Scientists Discover Non-Invasive Way to Treat Childhood Cavities Without Drilling or Anaesthesia

A simple liquid applied directly to cavities could help stop tooth decay in young children without drilling, injections or anaesthesia. A new clinical trial has found that silver diamine fluoride (SDF), an inexpensive dental treatment, can prevent existing cavities from worsening, potentially reducing the need for invasive dental procedures.

Published in the journal JAMA Pediatrics, the Phase III clinical trial led by researchers at the University of Michigan evaluated the safety and effectiveness of silver diamine fluoride in treating tooth decay among young children.

The study included 830 children younger than six years, recruited from dental clinics, paediatric practices and early childhood programmes across Michigan, New York and Iowa.

Researchers investigated a solution containing 38% silver diamine fluoride, which dentists applied directly to affected teeth using a small applicator. The treatment requires only seconds per tooth and does not involve drilling or injections.

The findings revealed that SDF successfully stopped the progression of tooth decay in more than half of the affected baby teeth when applied at six-month intervals.

The treatment works through the combined actions of silver and fluoride. Silver helps fight bacteria responsible for tooth decay, while fluoride strengthens tooth minerals and protects against further damage.

Importantly, the procedure offers a potentially useful option for young children who may struggle with conventional dental treatments because of fear, discomfort or difficulty remaining still.

However, researchers highlighted one significant drawback: SDF permanently darkens the decayed portion of the treated tooth, which may raise cosmetic concerns.

Additionally, the treatment does not restore damaged tooth structure and may not eliminate the need for future dental procedures.

Although SDF has been used internationally for decades, its use for stopping cavities remains off-label in the United States, where it was initially cleared for treating tooth sensitivity.

Researchers believe the findings could support broader regulatory approval and improve access to affordable dental care.

REFERENCE: Margherita Fontana, et al.; Efficacy of Silver Diamine Fluoride on Young Children With Severe Early Childhood Caries. JAMA Pediatrics, 2026; 180 (9): 942 DOI: 10.1001/jamapediatrics.2026.2567