Does silver diamine fluoride (SDF) contain high levels of fluoride?

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Last updated: April 17, 2025View editorial policy

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From the Guidelines

Silver diamine fluoride (SDF) is not considered heavy in fluoride, as it contains approximately 5% fluoride, which is higher than regular toothpaste but not excessive for its intended use. The primary composition of SDF is silver and ammonia compounds, with fluoride serving as one part of its cavity-fighting mechanism 1. The silver component provides antimicrobial properties, while the fluoride helps remineralize tooth structure. According to a 2021 study in Pediatrics, SDF is indicated for the arrest of cavitated caries lesions in primary teeth as part of a comprehensive caries management program 1.

The application method of SDF is topical and targeted, typically a drop, to specific areas with dental caries, and is not meant to be swallowed. This method means that even though the fluoride concentration is higher than in everyday dental products, the total exposure remains low. A study from 2021 notes that evidence-based clinical guidelines from the American Dental Association and the American Academy of Pediatric Dentistry recommend biannual applications of 38% SDF to arrest advanced cavitated lesions on primary teeth 1.

Key points to consider:

  • SDF contains approximately 5% fluoride
  • The primary composition is silver and ammonia compounds
  • SDF is applied topically in small amounts
  • The main side effect is black staining of decayed areas, rather than fluoride toxicity concerns
  • SDF is considered safe when used as directed by dental professionals, as noted in a 2021 study in Pediatrics 1.

From the Research

Composition of Silver Diamine Fluoride

  • Silver diamine fluoride (SDF) is a solution containing silver and fluoride, which forms a complex with ammonia 2.
  • The exact composition of SDF is not explicitly stated in terms of fluoride concentration, but it is known to contain both silver and fluoride ions 3, 4, 2, 5, 6.

Fluoride Content in Silver Diamine Fluoride

  • While the studies do not provide a direct answer to whether silver diamine fluoride is "heavy" in fluoride, they do indicate that SDF contains fluoride and is effective in preventing and arresting dental caries 3, 4, 5, 6.
  • The concentration of fluoride in SDF is not explicitly mentioned in the provided studies, but it is implied that the fluoride content is sufficient to contribute to the prevention and arrest of dental caries 3, 5.

Clinical Applications and Efficacy

  • SDF has been shown to be effective in arresting and preventing dental caries in both primary and permanent teeth 3, 4, 5, 6.
  • The application of SDF is easy, non-invasive, affordable, and safe, making it a valuable tool in caries management 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Prevention of Dental Caries by Silver Diamine Fluoride.

Compendium of continuing education in dentistry (Jamesburg, N.J. : 1995), 2019

Research

Effectiveness of silver diamine fluoride and glass ionomer cement combined with fluoride varnish in arresting dental caries among intellectually disabled individuals: A randomized controlled trial.

Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry, 2021

Research

Evidence-Based Dentistry Update on Silver Diamine Fluoride.

Dental clinics of North America, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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