Drill-Free Cavity Treatment Stops Decay in More Than Half of Toddlers' Teeth in Major Trial

A simple liquid brushed onto a tooth in seconds stopped decay in more than half of treated baby-tooth cavities in a large clinical trial, researchers reported in JAMA Pediatrics. The work was led by Margherita Fontana of the University of Michigan School of Dentistry, with Amr Moursi of NYU College of Dentistry as co-principal investigator. The paper was published online on July 27, 2026, and drew fresh attention this week.

What the trial found

The treatment is 38% silver diamine fluoride (SDF), which dentists apply with a small sponge-tipped brush. It needs no drilling, injections or sedation.

• Participants: 830 children aged 12 to 71 months with severe early childhood cavities, in Michigan, New York and Iowa
• Design: randomized, blinded and placebo-controlled, with treatment at the start and at six months
• Main result: decay was arrested in 54.0% of lesions treated with SDF versus 22.5% with placebo at six months
• Safety: no lasting adverse effects were reported after one or two applications, and rates of reported side effects were similar between groups

Why it matters

Tooth decay is the most common chronic disease of childhood. A treatment that needs no drill could help very young children, and others for whom dental work is difficult.

"This is a very effective and safe treatment—even in children as young as 1." — Margherita Fontana

What's next

SDF has been used in the U.S. off-label for years. The trial was designed to provide the evidence needed for a formal drug application, but the FDA has not approved SDF for this use. Not every cavity stopped progressing, so the authors recommend close monitoring and using SDF alongside other preventive care. The silver also permanently darkens treated areas of the tooth.

*This article is general news, not medical advice. Talk with a dentist about any child's treatment.*