Hawaii Dental Hygienists' Association 



The Hawaii Dental Hygiene Association represents a clinically trained group of licensed professionals prepared to improve oral health standards in our communities. With the use of Silver Diamine Fluoride, hygienists and dentists across the state now have another option to treat cavities. Answers to some of the most common questions are below.


Information referenced from the Hawaii Department of Health (DOH) and the American Academy of Pediatric Dentistry (AAPD):


  • What is Silver Diamine Fluoride (SDF)?
    • SDF is a colorless liquid made up of fluoride and silver ions. It acts as an antimicrobial agent that stops cavities from growing, makes the tooth stronger, and limits the growth of bacteria that causes tooth decay.


  • Why would a dental professional recommend SDF?
    • SDF temporarily stops cavities from growing. The treatment is quick, comfortable, and affordable. This can be a good option for those delaying restorative treatments such as fillings or crowns. Candidates are often children not yet able to sit through restorative treatment, older adults with root cavities, individuals with special needs, and those living with untreated cavities due to difficulties accessing care or financial restraints. Sometimes SDF is the only treatment needed if the cavities in the teeth are very small.


  • What is the treatment like?
    • SDF is painted on a cavity with a small brush. It takes about two minutes, is painless, and no drilling or anesthesia. The treatment has a metallic taste, and can sometimes cause a mild irritation to the gums that will heal by itself in a couple of days.


  • Is SDF safe?
    • Very safe, according to the evidence-based clinical guidelines of the AAPD. SDF has been used in Japan and Europe for decades. It can postpone or prevent the need for sedation or general anesthesia, especially for very young patients. The safety use of SDF is agreed upon by dentists and holistic communities.


  • You should not be treated with SDF if:
    • You are allergic to silver.
    • Cavities are so large that they involve the nerve of the tooth.
    • There are open sores or ulcers in your mouth.


  • Does it work to stop tooth decay?
    • Based on clinical trials, SDF works to stop cavities from growing in 70 to 90 percent of treated teeth. Teeth treated with SDF need to be checked by a dentist at least every six months to make sure the tooth decay has been stopped.


  • Is it true SDF turns teeth black?
    • Cavities treated with SDF turn black, and healthy tooth structure will not change in color. Staining is permanent, lasting the lifetime of the tooth. The decision to use SDF based on aesthetics would be similar to that of a metal filling or silver crown. If the cavities are on the back teeth it is barely noticable. If the cavities are on the front teeth, it can be very noticable. If SDF touches the skin, it will leave a dark stain for a few days.
    • As children get older, health conditions improve, or access/financial restraints resolve, fillings or caps may be placed on the teeth to cover the discoloration.


  • Why treat cavities in baby teeth?
    • Cavities on children’s teeth can grow very fast and cause pain and infection. The factors that started the cavities in the first place can cause decay in other teeth. As cavities get larger, the nerve of the tooth can become infected and lead to serious infections in the body.
    • Baby teeth also hold space for the proper placing of the permanent teeth. If a baby tooth is lost too early, it may lead to malalignment of permanent teeth.


  • How can SDF help oral health in Hawaii?
    • Addressing untreated tooth decay is an essential oral and total health initiative.
    • The state of Hawaii has the highest rates of childhood dental cavities in the United States. This is primarily attributed to the lack of community water fluoridation. Diets with high sugar consumption contribute significantly to the problem.
    • Across the state, approximately 3,000 emergency room visits occur annually because of preventable oral health pathology. Billed hospital services for this were $17m in 2016, averaging $5,600 per dental visit.
    • Approximately 225,000 adults in Hawaii are enrolled in the adult Medicaid dental benefits program, which provides emergency extraction services, but no prevention or cavity restoration services.


Smiles with Aloha


The chambered nautilus shell signifies growth, expansion and renewal.  It's the perfect symbol for the Hawaii Dental Hygienists' Association as we strive to promote excellence in oral healthcare.  Our mission:  to advance the art and science of dental hygiene by ensuring access to quality healthcare, and to increase awareness of the cost-effective benefits of prevention through promoting the highest dental hygiene standards for education, licensure, practice and research.  Welcome to our website!

E Komo Mai - The Hawaii Dental Hygienists' Association

A beautiful smile brightens every day and gives you the confidence you deserve! Dental hygienists are the prevention specialists in oral health care and we want to help you have a beautiful smile.  

As an affiliate of the American Dental Hygienists' Association, the Hawaii Dental Hygienists' Association keeps its members up to date on the best ways to maintain your healthy smile with preventive oral care. 

Making good habits


You can brush and floss correctly with these easy tips

Are you aware?


Learn about tooth decay, gum disease and more.  Dental hygienists help you prevent these conditions 

Who We Are

Care Advice

Oral Health Fast Facts

Meet our Leadership team


Dental hygienists are licensed healthcare professionals who specialize in the prevention of oral diseases