A patient from a disadvantaged socioeconomic background presents with multiple active caries lesions, is moderately uncooperative, and has traveled 1.5 hours to the clinic. What is the most appropriate first-visit treatment to arrest caries progression?

Silver Diamine Fluoride (SDF) is the most appropriate treatment for a patient with multiple caries, limited cooperation, and access barriers. SDF is a non-invasive, chair-time-efficient liquid applied topically that arrests active caries by: killing cariogenic bacteria (silver component), remineralizing demineralized dentin (fluoride component), and hardening the carious dentin. It requires no anesthesia, no drilling, and minimal patient cooperation, making it ideal for underserved populations and uncooperative patients. Its main limitation is irreversible black staining of arrested carious lesions. Conventional restorations require cooperation and multiple appointments. Fluoride varnish prevents new caries but does not arrest existing lesions as effectively as SDF.