Silver Nitrate

Silver nitrate has been used in dentistry for over one hundred years. In recent years it has been used in the Medical Management of Caries (tooth decay) with great success. The use of Silver Nitrate as an antimicrobial treatment of the infection that causes tooth cavities has been shown to be both effective and well received by thousands of patients over the last several years. The treatment does not arrest all tooth decay, and in such cases, other treatment will be needed, such as a filling, root canal treatment, or tooth extraction.

Description of Procedure: Application of FDA approved Silver Nitrate in very small amounts to appropriate teeth with visible cavities, followed by the immediate application of FDA approved  fluoride varnish over the treated cavity and the remainder of the teeth. One drop of Silver Nitrate will treat approximately 5-8 teeth. The fluoride varnish helps to seal the Silver Nitrate into the cavity so it can destroy the cavity causing bacteria. Fluoride varnish also assists to strengthen tooth enamel and from developing future decay. This treatment may be repeated at 2, 4, 8 and 12 week intervals following the initial application. When the protocol is complete, the dentist will examine the patient and suggest any necessary restorations.


  • Can stop active decay within two weeks.
  • No need for dental anesthetic.
  • Preventative effect for all other teeth.
  • Decrease in overall tooth sensitivity.
  • Acute fluoride exposure versus systemic fluoride exposure.
  • Retention of baby teeth that might otherwise be extracted due to decay. Allows time for the tooth to either fall out on its own and/or the patient to tolerate treatment better at an older age.


  • Silver Nitrate allergy (very rare; not the same as a nickel allergy).
  • Pregnancy - there is no evidence that Silver Nitrate as applied above might be harmful to the developing baby; however, given the lack of information on this topic, we remain conservative.

Possible Side Effects:

  • A cavity treated with Silver Nitrate will turn black over the course of one week. This is a good indication that the infection in the tooth is dying. 
  • If Silver Nitrate is placed on a tooth with a tooth-colored restoration, some discoloration may occur. 
  • Silver Nitrate placed on teeth with early demineralization (white spot) will cause discoloration. 
  • Less effective in oral environments characterized by low saliva and root caries (decay).

This cavity treatment does not eliminate the need for restorations in the future to repair function and aesthetics nor is it 100% guaranteed. Depending on each tooth’s unique situation, additional dental treatment may be required, including with the use of dental anesthetic. 

Do not eat or drink for one hour prior and do not brush your teeth for 24 hours after treatment.

silver nitrate

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Dr. Robert F. Childs, DDS, Inc.


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