Silver Diamine Fluoride Treatment (SDF)

Silver Diamine Fluoride, SDF, is an alternative treatment for tooth decay under certain conditions. Treatment of children’s deciduous (primary or “baby”) and permanent (“adult”) teeth with silver diamine fluoride is a rather new strategy provided by pediatric dentist Dr. Babich located on Manhattan’s Upper East Side aimed at preventing tooth decay (dental caries) and at arresting existing tooth decay.

What Is Tooth Decay?

Tooth decay is a bacterial infection, in which bacteria of the oral cavity, the main culprit is Streptococcus mutans, metabolize dietary sugars to sticky polymers that allow them to adhere within a biofilm to the tooth surface. In addition, bacterial metabolism of dietary sugars forms acidic end-products that demineralize (i.e., soften) the enamel, the hard tooth outer surface.

If left unchecked, the bacterial infection will advance, burrowing deeper into the tooth structure, first into the dentin and thereafter to the pulp, which houses nerve endings and blood vessels. Recognizing that tooth decay is a bacterial disease, the strategy behind topical application of silver diamine fluoride to tooth surfaces is to inhibit bacterial growth in existing areas of decay and to prevent the occurrence of areas new decay.

Read more on how to prevent tooth decay and about an association between lead poisoning and tooth decay.

What Is Silver Diamine Fluoride (SDF)?

The Food and Drug Administration has designated silver diamine fluoride with Breakthrough Therapy Status, which is the Agency’s designation of a process designed to expedite the development and review of medications that are intended to treat a serious medical condition.

Dental caries fits this criterion – childhood caries is a worldwide public health problem with untreated decay in deciduous teeth being the tenth most prevalent health risk and with untreated dental caries in permanent teeth being the most common.

Silver diamine fluoride provides a triple “punch” to promote oral health.

• Fluoride is a proven preventative against tooth decay. Fluoridation of community waters and the usage of fluoride-containing toothpastes are widely accepted strategies against dental caries. Minerals of tooth enamel are in flux, with demineralization and remineralization being competing processes.
  • Demineralization, occurring by acids formed through bacterial metabolism of dietary sugars, leads to the softening of the outer tooth surface.
  • Remineralization, occurring when minerals such as fluoride, calcium, and phosphate are redeposited into the enamel, serves to harden the tooth surface. Fluoride curtails dental caries by making the outer tooth surface more resistant to acid released from plague-forming bacteria.
• Silver is a strong antibacterial metal, exhibiting “oligodynamic” properties, i.e., low concentrations of this metal are biocidal. Silver ions immediately kill bacteria upon contact. Furthermore, the silver ions remain embedded in demineralized tooth structures, serving both to harden the tooth and to provide antibacterial properties to prevent reinvasion by bacteria of dental decay.
• Diamine is the source of ammonia, which stabilizes the solution and which acts as an antiseptic to kill harmful oral bacteria.

How Silver Diamine Fluoride Is Applied?

Topical application of silver diamine fluoride is a rather simple, noninvasive process. Using a microbrush, it may be used to curtail a current infection and thereby applied directly to the area of dental decay or to prevent an infection and applied to newly emerged, high-risk surfaces, such as first molars.

What Are the Side Effects of SDF?

The only known side effect of silver diamine fluoride is a black staining of the area of dental decay.

The blackening is due to the tarnishing of silver and, interestingly, is used as an indicator of the effectiveness of the treatment. Black staining indicates that the treatment was successful and that the bacterial infection was halted.

Effectiveness of Silver Diamine Fluoride

Silver Diamine Fluoride has been proven to be a very useful tool in arresting dental caries in patients with special needs. It clearly is not for everyone and every condition. You may not want to have this applied for esthetic reasons. Also if there is decay extending into the pulp or if too much tooth structure is gone because of decay or trauma, SDF would not be the dental treatment of choice.

In summary, SDF is a very valuable in the overall armamentarium of the pediatric dentist Dr. Babich. It is very important to trust your pediatric dentist to make the right choice.

Alternative Treatments To Silver Diamine Fluoride

Of course, silver diamine fluoride is just one treatment available to help fight tooth decay. Other options include:

• Fluoride treatments designed to strengthen children’s teeth. Fluoride varnish is highly effective and is another quick and non-invasive treatment that is completely painless. The fluoride varnish is painted onto newly cleaned teeth and will gradually sink into the tooth enamel over several hours or even overnight. Although the varnish can make teeth appear slightly yellowish, they will look perfectly normal after the varnish is removed during tooth brushing.
• Dental sealants which can be applied to a child’s back teeth and which are designed to protect their chewing surfaces. Usually, dental sealants are applied to a child’s newly erupted adult back teeth, but they can sometimes be used to protect children’s primary teeth, especially when a child is more prone to tooth decay.

Perhaps the most critical ongoing treatments are regular tooth brushing and flossing and visits to the pediatric dentist and hygienist. You’ll find your child’s dentist Dr. Babich is extremely helpful when it comes to dental education because she can provide practical advice on brushing and flossing which could make all the difference to your kid’s dental health.

Regular hygiene appointments are also crucial for removing the buildup of plaque and calculus from your child’s teeth, helping to ensure their teeth and their gums stay strong and healthy.

Do you have any questions about the Silver Diamine Fluoride (SDF) Treatment for kids and teens we offer in NYC? Would you like to schedule an appointment with the best in class New York City pediatric dentist and a top Silver Diamine Fluoride specialist Dr. Sara Babich? Please call our office at 212-988-4070 or visit our kids dentistry NYC center on Upper East Side.

Pediatric Dentistry: Dr. Sara B. Babich, DDS
116 E 84th St
New York, NY 10028
(84th St. btw Park Ave / Lex Ave)
☎ 212-988-4070

Contact us today to learn more about our
New York City pediatric dentistry practice 212.988.4070