Discussing silver diamine fluoride with patients/caregivers
Have consent discussion with patient/guardian 
- Take extra care with consent for potential SDF treatment in cosmetic areas
- Showing photographs are paramount
- Consent forms are available in multiple languages
- Consent forms can be modified for non-dental medical professional users
Risks:
- Dark stain to cavities
- Three day to two week brown stain if applied to skin
- One to two day light or dark stain if applied to gums
- Strong metallic taste for 2-15 minutes
- Cavities treated with SDF twice per year in clinical trials have increased risk of abscess (5%) or irreversible pulpitis (8%) compared to dental fillings (3%)
Benefits:
- Most efficient treatment for cavities
- Most effective disease control for cavities
- Dental fillings are usually simpler and less painful after SDF treatment
 Alternatives:
- Dental fillings or other dental treatment
- No cavity treatment
References:
Slayton, R. L., et al. (2018). Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: A report from the American Dental Association. J Am Dent Assoc.149(10):837-849.e19. doi:10.1016/j.adaj.2018.07.002.
Owais, A., et al., (2018). Silver Diamine Fluoride Chemical Mechanisms of Action as a Caries Arresting and Preventing Agent. Journal of the California Dental Association, 46:2, 113-120. doi: 10.1080/19424396.2018.12221992
Cleary, J., et al., (2022). A 12-Month Randomized Clinical Trial of 38% SDF vs. Restorative Treatment. JDR Clin Trans Res. 2022 Apr;7(2):135-144. doi: 10.1177/23800844211072741. Epub 2022 Feb 4.