Recently, the New York Times highlighted use of silver diamine fluoride (SDF) as an alternative approach to treatment of cavities in children. The article mentioned that SDF was faster and cheaper than removing a cavity and restoring the tooth with a filling.    It also mentioned the downside that when applied, SDF blackens the tooth.

Silver diamine fluoride (SDF) is a colorless liquid that at pH 10 is 24.4% to 28.8% (weight/volume) silver and 5.0% to 5.9% fluoride.  A number of products are currently available in other countries, but at this time, Advantage Arrest™ (Elevate Oral Care, L.L.C.) is the only commercially available SDF product for dental treatment in the U.S. Silver diamine fluoride has FDA approval for tooth hypersensitivity only, not for its treatment in treating cavities. 

SDF received coverage in the Times for its use in treating cavities in children, although this might be more accurately described as caries control and management.   While the Times article focused on the use of SDF in young children, it has also been shown to be effective in management of root caries in the elderly.  It likely has additional applicability as an interim approach for managing problematic caries in individuals currently unable to tolerate more involved dental treatment.

SDF is not a complete solution to caries risk.  A single application has been reported to be insufficient for sustained benefit.  Its downsides include an unpleasant metallic taste, potential to irritate and stain gingival and mucosal surfaces, and the characteristic black staining of the tooth surfaces to which it is applied.  The tooth will still remain unrestored and susceptible to future carious insults.  The oral cavity is not static and can be affected by medications, hormonal changes, diet, bacterial counts, home care, etc.  

Currently, there are more studies underway with SDF. With more scientific insight, more information will become available about potential usages.