[2] Ammonia compounds reduce the oxidative potential of SDF, increase its stability and helps to maintain a constant concentration over a period of time, rendering it safe for use in the mouth.

[3] Silver and fluoride ions possess antimicrobial properties[1] and are used in the remineralization of enamel and dentin on teeth for preventing and arresting dental caries.

[12] The product was cleared for sale by the U.S. Food and Drug Administration as a Class II medical device for the treatment of dentinal hypersensitivity,[13] and has been classified as an ‘effective, efficient, equitable and safe caries-preventative agent’ by the Institute of Medicine and the Millennium Goals of the World Health Organization in 2009.

Rosenblatt et al.[1] summarized how the constituents in SDF each have a role in the arrest of microbial species that cause dental caries.

Fluorides can bind to bacterial cell walls, inhibiting enzymatic processes associated with sugar uptake and metabolism of carbohydrate, therefore producing a surface more resistant to acid dissolution.

[2] CFU counts on Streptococci mutans, Actinomyces naeslundii, Lactobacillus acidophilus, Streptococcus sobrinus, Lactobacillus rhamnosus (all of which are bacteria intimately associated with the carious process) were significant lower in both dentin surfaces and demineralized dentin treated with SDF when compared to water application.

[26] This shows that SDF as a compound has better bactericidal effects than silver ammonium nitrate and sodium fluoride (commonly found in toothpastes).

[32] The American Academy of Paediatric Dentistry (AAPD) recommends a 2-4 week follow-up to assess the arrest of carious lesions treated with SDF.

The main side effect of SDF is non-medical and is the prominent black staining of carious tooth tissue where the solution is applied.

Chu et al. reported on the first modern clinical trial of SDF that the stain was generally acceptable and "the presence of darkened teeth was mentioned by around 7% of the parents.

[38][39] Pharmacokinetic studies in adults found no adverse effects and demonstrated a lack of any increase of Fluoride in the blood.