ADA supports silver diamine fluoride for caries management

The ADA has a new policy statement on the use of silver diamine fluoride for caries management.

Silver diamine fluoride, or SDF, is a topical antimicrobial and remineralizing agent. When used at 38%, it is approved by the U.S. Food and Drug Administration as a Class II medical device to treat tooth sensitivity. SDF may also be used as a non-restorative treatment to arrest carious lesions on primary and permanent teeth, which the ADA determined in its 2018 systematic review and subsequent evidence-based clinical recommendations for the arrest or reversal of noncavitated and cavitated dental caries using nonrestorative treatments in children and adults.

According to Res. 15H-2020, adopted by the House of Delegates in October, the “ADA Statement on the Use of Silver Diamine Fluoride to Arrest Carious Lesions” calls for dentists who use SDF to develop a “treatment-specific” plan for patients.

The resolution also directs dentists to inform patients and/or guardians of all available treatment options, possible side effects and the need for follow-up monitoring when giving informed consent. It also approves dental team members applying SDF as long as they have received the appropriate training and supervision in accordance with state laws.

Finally, the statement supports SDF being a covered benefit by dental insurers and urges them to continue covering treatment should the patient require a future restoration or extraction.

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