SDF Application Results in Savings for Medicaid
A recent peer-reviewed publication looked into Medicaid restorative treatment visit claims from seven states (AL, CT, MA, NC, NH, SC, VT). The author estimated that the use of SDF in place of approximately 50% of the restorative treatments could save from $110-350 per visit depending on the state of residence of the patients aged 1-5 years old that were reviewed. If this estimate is accurate, this has the potential for considerable cost savings and less invasive treatments for young patients. The full article can be read here, and a PEW Trust write-up can be found here.
Additionally, the Children's Dental Health Project wrote a great summary of this article that can be found here.
California Bill Could Make D1354 a Covered Treatment Through Medi-Cal
Bill 154 proposed by State Senator Richard Pan of California and supported by the CDA will make Silver Diamine Fluoride a covered treatment under Medi-Cal. There are approximately 13 million Medi-Cal patients and this bill will allow D1354 to be covered for a large portion of that total. Coverage would include children under 6, medically compromised patients, and elderly patients living in licensed assisted living facilities. Both the California Dental Association and Senator Pan are hopeful that Governor Newsom will sign this new bill. You can view the CDA write-up on the bill here, and the actual bill can be found here.
California Domain 2: Caries Risk Assessment and Disease Management Pilot includes SDF
Free Continuing Education Courses on SDF
Lots of great Continuing Education exists on Silver Diamine Fluoride, and there is more being released frequently. Compendium has just released a 2 CEU program that can be downloaded from its website. This time it's covering the primary preventive uses of SDF, not just the arresting ability. We've also made it possible to get the CE credit for FREE. Simply follow this link to download the program, read through it, take the test, and submit it to Aegis Publishing. Use this code CCEDORAL1 when you submit the test and you'll get it free.
Montana Joins Other States Allowing SDF Application by Dental Hygienists
Montana has joined several other states in allowing Dental Hygienists and Limited Access Permit RDH's to apply Silver Diamine Fluoride. Congratulations to those who helped gain this approval. This decision comes one year after a similar attempt was rejected due to a lack of time for public comment.
This article provides a recap of the approval.
Advantage Arrest Silver Diamine Fluoride 38% used fluoride varnish as the comparative device for FDA 510k clearance. The FDA’s clearance suggests an equivalency between the two products in safety and efficacy. It would stand to reason that the application clearance within each state for the application of fluoride varnish provides a similar path for the use of SDF. Check with your local Board of Dentistry for current information.
Worried about Ingestion of Silver and Fluoride from SDF? Don't be!
A new Journal of the American Dental Association publication discusses the pharmacokinetics of SDF use in adult patients. If you've been worried about ingestion of silver or fluoride when using the product with your patients, don't be. The study followed serum and urine levels of fluoride and silver for 24 hours after application of SDF to five teeth. The conclusion is that, "SDF is well-tolerated..." and "no adverse events were reported." You can find the article here.
The two dentists responsible for Silver Diamine Fluoride's FDA clearance have received the 2019 Public Service Award from the American Academy of Public Health Dentistry. A simple conversation they had in a pickup truck while driving through a snowstorm lead to Silver Diamine Fluoride being cleared for use after many years of hard work. Their conversation led to a contribution to public health improvement that has impacted many lives and improved the oral health of patients across the USA.
Dr. Shirtcliff and Milgrom received the award at the National Oral Health Conference on April 14th, 2019. In the photos, on the left, the individuals are Dr. Peter Milgrom and Dr. Jeff Chaffin, and in the photo on the right Dr. Mike Shirtcliff and Dr. Jeff Chaffin. They join a long list of recipients of this prestigious award. You can view all of the previous year's recipients here.
We're Learning How Deep SDF Penetrates Into Lesions
The first bit of research has been published on the depths that SDF penetrates into carious lesions. Researchers at NYU treated extracted carious teeth with SDF and then measured how deep silver and other elements penetrated into the tooth. Their results show that SDF can penetrate roughly 2.5 mm into the tooth, which is slightly deeper than estimates from clinicians who use the material regularly. Sometimes silver even found its way into the pulp chamber. This in-vitro study, published in one of the leading research journals, is the first step in learning how well and how thoroughly SDF can penetrate lesions. You can view the article here.
The Arizona SDF Summit Was a SuccessJanuary 12th, 2019, was a big day for Silver Diamine Fluoride. A full day CE program was put together by the Arizona Academy of General Dentistry, and it was an event to remember. Not only was the room at capacity, many of the researchers, product developers, and pioneers of the chemistry were present for the event. While this photograph by no means captures all of the people who helped start the SDF wave through dentistry, it's definitely an instrumental group.
From top left to bottom right, they are Kevin Thomas, Dr. Jeremy Horst, Dr. Mike Shirtcliff, Steve Pardue, Dr. Jeanette MacLean, Dr. Steve Duffin, Marcus Duffin, Dr. John Frachella, Dr. Peter Milgrom, and Dr. Jong Seto.
Previous Volumes of the Silver Bulletin
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