Fact Check: How does Silver Diamine Fluoride Work?

Posted on July 24, 2025 in Dental Health

Cavities are never any fun, but it’s critical that they’re treated as soon as possible by a dentist to avoid further decay and damage to surrounding teeth. To treat cavities, dentists have traditionally drilled out the decayed tooth and applied a dental filling. Many people find this an unpleasant experience. But what if a drill and needle weren’t needed? Silver diamine fluoride may be the answer.

What is silver diamine fluoride?

Silver diamine fluoride is a liquid composed of silver, fluoride, and ammonia. The substance is gaining recognition in the dental field for its ability to stop tooth decay and prevent new cavities.

When applied to a decayed tooth, silver diamine fluoride has been shown to reduce the risk of cavities spreading to surrounding teeth. It has also shown to be an effective way to manage root caries in older adults and as a temporary solution for patients who cannot undergo extensive dental procedures, including those with special needs.

While silver diamine fluoride has been used for decades outside of the United States, it was approved more recently by the Food & Drug Administration in 2014 as a treatment for tooth sensitivity. In 2017, the American Academy of Pediatric Dentistry (AAPD) guidelines recommended silver diamine fluoride to treat cavities in children and adolescents.

Today, the liquid is also used off-label to treat other oral health conditions. 

How does silver diamine fluoride work?

One of the best aspects of silver diamine fluoride is that it treats cavities without any pain.

During the procedure, the liquid is carefully applied to the area with tooth decay using a small brush and then allowed to dry completely. Once dry, the treatment is done!

Who is a good candidate for silver diamine fluoride treatment?

Because there are no drills, no needles, and the procedure takes less time than a traditional filling, silver diamine fluoride is especially useful for kids, people with special healthcare needs like cancer patients, and the elderly.

As a newer treatment, silver diamine fluoride may not be available at every dental office. It also may not be the right treatment for everyone. For example, if there is an infection or if the decay is too severe, it can’t be used.

Are there any side effects of silver diamine fluoride?

Once silver diamine fluoride is applied, the decay turns black permanently. If not applied carefully, the surrounding tissue can also temporarily turn black. This may be a deterrent for those who have decay in a highly visible location. However, there is an option to cover these stains with white filling material when the child is older.

Silver diamine fluoride also has a metallic taste, but it goes away quickly after application.

Is silver diamine fluoride different from fluoride varnish or a sealant?

Silver diamine fluoride is different from both fluoride varnish and dental sealants, even though all three are applied in a similar way.

Fluoride varnish is a protective dental treatment designed to help prevent tooth decay and slow its progression. However, research suggests that silver diamine fluoride offers superior cavity protection.

A 2023 study in The International Journal of Clinical Pediatric Dentistry said, “silver diamine fluoride was found to be most effective in preventing dental caries and also it appears to be the most cost-saving fluoride therapy” when compared to fluoride varnish treatment. 

Dental sealants are protective coatings applied to the chewing surfaces of molars and premolars. Once hardened, they create a barrier against cavity-causing bacteria, helping prevent tooth decay. Sealants are generally used as a preventive measure, while silver diamine fluoride can be used for treating active decay. 

Is silver diamine fluoride right for me?

Talk to your dentist if you’re interested in silver diamine fluoride as a treatment for tooth decay. It’s quick, painless, and has a high success rate of stopping decay and preventing new decay from forming.

A follow-up visit is recommended after the first application to ensure the decay has stopped. Additional silver diamine fluoride treatments can be done at the follow-up or during other future visits.

Silver diamine fluoride treatment is often covered by Delta Dental of Iowa plans, subject to some limitations. Be sure to check your benefits to make sure.