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Let’s Talk Silver Diamine Fluoride or SDF with Dr. Adena Borodkin of Golden Valley Kids Pediatric Dentistry in Golden Valley, MN

Silver diamine fluoride (SDF) is a minimally invasive way to treat small cavities and is easily the biggest innovation for pediatric dentistry in the US in decades. It has been used in other countries in Europe, Japan, Australia, etc., for a long time. The FDA approved it for use in 2014, and it became commercially available in 2015. SDF is a new treatment option for the medical management of smaller cavities.

Cavities are caused by bacteria (S. mutans) in the mouth. The bacteria feed on simple carbohydrates and release acids that eat away at teeth. Brushing and flossing help clean away the bacteria and prevent them from causing decay in your teeth. Silver diamine fluoride can stop current decay, harden the soft areas of the tooth, desensitize the tooth, and help prevent further decay.

Traditionally, when a dentist finds a cavity, they treat it surgically by removing the decayed area and placing a filling. SDF is a new way of treating these cavities medicinally AND in a minimally invasive way. The American Dental Association now says that non-restorative treatment options for cavities are the standard of care. SDF uses a high concentration of fluoride and the antimicrobial properties of silver to arrest decay.

Pros of SDF:

  • Easy, painless, and fast
  • No need for local anesthetic (shots)
  • Affordable
  • Very safe → very low toxicity
  • Desensitizes teeth
  • Stops cavities from progressing and prevents future cavities from forming
  • Alternative to sedations or general anesthesia


  • Metallic taste
  • Requires multiple applications
  • Permanently stains the decayed part of the tooth black
  • May require a traditional filling at a later date to restore the form and function of a tooth or to cover the black staining
  • Cannot be used if there is a deep cavity or an infection in the nerve of the tooth

While I love using SDF, it is not a “silver bullet” for every cavity and every tooth. Additionally, the research is still being completed on its effectiveness in arresting cavities. This is still an “off label” use for SDF, since it was originally developed for tooth hypersensitivity. Please call me and ask for a consultation. I would love to evaluate your child and see if he/she is a good candidate for this exciting and innovative alternative to traditional dental treatment. 763-222-1299.