Silver Fluoride Diamine (SDF) Supplies, Equipment, Storage and Handling

SDF should be stored according to the manufacturer’s product insert and discarded after the expiration date on the package. SDF should be dispensed from multi-use bottles just prior to use, as it may precipitate if dispensed in advance or left exposed. The requirement to dispose of open multi-use vials of medications after 28 days does not apply to SDF multi-use bottles. Clean technique should be used when handling SDF bottles including wearing gloves and contact between the tip of the bottle and any surfaces should be avoided to prevent contamination. 

List of Supplies and Equipment

• Key documents: Patient education materials, consent form 
• Personal Protective Equipment: Use to protect health professional(s) 
• Dental bib, towels or plastic tray-liners: Use to protect patient clothing (as a bib) and tray or counter from staining
• Cotton swabs & petroleum jelly: To apply to lips and gums to protect from SDF 
• Protective glasses (or sunglasses): To protect patient eyes from SDF. Could be cleaned and reused or disposable. 
• Gauze 2x2's and/or cotton rolls: To dry and isolate teeth being treated with SDF 
• SDF product: Based on anticipated frequency of use and cost, consider single-use ampules (gel formulation) and/or size of multi-use bottle 
• Microbrushes, size small and large: For SDF application 
• Dappen dishes: Small disposable unit with well. SDF drops are placed in dappen dish. Not needed if using single-use SDF ampules
• Fluoride varnish: For use after SDF application
• Toothbrushes and toothpaste: For distribution to patients to use at home. May also be used for brushing teeth to remove food in clinic before SDF application 

Optional Supplies

• Dental mirrors: Disposable or reusable (after sterile processing); helps with oral assessment 
• Headlamp: Flashlight worn around head as light source if needed, depending on available light sources within exam rooms/clinic
• Handheld mirror: Useful for children old enough to hold independently to watch during SDF application 
• Timer: To target 60 seconds of SDF absorption after application
• Tooth models or other teaching aids: Oral health education 
• Plastic caddy or organizing bins: For collecting and making supplies easily accessible and portable to exam rooms, if desired 
• Finger splint: Useful in cases where biting may occur 

*Preassembled SDF application kits are becoming available and eliminate the need to set up a caddy of supplies.