On August 1, 2020, D1354 application of Silver Diamine Fluoride 38% became covered for ages 0-20 twice within a calendar year and maximum of four applications per tooth per lifetime. Coverage is reimbursing $15 per tooth. The list of states offering Medicaid coverage is approximately 35 as of this bulletin publication. For a list of states providing coverage, please contact us at 877-866-9113.
In October, the ADA released "D1355 - ADA Guide to Reporting Caries Preventive Medicament Application." This document answers many of the top questions regarding the new D1355 code and clarifies the intent of the code, which medicaments it applies to and what to expect as the code begins being used in 2021. Take a look at the guidance here.Researchers from Texas A&M University recently presented a study to back up observational reports of gingival health improvement seen following SDF applications for caries arrest or prevention. They conducted a placebo-controlled, double-blinded study on a group of 25 geriatric, gingivitis active patients. In a follow-up email with the lead researcher, it was reported that Advantage Arrest Silver Diamine Fluoride 38% was applied to the labial and buccal surfaces of the teeth. This would be akin to the application of Advantage Arrest Silver Diamine Fluoride 38% for the new CDT D1355 code. A significant improvement in the gingival health of the active vs. the placebo (saline) control group was found. You can view the study here.
Researchers at Choson University in Korea have demonstrated that in a pH cycling study designed to demineralize teeth, Silver Diamine Fluoride prevents mineral loss better than sodium fluoride varnish and the control groups. This information coincides with the new CDT code D1355 for the preventive use of Silver Diamine Fluoride. More and more evidence is mounting for this non-staining use of SDF. You can view the abstract and full-text article here.
With the pandemic and increased needs for asepsis in the dental office, sharing an 8 mL bottle between operatories presents new issues with new protocols. Many offices asked for a kit in which smaller bottles could be purchased and used individually in operatories. You asked, and we answered. Elevate Oral Care is pleased to introduce the 3 mL - 3 bottle kit (9 mL total) of Advantage Arrest Silver Diamine 38%. You can see all of the details here.American Academy of Pediatrics and American Academy of Pediatric Dentistry Issue Statement Including Reference to SDF
Recently the AAP/AAPD joint oral health group came out with a new report that underscores the importance of fluoride for children. You can read the report here.
At the moment, there is no CPT medical code for the application of SDF. The report mentions SDF, suggesting that pediatricians be aware of the potential for SDF use to cause caries staining so when they look in the mouth and see SDF stains they do not disparage the care provided by the oral health professional. To our knowledge, this is the first reference to SDF treatment in the medical world.
The January 2021 California Dental Association technical journal featured an SDF cover article on a case report where SDF/SN are used to protect vital pulps in deep carious lesions of teeth in elderly patients. The case report found a 95% success rate using partial caries removal, SDF or SN application followed by the immediate placement of a restorative material. This article is the latest publication supporting the well-researched yet under-utilized practice of partial caries removal.
This publication can be seen on page 13 of the January California Dental Journal Issue. Also, the citations may prove helpful if you have interest in learning more about partial caries removal.
Previous Volumes of the Silver Bulletin
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