June 2020

Introduction: Silver diamine fluoride (SDF) is used to prevent and arrest caries across the globe, particularly in the developing world. Whilst its use in the Western World is increasing, it is not yet routinely used in the United Kingdom, nor is it advocated by our national guidelines. Objectives: To explore the literature surrounding the use of SDF, and consider the reasons why SDF has not yet been widely adopted in the United Kingdom (UK). Discussion: There is a growing evidence base for the use of SDF for the arrest and prevention of dental caries in the primary and permanent dentition. Potential side effects include staining of carious tooth structure, but in some cases this is acceptable to parents. There is no evidence for the cost effectiveness of SDF, although it may be a reasonably cost-effective option. Conclusion: SDF is perhaps not yet widely adopted in the UK due to a perceived parental concern about its staining effect. With a growing evidence base and reportedly higher efficacy than fluoride varnish for caries prevention and arrest, SDF has the potential to play an important role in managing dental disease in children and young people in both primary and secondary care. Keywords: paediatric dentistry, caries, silver diamine fluoride