay treatment until the child is old enough to receive dental treatment without being scary. SDF can be used in a variety of situations, including:

  • Very young children with shallow cavities that are visible in the mouth – SDF will help to stop the cavity from progressing, and delay the need for invasive treatment until the child is older.
  • Children of all ages that have small pit/fissure cavities located on the chewing surfaces of primary (baby) molars;
  • Front teeth that have deep cavities, but that might fall out in the next 2 years;
  • Pre-cooperative children with cavities on the chewing surfaces of teeth.

SDF is NOT for:

  • Teeth that are broken or infected, needing crowns, pulpotomies (baby root canals) or extraction.
  • Cavities that are very deep – SDF cannot rebuild tooth structure needed for function- it can only slow down/stop the progression of cavities;

How is it applied?

SDF is applied two or more times on teeth that have carious lesions. Application is continued until the child is old enough to receive dental treatment. We do not currently apply Silver Diamine Fluoride to teeth that are cavity-free, unless they have enamel hypoplasia. In those cases, the teeth are treated with SDF as a de-sensitizing agent.

SDF is applied by using a small paintbrush dabbed in the liquid. We will scrub/brush your child’s tooth for up to two minutes to make sure that the liquid is able to penetrate as deeply into the cavity as possible. In more cooperative kids, we will first drill out as much of the cavity as your child will allow with no anesthetic or nitrous oxide. This allows for deeper penetration of the SDF.

Is it safe for my child? Does it hurt?

SDF has been consistently used in Europe and Asia for many years- its first use was documented in 1891. It is generally considered safe for use in toddlers and children. It is NOT for use in children who have a silver allergy. Application is done with a plastic paintbrush that doesn’t hurt, and is applied at least twice, depending on the circumstances of the cavity.

What are the disadvantages of using SDF?

There are very few drawbacks to using SDF! Here is the rundown of the disadvantages:

  • Black teeth – The biggest disadvantage is that SDF will turn the cavity black. While this may be unappealing visually, this actually indicates that the SDF has slowed the cavity from progressing;
  • Brown stains on the surrounding tissue – although these brown stains do wash out or go away with regular brushing and flossing within a few weeks.
  • SDF does not structurally repair the tooth- it only prevents the cavity from progressing.  Teeth that receive SDF treatment will eventually need to be restored.

HHPD will offer SDF treatment as an option if it is appropriate for your child.

If you think your young child may have cavities, and are worried if they will be able to sit through a filling appointment, come and talk to Dr. Ray at High House Pediatric Dentistry to learn more about Silver Diamine Fluoride.

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