You’re at the dentist when the bad-news bomb drops. Your child has a cavity on a permanent tooth. What now? Some dentists may opt to use silver diamine fluoride (SDF) to treat it, but is it right for your child? The pediatric dentists at Swauger Pediatric Dentistry (Swauger) shared with us about the topic.

The Use of SDF

Swauger says the American Academy of Pediatric Dentistry (AAPD) may consider SDF in patients younger than 3 years old, patients with special health-care needs and patients with multiple active cavities needing treatment. SDF is most effective at stopping cavity progression on the top, front teeth rather than the biting surfaces of back teeth. However, it’s one of several techniques that can slow cavity progression. Discuss all options with your dentist to determine the best approach for your child. However, if SDF is the chosen method to treat the cavity, know the side effects.

Side Effects of SDF

The most significant side effect is the black stain left on treated teeth Swauger reports. Anywhere decay is present on the tooth, a black stain will be present. Studies have shown that staining lightens with time, but it actually darkens as decay is stopped. You can opt for a filling to be placed over the stain after some time, but this depends on several factors such as patient behavior and diet. Other side effects are a bitter/metallic taste; temporary staining of the skin or gums (resolves in two to 14 days) and a decrease in sensitivity for most patients. Know that one application is not always enough.

Because of staining, Swauger says SDF is not recommended unless the parent and child (depending on age) have seen pictures of the stains left on treated teeth. If you have aesthetic concerns about staining, then it’s best to employ other treatment options. “At this time there’s not sufficient clinical research for the AAPD to support use of SDF in permanent teeth,” says Swauger. “Desensitizing permanent teeth in children can be accomplished through other AAPD-approved methods such as topical fluoride application or covering sensitive enamel with a filling.”