A marginalized child with poor oral hygiene, multiple caries, and moderate uncooperativeness presents for the first time. What is the most appropriate initial treatment?

Silver Diamine Fluoride (SDF) is a 38% silver fluoride solution that can arrest active dental caries without drilling or anesthesia. It is the ideal first-visit treatment for: young or uncooperative children (no need for chair-side cooperation), multiple carious lesions requiring interim management, and patients from marginalized communities with limited access to care. SDF arrests caries by killing cariogenic bacteria (silver ion) and promoting remineralization and hardening of demineralized dentin (fluoride). The main disadvantage is that it permanently stains arrested carious lesions black. SDF is particularly valuable as a bridge to more definitive treatment.