European Archives of Paediatric Dentistry

, Volume 19, Issue 4, pp 221–227 | Cite as

A silver renaissance in dentistry

  • S. HuEmail author
  • B. Meyer
  • M. Duggal
Invited Review



Recently, there has been interest in biological approaches for caries management, with techniques such as interim therapeutic restorations and Hall technique crowns showing comparative effectiveness against conventional restorative methods. One of these approaches is the use of silver diamine fluoride (SDF) as a restorative option. In this invited review, the aim was to critically appraise the currently available literature with regards to the indication, technique and outcome of SDF.


A review of the literature on SDF with a focus on its use in the primary dentition was conducted.


There has been a recent explosion in the literature regarding the use of SDF, from in vitro studies on the mechanism to clinical studies on the effectiveness and patient acceptance of the technique. A systematic review in 2016 concluded that SDF application resulted in caries arrest in 81% of active lesions in primary teeth over 30 months. Additionally, over 60% of parents reported being satisfied with the aesthetic outcome with most children finding the procedure to be acceptable, comfortable and relatively pain-free.


Silver diamine fluoride is a safe and effective alternative technique to caries management in the paediatric population. Given the ongoing worldwide debate on cost-effectiveness of biological approaches coupled with the increasing concerns and limited accessibility of treatment under general analgesia, SDF should form an important addition to every dentist’s armamentarium.


Review Dental caries Early childhood caries Silver Minimally invasive dentistry 


Author contributions

SH, BM and MD conceived the idea; SH led the writing, BM and MD revised the manuscript for important intellectual content.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest. All authors have made substantive contribution to this study and/or manuscript, and all have reviewed the final paper prior to its submission.


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Copyright information

© European Academy of Paediatric Dentistry 2018

Authors and Affiliations

  1. 1.Discipline of Orthodontics and Paediatric Dentistry, Faculty of DentistryNational University of SingaporeSingaporeRepublic of Singapore
  2. 2.Department of Pediatric Dentistry, School of DentistryUniversity of North CarolinaChapel HillUSA

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