Let’s Talk Silver Diamine Fluoride or SDF with Dr. Krista Kunz of Magnolia Pediatric Dentistry in Mount Pleasant, SC

Silver diamine fluoride (SDF) is a minimally invasive way to treat cavities and is easily the biggest innovation for pediatric dentistry in the US in decades. It’s been used in other countries in Europe, Japan, Australia, etc., for a long time. The FDA approved it for use in 2014, and it became commercially available in 2015. SDF is a new treatment to option for the medical management of cavities.

Cavities are caused by bacteria (S. mutans) in the mouth. The bacteria feed on simple carbohydrates and release acids that eat away at teeth. Brushing and flossing help clean away the bacteria and prevent them from causing decay to your teeth. Silver diamine fluoride can stop current decay, harden the soft areas of the tooth, desensitize the tooth, and help prevent further decay.

Traditionally, when a dentist finds a cavity, they treat it surgically by placing a filling. SDF is a new way of treating these cavities medicinally AND in a minimally invasive way. The American Dental Association now says that non-restorative treatment options for cavities are the standard of care.

The product I use is Advantage Arrest by Elevate Oral Care. It is 38% silver diamine fluoride. It’s a clear blue liquid the consistency of water. It only takes a drop to treat multiple teeth. I clean the teeth, dry them with air or wipe them dry with gauze, then apply the SDF with a microbrush to the cavity. I also like to apply a fluoride varnish over the SDF to seal it off from the oral cavity and to disguise the taste.

Pros of SDF:

  • Easy, painless, and fast
  • No need for local anesthetic (shots)
  • Affordable
  • Very safeà very low toxicity
  • Desensitizes teeth
  • Stops cavities from progressing and prevents future cavities from forming
  • Alternative to sedations or general anesthesia


  • Metallic taste
  • May require multiple applications
  • Permanently stains the decayed part of the tooth black
  • May require a traditional filling or a SMART filling to restore the form and function of a tooth or to cover the black staining
  • Cannot be used if there is an infection in the nerve of the tooth

While I love using SDF, it is not a “silver bullet” for every cavity and every tooth. Please call me and ask for a consultation. I would love to evaluate your child and see if he/she is a good candidate for this exciting and innovative alternative to traditional dental treatment. 843-996-6796

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