CSL 8 SDF (medium)

Study Notes

SDF is a colourless fluoride delivery solution containing approximately 44,800 ppm fluoride and 255,000 ppm silver.
SDF effectively arrests active dentinal carious lesions.
The remnant ionic silver inhibits further biofilm formation and renders the treated dentin more resistant to cariogenic bacteria, thereby preventing further cavity formation.
SDF's antimicrobial properties are primarily due to silver and its remineralisation effects via fluoride.
SDF is applied topically to the affected area.
SDF is economically priced and non-invasive.
SDF discolours the affected area black.

Primary teeth with areas of active cavitated dentinal lesions (Frank soft carious lesions in dentin) and no signs or symptoms of pulp involvement.
Children with limited cooperation due to age or disabilities where conventional operative dentistry is challenging.
Deep active carious lesions (where the clinician wants to scrub the lesion to arrest its progress before restoring it with an intra/extra-coronal restoration).
Inaccessible proximal lesions requiring extensive tooth preparation for restoration.
Multi-surface dentinal lesions or difficult-to-treat cavitated carious lesions.
Lower anterior primary teeth where the longevity of the restoration is questionable.
In children with restricted dental access, SDF is the preferred treatment choice.

Increased resistance to acid dissolution and enzymatic degradation through silver protein conjugate formation.
Increased mineral density and hardness through hydroxyapatite and fluorapatite formation.
Anti-protease activity preventing the breakdown of the dentinal organic matrix
Direct antibacterial action killing cariogenic bacteria.
SDF-treated lesions become more resistant to biofilm formation.

One drop of SDF is sufficient to treat roughly 6 teeth.
Isolation with cotton rolls is adequate.
Remove any loose debris prior to application.
Air-dry the lesion, applying SDF and scrubbing for a minute, then gently drying the area.
Isolate the application site for up to 3 minutes post-application.
Application of fluoride varnish after SDF can mask the taste and keep SDF in contact with the lesion for 30 minutes.
Post treatment, patients should avoid eating or drinking for 30 minutes.