Silver Diamine Fluoride: An Option For More Effective Dental Care

Author: Dr. David Dickerhoff, DDS, MAGD, FOCOI

Spring Lake Dental Group is increasing your options for treating active decay, in a way that will give you more ways to practice preventative oral care. It is a liquid material that is used to arrest dental caries and is marketed under the name “Advantage Arrest” from Elevate Oral Care ( The active ingredient in this product is Silver Diamine Fluoride and it is applied to teeth that have active decay. It penetrates only 25 microns into healthy teeth but has the ability to penetrate active decay up to 2 milliliters. As we all know, dental caries is a bacterial infection that produces acids that break up the tooth enamel and dentin structure. This medication kills the active bacteria and arrests the further development of any additional tooth destruction. It has been cleared by the FDA as a desensitizing agent for adults over 21 years of age but is being used off-label for many different indications. Some being, for young children with rampant decay where you are trying to eliminate further decay, prevent pulpal death or where behavioral considerations make traditional dentistry difficult. It is also useful in patients with very complex prosthetic dentistry such as, crowns and bridges with active decay around margins of the restoration and you have elected not to replace or re-do the restoration.

It seems like an amazing product and I am sure you are asking why it has not become more widespread in its use. Well, with any material, there is always an upside and a downside. The downside of this product is that the stained active decay picks up a dark brown to black hue once treated. This unaesthetic staining can be a large detractor to patients acceptance to its use. But as with all treatment planning in dentistry, having an informed conversation with your dentist and hygienist can help you to understand the risks and benefits of using this material. For that child that presents with multiple large carious lesions throughout his or her mouth, using this product in a well thought out program of preventative care, it can be an invaluable tool. Plus, for that elderly veteran living on a fixed income, redoing his complex prosthetic work may be an undo strain on his family budget.

We have incorporated this technology into our program of preventative dentistry so that our patients can potentially benefit. At your next visit, please speak with your dentist or hygienist about this product and see if you or your family could benefit from its cavity arresting ability.