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DE0927: 2024 National Children's Dental Health Message 2: Silver Diamine Fluoride [2/5/2024]
Each year, the Indian Health Service Division of Oral Health shares messages related to National Children’s Dental Health Month [NCDHM], which is in February. This year, we are focusing our messaging on glass ionomer sealants, silver diamine fluoride, and immunization screenings by oral health professionals in our IHS, tribal and urban dental programs. This message focus is on silver diamine fluoride.
SDF is used to arrest dental caries through the antibacterial property of silver and the remineralizing effect of fluoride. This non-invasive option can be considered for treating pre-cooperative children with dental caries and can potentially delay or prevent the need for additional dental treatment in the operating room. Since SDF was first approved by the U.S. Food and Drug Administration [FDA] in 2014 as a desensitizing agent – and used off-label for caries arrest – it has primarily been used by dental staff. However, in recent years, there has been growing interest among medical professionals to apply SDF in close collaboration with dental providers. Below are some resources to help you learn more about SDF and how it applies to both the dental and medical settings.
Reading:
• IHS Dental Public Health Specialty Pearl – Silver Diamine Fluoride Updates, Dr. Sarah Shoffstall-Cone, 2023: https://www.ihs.gov/doh/index.cfm?fuseaction=clinicmanagement.pearls&id=32 [in the IHS Dental Portal – Clinic – Specialty Consultants section; login required]
• IHS Silver Ion Antimicrobial Guidelines, IHS Oral Health Program Guide, CH4, Section V: https://www.ihs.gov/doh/index.cfm?fuseaction=clinicmanagement.ohpg [in the IHS Dental Portal – Clinic section; login required]
• IHS Medical-Led Silver Diamine Fluoride Demonstration Project, 2022: https://www.ihs.gov/doh/documents/SDF_FINAL%20_REPORT_DOH.pdf
• American Academy of Pediatric Dentistry, SDF Chairside Guide: https://www.aapd.org/media/Policies_Guidelines/R_ChairsideGuide.pdf
• CareQuest – The Non-Invasive Caries Therapy Guide, page 9: https://www.carequest.org/sites/default/files/2023-07/CareQuest_Institute_Non-Invasive-Caries-Therapy-Guide_071023.pdf
• ASTDD Silver Diamine Fluoride Fact Sheet: https://www.astdd.org/docs/SDF-fact-sheet-upd-oct_23.pdf
• Physician Use of Silver Diamine Fluoride [SDF] in Dental Caries Management - Guidance from the American Academy of Pediatric Dentistry: https://www.aapd.org/globalassets/sdf-guidance-for-physicians_aapd_2023.pdf
• CareQuest. The CPT Code for the Application of Silver Diamine Fluoride, Explained: https://www.carequest.org/about/blog-post/cpt-code-application-silver-diamine-fluoride-explained
Upon completion of this self-study reading, participants should be able to:
1. Describe how a dental provider knows when an SDF treated lesion is arrested;
2. Cite the effectiveness of SDF with a one-time application; and
3. List the contraindications for applying SDF.
Timothy Ricks — Personal Description / Biography not available. For follow-up questions, please contact the speaker at tim.ricks@ihs.gov.
Nathan Mork — Personal Description / Biography not available. For follow-up questions, please contact the speaker at nathan.mork@ihs.gov.
The speaker has no conflicts of interest to report.
It is the policy of the Indian Health Service, Division of Oral Health, that faculty/planners disclose any financial or other relationships with commercial companies whose products may be discussed in the educational activity. The Indian Health Service, Division of Oral Health, also requires that faculty disclose any unlabeled or investigative use of pharmaceutical products and medical devices. Images that have been falsified or manipulated to misrepresent treatment outcomes are prohibited.
None of the faculty/planners for this activity has a conflict of interest, and there is no use of unlabeled or investigative pharmaceutical products or medical devices. No images have been falsified or manipulated to misrepresent treatment outcomes.The educational objectives, content, and selection of educational methods and instructors are conducted independent of any commercial entity.
The IHS Division of Oral Health is an accredited sponsor of continuing education under the American Dental Association Continuing Education Recognition Program (CERP). ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the IHS at IHS CDE Coordinator or to the Commission for Continuing Education Provider Recognition at CCEPR.ada.org
Reading:
• IHS Dental Public Health Specialty Pearl – Silver Diamine Fluoride Updates, Dr. Sarah Shoffstall-Cone, 2023: https://www.ihs.gov/doh/index.cfm?fuseaction=clinicmanagement.pearls&id=32 [in the IHS Dental Portal – Clinic – Specialty Consultants section; login required]
• IHS Silver Ion Antimicrobial Guidelines, IHS Oral Health Program Guide, CH4, Section V: https://www.ihs.gov/doh/index.cfm?fuseaction=clinicmanagement.ohpg [in the IHS Dental Portal – Clinic section; login required]
• IHS Medical-Led Silver Diamine Fluoride Demonstration Project, 2022: https://www.ihs.gov/doh/documents/SDF_FINAL20_REPORT_DOH.pdf
• American Academy of Pediatric Dentistry, SDF Chairside Guide: https://www.aapd.org/media/Policies_Guidelines/R_ChairsideGuide.pdf
• CareQuest – The Non-Invasive Caries Therapy Guide, page 9: https://www.carequest.org/sites/default/files/2023-07/CareQuest_Institute_Non-Invasive-Caries-Therapy-Guide_071023.pdf
• ASTDD Silver Diamine Fluoride Fact Sheet: https://www.astdd.org/docs/SDF-fact-sheet-upd-oct_23.pdf
• Physician Use of Silver Diamine Fluoride [SDF] in Dental Caries Management - Guidance from the American Academy of Pediatric Dentistry: https://www.aapd.org/globalassets/sdf-guidance-for-physicians_aapd_2023.pdf
• CareQuest. The CPT Code for the Application of Silver Diamine Fluoride, Explained: https://www.carequest.org/about/blog-post/cpt-code-application-silver-diamine-fluoride-explained
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