Silver Diamine Fluoride
Silver topical products, e.g., silver nitrate and silver diamine fluoride (SDF) have been utilized in Japan for decades to arrest dental caries and reduce hypersensitivity in primary and permanent teeth. Over the last decade it has been introduced in other countries internationally. SDF has been marketed in the U.S. as a 38% product, equivalent to a 5% fluoride and a pH of 10. One side effect with SDF is the discoloration of demineralized or cavitated surfaces. The FDA approved its use as a desensitizing agent and over-label as an anti-caries agent. There are many research studies on SDF indicating it is more effective in arresting dental caries than sodium fluoride varnish. Therefore, the AAPD supports the use of a 38% SDF, as part of a caries management plan. Prior to the placement of SDF, the AAPD recommends patients receive a comprehensive dental exam, diagnoses, and a plan for ongoing disease management.