Silver Diamine Fluoride: Caries Arrest And Aesthetic Smile Rehabilitation

Silver diamine fluoride (SDF), a minimally invasive topical agent, has gained recognition for its capacity to arrest dental caries. Emerging evidence supports SDF’s role in bridging preventive and restorative dentistry, aligning with the global shift toward minimally invasive, patient-centered care. A 34-year-old male with a high caries risk index—exacerbated by chronic tobacco use and drug addiction—presented with multiple active cavitated lesions across anterior and posterior teeth, seeking a comprehensive smile rehabilitation to regain employability and psychosocial confidence. Given his complex medical history and limited initial capacity for extensive restorative care, silver diamine fluoride (SDF) was prioritized as a first-line therapy to arrest caries progression. Over three monthly applications, SDF’s antimicrobial and remineralizing properties stabilized lesions. Interim glass ionomer restorations were placed in esthetically sensitive zones to restore function while managing aesthetic compromises. Following six months of caries arrest, smoking cessation support, and improved oral hygiene compliance, definitive composite veneers were fabricated for anterior teeth. This phased approach not only halted disease progression but transitioned the patient from urgent biological stabilization to life-changing aesthetic renewal, culminating in restored dental function, a harmonious smile, and renewed self-efficacy, enabling his successful reentry into the workforce. This case exemplifies the transformative potential of silver diamine fluoride (SDF) within minimally invasive dentistry (MID) frameworks, particularly for high-risk patients. The phased protocol prioritized disease control before aesthetic rehabilitation, aligning with MID’s core tenets of preserving tooth structure and adapting to patient readiness.