Which fluoride treatment has been shown to work best in arresting advanced cavitated carious lesions?

• A. Silver diamine fluoride
• B. Fluoride varnish
• C. Fluoride toothpaste
• D. No treatment

Answer: (A)

Silver diamine fluoride stands out because it combines fluoride’s remineralizing effect with a potent antimicrobial silver component that penetrates decayed dentin and rapidly halts bacterial activity. This dual action arrests the progression of advanced cavitated lesions, turning them into stable, hard, darkened tissue rather than letting decay continue. Fluoride varnish and fluoride toothpaste mainly help prevent new caries or slow progression in early or non-cavitated lesions, and they don’t reliably arrest established cavitation. No treatment obviously won’t stop the decay. In real-world practice, SDF is especially valuable when drilling and traditional restorations are difficult, such as with young children or in settings with limited access to care, and it’s quick and cost-effective. The trade-off is that arrested lesions darken, which is a cosmetic consideration on visible teeth.