The Academy of General Dentistry (AGD) is concerned that the American Medical Association’s (AMA) recent decision to allow non-dental health care workers to administer silver diamine fluoride is a temporary solution to a growing oral health crisis. The AMA’s establishment of a new Category III CPT code allows silver diamine fluoride (SDF) to be applied by health care personnel that are not affiliated with dental practices and is expected to be added to code sets and made available by electronic health records vendors in July 2023. While physicians and health care professionals can apply SDF as an interim treatment solution for dental decay and to increase access to care, they should refer to a dentist to establish a dental home for long-term and ongoing oral care. SDF is cleared for marketing to decrease the sensitivity of dentin; the use of SDF to arrest caries is an off-label use.
General dentists are trained to identify systemic healthcare issues in oral health patients. Yet, when we recognize conditions such as heart disease, lung cancer, the onset of diabetes and other health issues, we refer patients to a primary care physician to establish a medical home for evaluation and the necessary care. Allowing non-dental healthcare providers to administer SDF to patients is only a temporary band-aid solution. If referrals to a dental home are not made, this process can become very expensive for patients treated by health-care professionals not skilled or licensed to treat dental caries. In addition, SDF applied in the non-dental setting continues to be an off-label use of the product and is not sold for treatment or arrest of dental decay.
The AGD supports a patient-centered dental home led by the general dentist. The idea of a dental home is closely aligned to the concept that oral health care is essential health care and is based on the core principle that supporting patients’ oral health supports their overall health and wellbeing–through the prevention of future oral disease. It recognizes that patients’ oral health status has a direct correlation to their systemic health. General dentists are the managers of the dental home since they provide the full range of oral health care, coordinating specialty services when indicated and appropriate.
In a dental home, general dentists or pediatric dentists are the gatekeepers of oral health care.
Optimally, establishment of a dental home begins at the eruption of a child’s first tooth or no later than 12 months of age.
About the Academy of General Dentistry
The Academy of General Dentistry (AGD) is a professional association of more than 40,000 general dentists dedicated to providing quality dental care and oral health education to the public. Founded in 1952, AGD is the largest association of general dentists. For more information about AGD, visit, www.agd.org.
 AGD Off-Label Use of Dental Products https://www.agd.org/docs/default-source/default-document-library/agd-off-label-statement.pdf?sfvrsn=0