A low-cost liquid treatment could reshape how pediatric dentists tackle cavities, according to a University of Michigan study that found silver diamine fluoride (SDF) halted decay in more than half of treated baby teeth without the need for drills, shots, or sedation.
The Phase III trial, launched in 2018 and involving 830 children under age 6 across three states, showed that when applied every six months, SDF stopped cavities in 38% of children's affected baby teeth. Participants were recruited from dental offices, pediatric medical practices, and Head Start programs.
“This is a very effective and safe treatment — even in children as young as 1,” said Dr. Margherita Fontana, the study's lead investigator from the University of Michigan. Ultra-processed toddler foods have been linked to rising childhood health issues, making accessible dental interventions like SDF even more critical.
Tooth decay remains the most common chronic disease among children, affecting over 40% of kids in the U.S. alone. Left untreated, cavities can lead to infections, severe pain, and repeated medical visits, often requiring costly procedures.
What Is Silver Diamine Fluoride?
SDF is a liquid painted onto cavities using a sponge-tipped applicator. It prevents or slows decay without drilling or injections. While the U.S. Food and Drug Administration has approved SDF for tooth sensitivity, it is used off-label for cavity treatment due to a lack of clinical trials. The treatment has been used successfully for decades in many other countries.
Dr. Amr Moursi of New York University said the study results support FDA approval of SDF for managing tooth decay in young children. “Removing SDF from off-label status would be an important innovation which could lead to increased utilization by providers, enhanced payments by insurers and more consistent product quality,” he noted.
Cost and Accessibility
According to the Dental Clinics of Texas, SDF treatments typically range from $20 to $75 per application. The clinic confirms the treatment is safe for cavities. Fontana emphasized that for children, SDF can control decay until the baby tooth falls out naturally, while for adults it can serve as a long-term solution.
“For almost anyone, this can arrest the decay and stop the infection and the pain it causes,” Fontana said. “This could benefit many people.”
The findings come as broader debates over healthcare access and costs intensify. Social Security deficit reduction proposals and immigration's impact on rural workforces highlight the economic pressures on families, making affordable dental care a policy priority.
If approved by the FDA, SDF could dramatically reduce the need for drilling and sedation in pediatric dentistry, cutting both costs and anxiety for millions of families.
