Evidence-Based Dentistry Update on Silver Diamine Fluoride

Dent Clin North Am. 2019 Jan;63(1):45-68. doi: 10.1016/j.cden.2018.08.011.


This article reviews current evidence on the effectiveness of silver diamine fluoride (SDF) as a caries arresting and preventive agent. It provides clinical recommendations around SDF's appropriate use as part of a comprehensive caries management program. Systematic reviews confirm that SDF is effective for caries arrest on cavitated lesions in primary teeth and root caries in the elderly. It may also prevent new lesions. Application is easy, noninvasive, affordable, and safe. Although it stains the lesions dark as it arrests them, it provides clinicians with an additional tool for caries management when esthetics are not a primary concern.

Keywords: Caries arrest; Caries management; Dental caries; Pediatric dentistry; Silver diamine fluoride.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Cariostatic Agents / therapeutic use*
  • Child
  • Dental Caries / prevention & control*
  • Evidence-Based Dentistry*
  • Fluorides, Topical / adverse effects
  • Fluorides, Topical / therapeutic use
  • Humans
  • Patient Satisfaction
  • Pediatric Dentistry
  • Quaternary Ammonium Compounds / adverse effects
  • Quaternary Ammonium Compounds / therapeutic use*
  • Root Caries / prevention & control
  • Silver Compounds / adverse effects
  • Silver Compounds / therapeutic use*
  • Tooth Remineralization
  • Tooth, Deciduous


  • Anti-Bacterial Agents
  • Cariostatic Agents
  • Fluorides, Topical
  • Quaternary Ammonium Compounds
  • Silver Compounds
  • silver diamine fluoride