The California Dental Association (CDA) is sponsoring state legislation that will allow dentists who provide care in the Medi-Cal dental program to be reimbursed when using silver diamine fluoride (SDF) as a caries-arresting agent in a comprehensive treatment plan. The CDA says that evidence supports the use of SDF and that it is particularly beneficial for patients who face challenges in traditional treatment due to their age, behavioral issues, or medical conditions.
“The Medi-Cal dental program is testing SDF now in one of the Dental Transformation Initiative domains. While that program will provide good information when the pilot ends, we know that SDF is very effective and we should make it more widely available now,” said John Blake, DDS, chair of the CDA Government Affairs Council.
SDF is a topical medication used to slow down or stop dental decay. The colorless liquid includes silver, which has antibacterial properties, and fluoride, which can remineralize damaged tooth enamel. Together, the CDA says, silver and fluoride can be used to stop the progression of tooth decay and stabilize the tooth until the dentist determines further dental treatment is needed.
The Food and Drug Administration approved SDF as a desensitizing agent in 2014, enabling its introduction into the United States market. The CDA notes that its main advantages include its ability to kill cariogenic bacteria, arrest caries without a local anesthesia or excavation, and promote mineralization. These benefits are appealing in the care of those with disabilities, frail and elderly patients, young children, and children with special healthcare needs, the CDA says.
“The public is looking for low-cost, safe, nonsurgical methods to treat children’s teeth,” said Gary D. Sabbadini, DDS, who described how he uses SDF to treat patients of all ages including an adult with Down syndrome who was not a good candidate for sedation in a February 2018 CDA Journal article. “While SDF is not a remedy for all dental caries, I am glad that I have a nonsurgical option to offer to parents.”
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