My toddler's teeth are black. It's caused by a treatment to avoid more cavities in her teeth.

My toddler's teeth are black. It's caused by a treatment to avoid more cavities in her teeth.
The author and her daughter.Courtesy of Jillian Pretzel
  • My family has had terrible teeth throughout many generations.
  • My daughter had three cavities in her front teeth when she was only 1.

My family has horrible teeth. They've got chompers lined with crowns and fillings, and silver smiles back when they open their mouths. I'm convinced that a small community of dentists has stayed in business because my family name keeps showing up on their calendars.

Don't get me wrong: We brush and floss like the best of them, but our teeth are just soft and delicate, with crevices that welcome clinging grains of sugar and morsels of meat. I've gotten the least of this "family curse," with, so far, only a handful of fillings. But I fear my toddler, Elle, has the worst of it.

As a baby, she'd nap in my arms as I sat on the couch, a time I often used to wipe food stains off her cheeks and lightly brush her few teeth with a rubber baby toothbrush. When Elle was about 1 year old, I started brushing what I thought was plaque on her front teeth, but it wouldn't come off.

"Oh, no," I thought, "cavities."

I took Elle for her first dental visit shortly thereafter — and a tall dentist with kind eyes confirmed she had small cavities on three of her front teeth.


I felt like a failure for letting my 1-year-old's teeth get so bad. I was also nervous, wondering whether this meant Elle would get more cavities. Our dentist offered to put silver diamine fluoride over my daughter's front teeth to halt cavity growth until she's old enough to sit for fillings without general anesthesia, or until her baby teeth fell out.

Silver diamine fluoride is safe and effective

My daughter's dentist explained that SDF was safe and painless and that it came at a fraction of the cost of fillings. Still, with safety as my No. 1 priority, I wanted to do my own research. I needed to make sure I wasn't skipping anesthesia risks in favor of a worse list of side effects.

Lynn Gargano, the clinical director of pediatric dentistry at the Family Health Centers at NYU Langone, confirmed SDF was safe.

"Scientific reviews and clinical trials report no adverse events or serious side effects in either children or adults," she said, adding that the only known side effects were minor nuisances, like short-term gum irritation or a metallic taste.

"SDF has been proven to arrest decay up to 80% of the time," Gargano said. "In my practice, SDF is a viable alternative in very young children and patients with special management considerations."


After talking it over with my husband, we decided SDF would be the best choice, and the following week, Elle's dentist brushed the tops of her teeth with what looked like a little plastic stick. We were in and out of the office in a matter of minutes.

Her teeth turned black with the treatment

Before applying SDF, the dentist warned me — a few times — that the solution would permanently stain the areas of decay, meaning parts of Elle's teeth would remain black unless we decided to do the fillings later. He mentioned that some parents weren't thrilled with this, but I waved off his warning.

Still, SDF as a cavity treatment is relatively new in the US. It's been used for oral care in Japan for over 50 years, but the Food and Drug Administration didn't approve it for dental use until 2014. So while Gargano said that SDF had been gaining popularity in the states, I've found that most people don't know what it is.

"Was she eating Oreos?" other parents have asked after seeing my daughter laugh on the playground.

Sometimes I just nod and smile, blaming the darkened area on cream-filled cookies. But most of the time, I'm forced to explain that my daughter has cavities and this was the alternative to general anesthesia. I've gotten some raised eyebrows, but most of the time, other parents empathize with a tough decision. Plus, they're often interested to hear that fillings aren't the only option. I'm glad to be able to tell them about our experience.


When my pediatric dentist warned about the SDF stains, I knew he was worried I wouldn't like the look of Elle's teeth. But my daughter isn't bothered by her stained teeth, and I don't mind the look at all. In fact, I kind of like it. It makes her look more like my side of the family.