A Painted Liquid Can Stop Tooth Decay in Children Without Drilling

A Phase III clinical trial led by the University of Michigan School of Dentistry and published in JAMA Pediatrics has provided rigorous evidence that a 38% silver diamine fluoride (SDF) solution can effectively stop cavities in young children without any invasive procedures. The study enrolled 830 children under age six across Michigan, New York, and Iowa and was funded by the National Institute of Dental and Craniofacial Research with more than $12 million. Applied at six-month intervals using a tiny sponge-tipped applicator, the liquid arrested decay in more than half of treated baby teeth. The silver in the solution helps combat bacteria associated with tooth decay, while fluoride strengthens the mineral structure of teeth against further damage. The only significant drawback is cosmetic: treated decayed areas permanently darken, which may be noticeable on front teeth but carries no health risk. Tooth decay affects over 40% of American children, and thousands visit emergency departments annually for untreated cavities. The trial results are expected to support an FDA approval pathway that could allow the treatment to be used in pediatric medical settings, not just dental offices, enabling broader implementation across the United States.