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Silver Diamine Fluoride (SDF) is a topical solution that contains fluoride and silver that has been mainly used for caries treatment in younger children in other countries.  The US Food and Drug Administration approved its use in 2016 as a dentin desensitizing agent.  However, practitioners have used SDF as an off-label treatment for caries.

A recent systematic review* showed that an annual application of 38% SDF to root surfaces of older adults decreased the incidence and progression of carious lesions by at least 50%.  This study also revealed that SDF was equal to or more effective in preventing new carious lesions as compared to 5% fluoride varnish and 1% chlorohexidine varnish.

The application of SDF is painless, simple, noninvasive, and inexpensive.  Although more studies are needed, SDF must be considered as an option for prevention and treatment of root caries in adults, especially if self-care is limited and/or regular dental care is not available.  SDF can be purchased under the label of Advantage Arrest, directly from Oral Elevate LLC.

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