Dental caries has a multifactorial etiology and has been a public dental health concern worldwide. Dental caries influencesvarious aspects of the health of pediatric patients. Multiple advantages of using silver diamine fluoride (SDF) have been described in the available published literature. The existing literature reveals that, in recent years, SDF has emerged as a promising option to address the global burden of dental caries in certain clinical scenarios. However, the literature also mentions the negative aspects and demerits of SDF in clinical dentistry. Dental clinicians using SDF should have updated, evidence-based knowledge for its safer and more effective use in managing dental problems, especially dental caries in pediatric patients. Hence, the aim of the current review article was to thoroughly explore and present the literature regarding the negative facets (shortcomings) of silver diamine fluoride and also the precautionary/preventive measures and clinical solutions for its safer and more effective use in clinical practice.