Copyright 2000 Alliance of Dental Hygiene Practitioners. All rights reserved.
The Silver Bullet - Silver Diamine Fluoride
Use in Older Adults and Children
“Annual application of silver
diamine fluoride prevented
many more carious lesions
fluoride varnish in both children
and the elderly.” pg 19.
Consider silver diamine fluoride for patients who are at an
extreme risk for caries with limited access to care and in
Silver diamine fluoride (SDF), approved in Japan for caries arrest more than
80 years ago, was cleared by the Food and Drug Administration (FDA) in
August of 2014, and has been available to the U.S. market since April 2015,
with approved CDT code:
SDF is described as a new, old approach to dental caries because early
literature (1907) reports G.V. Black, the Father of Modern Dentistry, once
gave protocol for silver nitrate solution on multiple caries arrest in children
and root surfaces in adults. (2) Both fluoride and silver ions contribute to
mechanism of action. The silver acts as an anti-microbial agent killing
bacteria and preventing the formation of new biofilm, while the fluoride acts
to prevent further demineralization.
Today, SDF is labeled a topically applied, inexpensive, non-invasive
medicament that is only available in the U.S. from Elevate. The University of
California, San Francisco, School of Dentistry provides practitioners with
guidelines for clinical application and informed consent sample. Read more
and download your copy now.
1. Horst J., Ellenikiotis H., & Milgram P., (2016). UCSF protocol for caries arrest using silver diamine
fluoride: Rational, indications and consent. California Dental Association Journal, 44 (1). Retrieved
2. Chiang H., Goolsby S., Chiangt, S., & Moon P., (2015). Silver diamine fluoride: A new weapon for
caries arrest is now FDA approved in US. Virginia Dental Journal, 92 (3). Retrieved from