Stopping Cavities: Silver Diamine Fluoride (SDF)

Silver Diamine Fluoride, or SDF, is a liquid medicine applied directly to a tooth to stop a cavity from growing without any drilling or numbing. It is a painless, fast, and highly conservative treatment option that combines silver to kill bacteria with fluoride to strengthen the remaining tooth structure. While it is an excellent tool for young children, anxious patients, or older adults, it does permanently turn the decayed area of the tooth black. This treatment makes sense for early cavities in between teeth and in areas that are not visible when speaking, smiling, or laughing. 

Quick Summary

SDF offers a quick, needle-free, drill-free alternative to traditional dental fillings for managing active tooth decay.

• No Drilling Needed: The liquid is simply painted onto the cavity with a small brush.

• Instantly Stops Decay: Silver ions kill the active bacteria causing the infection.

• Protects Enamel: High concentrations of fluoride help rebuild the surrounding tooth structure.

• Painless Application: Ideal for young pediatric patients or adults with dental anxiety.

What is Silver Diamine Fluoride?

Silver Diamine Fluoride is an FDA-approved liquid medication used to treat active dental cavities conservatively. Traditional fillings require a dentist to drill away decayed tooth structure before placing a restorative material. SDF takes a different approach by chemically freezing the decay in its tracks, making it a valuable tool in pediatric and preventive dentistry.

Definition: Cavity Arrest

The process of stopping a dental cavity from growing deeper or spreading further into the tooth without physically removing the decayed tissue.

How SDF is Applied

The application of Silver Diamine Fluoride is one of the fastest and simplest procedures performed at Lohr Family Dentistry. The process follows these basic steps:

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• Cleaning: The dentist or hygienist gently cleans the tooth and removes loose food particles or debris from the cavity.

• Drying: The targeted tooth is isolated with cotton rolls and dried completely, as saliva can dilute the medicine.

• Application: A tiny drop of SDF is painted directly onto the cavity using a small brush and allowed to soak in for about one minute.

• Curing: The area is gently rinsed or sealed to set the medication, and the patient is finished with no numbing required.

Pros and Cons of SDF Treatment

While SDF is highly effective, it is not the right choice for every cavity or every patient. This comparison matrix highlights what to consider:

Advantages of SDF	Disadvantages of SDF
Requires no needles, numbing, or drilling	Permanently stains the decayed area black
Completed in less than five minutes	Does not restore the original shape of the tooth
Very affordable compared to a traditional filling	Cannot be used if decay has reached the nerve
Helps reduce tooth sensitivity to hot and cold	May require re-application every six to twelve months

Frequently Asked Questions

Why does Silver Diamine Fluoride turn the tooth black?

The silver in the liquid reacts with the bacteria and decayed tissue, oxidizing and changing color just like silver jewelry tarnishes. It is important to know that healthy parts of the tooth will not turn black; only the active cavity turns dark.

Can SDF be used on baby teeth?

Yes, this is one of its most common uses. If a young child has a cavity but is too anxious to sit through a traditional filling, we can use SDF to freeze the cavity until the baby tooth naturally falls out on its own.

Does an SDF treatment mean my child will never need a filling?

Not necessarily. SDF stops the decay, but it leaves a literal hole in the tooth where the cavity was. In some cases, we may place a soft filling material over the black spot later once the child is older or less anxious.

Is SDF safe for patients?

Yes, SDF is exceptionally safe and has been used globally for decades. The only common side effect is the intentional dark staining of the cavity. It should not be used, however, if a patient has a known allergy to silver.

Does the black stain spread to the gums?

If SDF touches the gums, it can leave a temporary dark mark that looks like a small bruise. Unlike the permanent stain on the tooth structure, any marks on the gums or skin are completely harmless and will wash away naturally in a few days.

How do I know if my cavity can be treated with SDF?

SDF works best on small to medium cavities that are caught early. If a cavity has grown deep enough to cause a severe toothache, it means the bacteria have likely reached the nerve, and the tooth will require a crown, root canal, or extraction instead.

Conservative Dental Care in Sioux City

At Lohr Family Dentistry, we believe in using the most conservative methods possible to keep your family's smiles healthy. Silver Diamine Fluoride allows us to provide a gentle, stress-free experience for our youngest pediatric patients and senior community members alike. We are proud to offer this painless tool to help our Siouxland neighbors protect their teeth without the need for unnecessary anxiety or extensive drilling.

By: Dr. Julie Lohr

Last Updated: July 2026

Dr. Julie Lohr is a Sioux City native who earned her Doctor of Dental Surgery from the University of Iowa College of Dentistry in 2008. She serves the community through gentle, comprehensive family dental care and active volunteer work.