This article describes the clinical protocol of using potassium iodide (KI) to reverse staining caused by silver diamine fluoride (SDF). SDF contains silver, fluoride, and ammonia. It has been used to arrest dental caries mainly in pediatric applications.

How do you remove SDF stains?

Do not wipe it; wiping can spread it and result in a larger stain. Instead, blot the area of any excess material, and wash the area thoroughly with soap and water, 3% peroxide, or an iodine tincture. Staining on skin will fade, like a henna tattoo. Wash operatory surfaces, instruments, and dappen dishes thoroughly.

Does SDF stain teeth permanently?

The affected area will stain black permanently (see photos at right). This means SDF is working! Healthy tooth structure will not stain. If accidentally applied to the skin or gums, a brown or whitespot may appear that causes no harm, cannot be washed off and will disappear in one to three weeks.