Dental caries is among the most-common childhood diseases around the world, and neglected caries can result in pain, infection, and can have a negative cascading impact on a child’s overall well-being. Definitive care of these lesions involves restorative procedures and/or extractions, but these treatment options require some level of child cooperation, which can sometimes be a challenge with very young children.

Silver diamine fluoride (SDF) is a non-invasive treatment intended to arrest the caries process. SDF is a liquid solution that contains a high concentration of silver and fluoride ions and has been used as an alternative agent for treating caries, showing effectiveness in arresting caries lesions in primary teeth and reducing the incidence of dental emergencies in childhood. This paper describes the mechanism of action of SDF; considerations and evidence for use; indications and contra-indications including safety considerations; side-effects and adverse events; and describes the sequence of treatment in four clinical cases.