Silver Diamine Fluoride – Review

Abstract

Dental caries remains one of the most prevalent chronic diseases affecting children worldwide, particularly among high‐risk populations. Silver diamine fluoride (SDF) has emerged as an effective, non‐invasive, and cost‐efficient therapeutic agent for the prevention and arrest of dental caries. SDF is an alkaline solution containing silver, fluoride, and ammonia, each contributing to its unique properties. Silver provides potent antimicrobial action by disrupting bacterial cell membranes, inhibiting metabolic processes, and reducing cariogenic biofilm formation. Fluoride promotes remineralization by forming fluorohydroxyapatite, while ammonia stabilises the solution and maintains its effectiveness. SDF has broad antimicrobial activity against cariogenic bacteria, periodontal pathogens, and fungal species, and also protects both inorganic and organic components of tooth structure. Its clinical application is simple, painless, and particularly beneficial in pediatric patients, individuals with special healthcare needs, and those with limited access to dental care. Despite disadvantages such as black staining of treated lesions and lack of restorative function, its advantages, including safety, affordability, ease of use, and effectiveness in caries arrest, make it an important tool in modern minimally invasive dentistry. This review highlights the composition, mechanism of action, clinical applications, advantages, and limitations, highlighting its significant role in caries management and prevention.