AN ALTERNATIVE TO FILLINGS AND DRILLSMany people fear going to the dentist, and that fear is made worse by the dreadful prospect that on any given visit, you may have a cavity that needs drilled and filled. And if your child has their first cavity, they may be terrified of what will happen next.

But there are alternatives to having teeth drilled! One of those alternatives is an antimicrobial liquid that can be brushed on the cavity to stop tooth decay, and it’s called silver diamine fluoride, or SDF.

The California Dental Association reports that various “clinical studies unanimously confirm better caries (cavity) arrest and/or prevention by silver diamine fluoride over control or other materials.”

We may recommend using SDF in children who may have excessive decay, young children who have difficulty cooperating for a treatment, special needs patients, and children with dental decay that may not all be treated in one visit.


Silver Diamine Fluoride is an FDA-approved antibiotic liquid clinically applied to control active dental caries and prevent further progression of disease. While the ideal way to treat teeth with decay is by removing the decay and placing a restoration, this alternative treatment is quick, painless, and allows us to stop decay with noninvasive methods, particularly with young children that have baby teeth.


SDF is composed of two primary components: silver and fluoride. Silver acts as an anti-microbial agent that simultaneously strengthens the underlying protective layer of your teeth called dentin. Fluoride is the active ingredient that puts a stop to tooth decay and helps prevent additional decay from appearing.

During your child’s visit, our pediatric dentists will brush and rinse their teeth without paste to prepare for the treatment. Your child’s teeth will then be dried, and any debris removed. SDF is applied to the affected teeth and left to cure on the tooth for two minutes. Once the tooth has been treated, we advise patients not to eat or drink or at least an hour to allow it to cure.


There are some risks associated with it, which include, but are not limited to the following:

• Any decayed areas will stain black. Healthy tooth structure will not stain. Stained tooth structures can be replaced with a filling or crown. SDF may discolor dental fillings and crowns.

• If SDF is applied to skin or gums, a harmless temporary brown or white stain may appear on the area. The stain will disappear in one to three weeks. It cannot be washed off.

• The patient may notice a metallic taste after an application which will go away shortly after application.

• Every reasonable effort will be made to ensure the success of the treatment. There is a risk that the procedure will not stop the decay, and no guarantee of success. If the tooth decay is not arrested, it may require further dental treatment such as further SDF application, dental fillings, root canal therapy, or extraction.


The best way to prevent cavities is to brush twice a day for two minutes, limit between-meal snacking, and limiting or avoiding sugary treats and beverages.

Even baby teeth, despite the fact they eventually fall out, must be fixed to prevent pain and facial swelling or infection. Remember that baby teeth are much smaller than adult teeth, and cavities quickly get to the nerve and cause pain and infection. Delaying treatment for a cavity may result in the need for pulp therapy or an extraction.

If we do find your child has a cavity, silver diamine fluoride is a safe, effective children’s fluoride treatment that can help treat and prevent further tooth decay and help your child maintain a healthy smile for life.

If it has been more than six months since your child’s last dental visit, or if you think your child may have a cavity, please call us at (510) 521-KIDS to schedule an appointment with one of our friendly pediatric dentists.

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