Integrated & Community Services - Silver Diamine Fluoride (SDF) liquid treatment

Why have I been given this leaflet?

There is dental decay present and affecting the patient’s teeth. Your dentist thinks that Silver Diamine Fluoride (SDF) liquid is a treatment option to treat the decay.

What is SDF liquid?

SDF liquid contains silver and fluoride which work together to stop decay progressing further. It is a clear liquid, that has a temporary metallic taste while it is being painted on to teeth.

Why is SDF liquid recommended?

Tooth decay can progress rapidly, especially in baby teeth which have thinner enamel than adult teeth. By applying SDF liquid, your dentist can stop decay progressing which reduces the risk of toothache or infection. SDF liquid combined with improved oral hygiene and a change in diet can save teeth.

What is involved in the treatment?

To protect lips and gums, your dentist will first apply petroleum jelly (or an alternative) and also place cotton wool next to the teeth. The teeth will then be dried.

The SDF liquid is painted on to the teeth for 1-3 minutes. Following this the teeth are dried a second time. Sometimes, the dentist may then place a filling over the top.

This is all done in one appointment. A second appointment may be made to comeback 2-4 weeks later to check the teeth and apply more SDF liquid if needed.

SDF liquid is usually reapplied every 6 months.

Before treatment

After treatment

How should I prepare for the visit?

There are no special preparations required. However, SDF cannot be used if:

• Allergic to silver or another heavy metal, or another component of SDF
• Painful gums, ulcers or sores are present in the mouth
• Pregnant or breastfeeding
• Please tell the dentist if you think that any of the above apply

What are the advantages of SDF liquid?

• It is a simple procedure that reduces sensitivity and slows down or stops tooth decay
• In many instances SDF is more effective than fluoride varnish
• It can buy time for patients who cannot currently manage dental treatment by stopping the decay getting worse

What are the disadvantages of SDF liquid?

• It can temporarily stain the skin, lips, gums and cheeks, brown or white for 1-3 weeks, this will then disappear
• It can also discolour tooth-coloured fillings. Polishing these fillings can help remove this stain but it may stay visible at the join between the tooth and the filling
• In the unlikely event of SDF being accidentally spilled on clothes, it can leave a stain that does not come out
• It permanently discolours the decayed area of teeth black. Healthy parts of the tooth do not discolour

What are the alternatives?

• Keeping the tooth under review, but it is likely the decay will get worse
• Placing fluoride varnish
• Filling the tooth
• Placing a silver cap/crown
• Removing the tooth

Please discuss with your dentist which options are best.

You may be asked to sign a written consent form, giving your consent to have SDF liquid applied to affected teeth. This will be after your dentist has discussed the risks and benefits of all the options available.

If you have questions about the treatment, please ask your dentist either at your next appointment or over the phone.

What else do I need to know?

SDF is fully licensed in many countries around the world where it has been safely used for many years.

In the UK it is licensed for treating sensitivity only and has not been widely used until recently. It can be used for decay ‘off- label’ and is being more widely recommended.

If the SDF does not stop the decay progressing, other treatments may be required such as fillings or tooth removal.

It is vital to maintain good tooth brushing habits and to keep sugary sweets and drinks to mealtimes to stop decay getting worse or developing in other teeth.

If you have any questions, please ask your dentist or dental team.

Contact information

Pendleton Gateway
1 Broadwalk, Salford, M6 5FX Tel: 0161 206 1513

Eccles Gateway
28 Barton Lane, Eccles, M30 OUT Tel: 0161 206 1699

Walkden Gateway
2 Smith Street, Worsley, M28 3EZ Tel: 0161 206 1634

Further information

For fun videos for children: www.bspd.co.uk/Kidsvids
For advice on tooth brushing and diet:
www.bspd.co.ukPatients
www.dentalhealth.org/childrens-teeth
www.nhs.uk/live-well/healthy-body/taking-care-of-childrens-teeth/
For a music-based app to make brushing fun: www.brushdj.com