How often should silver diamine fluoride be applied?

Frequency of Application for Best Results:

Silver diamine fluoride, when applied correctly, should be effective after a single application. However, multiple applications are likely to be more effective. For maximum caries-arresting benefit, SDF should be reapplied at six-month intervals for two years.

How long does silver diamine fluoride last?

Typically, the SDF treatment be effective for 3-12 months at least, after which time it will be re-applied to ensure the cavity does not get bigger.

How many times does SDF need to be applied?

Silver Diamine Fluoride is applied every 3 to 12 months, or as determined by the doctor. After SDF is placed, your child should not eat or drink for 60 minutes or have their teeth brushed until the next morning. Treatment with SDF does not stop the need for dental fillings or crowns to fix function or aesthetics.

How do you use sodium diamine fluoride?

Dip brush into SDF and dab on the side of the plastic dappen dish to remove excess liquid before application. Apply SDF directly to only the affected tooth surface. Remove excess SDF with gauze, cotton roll, or cotton pellet to minimize systemic absorption. Application time should be at least one minute if possible.

How long should SDF be applied to a lesion?

Saturate the lesion or high-risk surface with SDF using a microbrush and allow absorption of SDF by capillary action for at least 1 minute.

Silver Diamine Fluoride (SDF) Application: Evidence-Based Recommendations

How effective is silver diamine fluoride?

A systematic review of 7 studies indicated that SDF, at concentrations of 30% and 38%, is more effective than other preventive management strategies for arresting dentinal caries in the primary dentition.

How long does it take for SDF to turn black?

If SDF comes into contact with skin, it will cause a small dark spot that will go away on its own in 1-2 weeks. If it comes into contact with existing white fillings, it might stain the margins if they are open. And if a filling is placed the same day, it will probably stain.

Does silver diamine fluoride turn teeth black?

Educate your patients.

Silver diamine fluoride will stain carious tooth structure a dark brown or black color. Caution should be used on other tooth surfaces and near the margins of composite restorations or crowns. Explain the risks of discoloration to tooth structure before application.

Does silver diamine fluoride permanently stain teeth?

Yes. One of the primary drawbacks of treating cavities with SDF is that it results in permanent black staining on the decayed portion of the child's tooth. This staining is significant and generally cannot be completely masked by any white filling material that is subsequently applied over the cavity.

How do I get rid of silver diamine?

If the product comes into contact with the patient's tissues (lips, cheeks, and gingiva), these areas will temporarily stain dark. Applying a 2 x 2 or cotton roll with some hydrogen peroxide to the area will lighten the stain immediately, or it will disappear within two to three weeks.

Does SDF always stain teeth?

Healthy tooth structure will not stain. Stained tooth structure MAY be able to be covered when appropriate at a later time with a filling or crown. If SDF touches the gums or skin, a temporary brown stain may appear that cannot typically be washed off.

How much fluoride is in SDF?

SDF is a colorless liquid with a pH of 10, 24.4-28.8% (253, 870 ppm) volume of silver, 5.0-5.9% fluoride (44,800 ppm), and ammonia7,9. This alkaline solution has been shown to aid in the formation of covalent bonds of phosphate groups onto proteins and crystallites to grow10.

Will silver diamine fluoride fade?

While SDF permanently stains cavities, it can also stain clothes and other surfaces. If accidently exposed to the skin or lips, SDF can leave a temporary light gray stain, similar to a henna tattoo, which will eventually fade within 2-14 days.

Is silver diamine fluoride a filling?

Limitations of Silver Diamine Fluoride

First, SDF doesn't fill the cavity, which means that you might still have a hole in your teeth. This can be a nuisance if food gets stuck in there. If you have a significant cavity, we might recommend a filling. Second, SDF stains the cavity black.

Can adults use silver diamine fluoride?

Silver diamine fluoride (SDF): Dental caries in older adult patients. Silver diamine fluoride is a cost-effective treatment for arresting and preventing caries in older adults.

Is silver diamine safe?

The antibacterial properties of SDF make the treatment useful for fighting harmful bacteria in the mouth as well as between teeth and the deep pits of back teeth. Dental experts continue to use SDF because it has low toxicity levels. This is what makes the treatment safe for the use of humans, including children.

Can you brush after SDF treatment?

Silver Diamine Fluoride Facts

A small amount of SDF is applied to the decayed tooth area. After SDF application, no eating or drinking for 60 minutes and no tooth brushing until the following morning. Healthy tooth structure will not stain.

Does SDF prevent caries?

A 2019 systematic review by Horst et al. found that once-yearly SDF application was more effective in preventing caries than more frequent application (i.e., 2 to 4 times yearly) of fluoride varnish. Whereas when compared to occlusal sealants, SDF was only more effective in preventing caries if continuously applied.

Do SDF stains go away?

If SDF accidentally gets on the skin, tongue, gums, cheek, or lip, you will see a stain that causes no harm, like a temporary tattoo. This stain should disappear on its own within one to three weeks. Tooth-colored fillings that are exposed to SDF may change color. These may be able to be polished off.

Is silver diamine fluoride FDA approved?

The U.S. Food and Drug Administration (FDA) has granted its breakthrough therapy designation to silver diamine fluoride 38% (Advantage Arrest, Elevate Oral Care) for use in arresting dental caries in children and adults.

How does fluoride work?

When your saliva has fluoride in it from sources like toothpaste or water, your teeth are able to take it in. Once in your enamel, fluoride teams up with calcium and phosphate there to create the most powerful defense system your teeth can have to prevent cavities from forming: fluoroapatite.

Is SDF a topical fluoride?

Topical silver diamine fluoride (SDF) is a liquid that is applied to a tooth surface with an active dental caries lesion to arrest the lesion. SDF has been used in Japan for over 40 years to arrest dental caries lesions and reduce tooth hypersensitivity in primary and permanent teeth.

Can fluoride treat cavities?

If your cavity just started, a fluoride treatment may help restore your tooth's enamel and can sometimes reverse a cavity in the very early stages. Professional fluoride treatments contain more fluoride than the amount found in tap water, toothpaste and mouth rinses.

When did the FDA approve silver diamine fluoride?

In 2014, the FDA cleared SDF as a medical device for treating tooth sensitivity. In 2016, the FDA awarded breakthrough therapy status as a commitment to an application for approval of SDF as a drug to treat severe early childhood caries (press release from Elevate Oral Care, October 30, 2016).