What is Silver Diamine Fluoride? – Let’s Find Out


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Dr Sukanya Goswami
Sukanya has done BDS. She is a dentist, a blogger, an extrovert, and a travel enthusiast. She is also a spiritual believer. When she is not working, you can find her reading books.

In today’s world, untreated dental caries is a significant pediatric dental health problem. There are several preventive therapies like fluoride treatment, routine teeth cleaning, and sealant placement procedures that help to reduce the incidence of caries. However, there are very few non-invasive dental treatments that treat carious lesions and slows down the progression of caries. One among such procedures is the silver diamine fluoride therapy.

Silver diamine fluoride is a topical medicament which helps to control the active progression of caries. It is an excellent alternative to the traditional drilling and filling method used in children with dental caries. Caries arresting properties of silver diamine fluoride mainly comes from its active ingredient. Fluoride is the active ingredient that helps to remineralize and strengthen the tooth structure. Moreover, it inhibits the growth of caries-producing bacteria.

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The Food and Drugs Administration encourages the use of silver diamine fluoride in pediatric dental offices to treat early or active carious lesions with the non-invasive technique. Today’s article will highlight the techniques of silver diamine fluoride application. Moreover, we will also discuss the benefits, risks, and cost of silver diamine fluoride treatment.

What is silver diamine fluoride?

Silver diamine fluoride is an FDA approved liquid antibiotic that is mainly used to prevent dental caries and cavity progression in the teeth of young children. Silver diamine fluoride is primarily used under the supervision of a dentist. However, prescription-based solutions may be available for home use. (1)

Typically, it has three prime actions –

  • Inhibit the growth of caries-producing bacteria
  • Reduce the progression of active caries
  • Stop the formation of tooth cavities

Silver diamine fluoride consists of the following ingredients –

  • Silver which helps to kill the harmful bacteria in the mouth
  • Fluoride which helps to strengthen the tooth structure by the process of remineralization
  • Water helps to provide a liquid base (2)
  • Ammonia helps to maintain the concentration of the mixture which maximizes its effects

What are the benefits of silver diamine fluoride?

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Some of the significant benefits associated with silver diamine fluoride therapy include the following –

  • It is useful in arresting the progression of tooth cavity after the cavity has been formed on the tooth surface.
  • It inhibits the growth of harmful bacteria, such as streptococcus mutans. Moreover, it minimizes the spread of bacteria to the healthy tooth surface. (3)
  • It is a non-invasive approach to treat dental caries and is exceptionally comfortable and convenient for children who fear dental treatments.
  • It is the best treatment option for treating dental caries in children with special needs. Moreover, the non-invasive procedure helps to reduce the anxiety and nervousness of the child towards dental treatments. (4)
  • It is a relatively quick procedure and does not require any special equipment. Additionally, a single application of silver diamine fluoride per year is sufficient to reduce or prevent caries.

What are the risks associated with silver diamine fluoride?

As beneficial as silver diamine fluoride is for preventing cavity progression, there may be slight side-effects associated with this treatment. Some of them are as follows –

  • Patients with silver allergy may experience oral ulcerations or canker sore formation in the mouth.
  • The acid or ammonia present in the solution may irritate the gums and surrounding soft tissues.
  • The presence of silver can stain the tooth black sometimes. This is one of the common disadvantages of silver diamine fluoride. Moreover, it can stain other areas of the tooth or nearby tissues that come in contact during application.
  • Patients may experience an unpleasant metallic taste in the mouth after the treatment. However, it quickly fades away as the solution cures on the tooth surface.

What is the treatment procedure for silver diamine fluoride?

A pediatric or general dentist performs silver diamine fluoride therapy. The solution acts as an anti-microbial agent with tooth remineralizing properties. (5) Usually, the carious lesion of the cavity is dried using a cotton pellet. Moisture control is essential to increase the efficiency of silver diamine fluoride.

A cotton or gauze is placed around the affected tooth to control saliva contamination. The silver diamine fluoride solution is then applied to the carious area of the tooth. In some cases, silver diamine fluoride can also be used on the tooth surface covered by tooth filling and dental crown.

The silver diamine fluoride solution is applied using a micro brush. Once asked, the solution is allowed to cure on the tooth surface for at least two minutes. Patients are advised to not eat or drink for at least one hour after the treatment. Although silver diamine fluoride is typically applied to the carious areas of the tooth, it can also be used as a protective coat on the healthy tooth surface to reduce the incidence of caries. (6)

What is the cost of silver diamine fluoride treatment?

On average, the cost of a single application of silver diamine fluoride may range from $20 – $25 per tooth. Some dental insurance plans may cover the cost of silver diamine fluoride treatment. Additionally, many states in the U.S. offer Medicaid plans that cover the cost of the procedure. Recently, the state legislatures have proposed a plan to add silver diamine fluoride to other government-sponsored healthcare plans as well.

Take away message

Silver diamine fluoride is a unique and innovative dental approach to treat tooth cavity and caries progression among children. Many pediatric dentists encourage the use of silver diamine fluoride. It is an FDA approved liquid antibiotic which fights active caries on the tooth surface and arrests its progression.

The non-invasive silver diamine fluoride treatment does not require the removal of caries as followed in traditional drilling and filling procedures. Moreover, it helps to reduce the anxiety of children while undergoing the procedure.

Although the silver diamine fluoride comes with a wide range of benefits, some side-effects may concern the parents. Some of them include allergic reactions to silver, tooth discolorations, and soft tissue irritation. It is best to consult your dentist and understand the need for silver diamine fluoride treatment.

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