One of the greatest benefits of silver diamine fluoride treatment is that it carries very little risks and is generally free of side effects. The most prominent risk is a completely aesthetic one — blackening of the treated teeth. When the silver in SDF is applied to a tooth, it oxidizes and leaves a black stain on the damaged cavity portion of the tooth (it does not stain healthy enamel). It can also temporarily stain any tissue surfaces it contacts (for example, lips or gums).
For gums and tissue in the mouth, the staining is temporary. The cells in these soft tissues shed and are replaced quickly, so stains may persist for a few days up to a couple of weeks. When applied by a skilled dentist, the chances of tissue staining are fairly low.
The blackening is permanent on the teeth, however, which may be enough to deter adults from choosing this form of treatment. For children with baby teeth, however, the stains are effectively temporary because the teeth will fall out on their own. Even so, some parents opt to hide the staining with crowns, which is why some kids have silver teeth.
There is a chance that SDF that comes in contact with oral tissues will cause some irritation, but this is quite mild as well as temporary. It should not be used on patients who have a silver allergy. Other than that, silver diamine fluoride safety is a key part of the treatment’s appeal.