Silver diamine fluoride (SDF) is the newest buzzword in dentistry. What can this new formulation do? As an oral health care provider, here’s what you need to know about it.
Although SDF has only recently started making headlines in the U.S., it has been approved for use in Japan for more than 80 years. Currently, it has been cleared by the Food and Drug Administration for use in adults 21 and older. But dentists have increasingly been taking advantage of its off-label uses to halt the progression of caries in younger patients and manage root caries in older patients. Presently, Advantage Arrest™ is the only SDF solution available for professional use in the U.S.
So, how does it work? As you may have guessed from the name, silver diamine fluoride is composed of two main components. Silver works as an antimicrobial, while fluoride binds to the tooth to accelerate mineralization. Using SDF has many benefits, including no required anesthesia or drilling, lower cost to the patient and speed (it only takes a few minutes). The main side effects include black staining of the tooth around the cavity and mucosal or gingival irritation. Saliva may also play a role in SDF’s effectiveness. For example, older patients often have less saliva, higher caries rates and the lowest rate of arrested decay after SDF treatment.
According to the New York Times, SDF may be a wonderful new resource, especially when working with patients with limited access to care, those who are medically compromised or cannot tolerate conventional restorative procedures. The Center for Disease Control and Prevention reported that in 2011-2012, 17.5 percent of children aged 5-19 and 27.4 percentof adults aged 20-44 had untreated dental caries. For young children, restorative procedures can be costly and stressful. SDF could be a good alternative for some cases.
~Deepti Shroff, Harvard ’19