Parental Expressed Concerns about Silver Diamine Fluoride (SDF) Treatment

J Clin Pediatr Dent. 2019;43(3):155-160. doi: 10.17796/1053-4625-43.3.2. Epub 2019 Apr 9.


Background: The staining associated with its caries arrest may be a deterrent for the use of Silver Diamine Fluoride (SDF). This study aims to elucidate the concerns that inform parents' perceptions and acceptance of SDF as a treatment option for their child. Study Design: We analyzed qualitative data obtained through an investigation in which parents attending a pediatric dental appointment participated in a survey, which included an open-ended question to evaluate their opinions about SDF staining. Thematic analysis of the comments, offered by the subsample of participants who replied to this question (n=43), yielded insights about perception of SDF therapy. Results: Most parents who provided comments were mothers (83.7%), college graduates (72.1%), primarily white (48.8%) or Hispanic (27.9%). Six themes emerged from the thematic analysis of the parents' responses: Esthetic Concerns, Psychosocial Concerns, SDF Treatment Process, Risks and Side Effects, Situational Benefits, and Dental Treatment Process. While many of the parents' comments are related to appearance, other topics that merit consideration when discussing SDF treatment were mentioned. Conclusions: Although parents are concerned about the esthetic impact of SDF, they understand the risks of alternative treatments and welcome information that will allow them to make an informed decision. Location of the cavities and visibility of the staining appear to heavily influence the decision to accept or reject this therapy.

Keywords: Esthetics; Silver Diamine Fluoride.

MeSH terms

  • Cariostatic Agents*
  • Child
  • Dental Care for Children* / psychology
  • Esthetics, Dental* / psychology
  • Female
  • Fluorides, Topical
  • Humans
  • Male
  • Patient Acceptance of Health Care* / psychology
  • Quaternary Ammonium Compounds
  • Silver Compounds


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