Position Statement on Silver Diamine Fluoride

Our National Dental Association: (1) affirms bi-directional medical-dental integration within the practice scope of care; (2) supports the treatment of dental caries with silver diamine fluoride (SDF)1 as indicated because it is clinically effective in noninvasively arresting established caries and preventing new carious lesions in various tooth types and across patient demographic groups whether used alone, with a sedative filling or with a permanent restoration1; (3) supports the treatment of dental caries with SDF because it is cost-effective, safe and efficient to apply, and portable to various settings; (4) supports SDF to be added to the Current Procedural Terminology (CPT®) codes which provide a uniform nomenclature for coding medical procedures and services; (5) supports a fee reimbursement scheme both for medical and dental teams applying SDF therapeutically; (6) stresses the importance of proper training for dental and medical teams on the indications and contraindications for the application of SDF as well as on the application technique; (7) is committed to strengthening the oral health workforce and improving oral health care access with the recognition that the application of SDF by medical teams where patients do not have access to oral health teams is a health equity measure; (8) urges that medical teams who treat visible cavitated lesions with SDF provide care coordination so that patients may be connected expeditiously when possible to dental homes where they will receive caries management by risk assessment (CAMBRA®) and continuity of oral health care. 

The National Dental Association’s mission is to promote oral health equity among people of color by harnessing the collective power of its members, advocate for the needs of and mentoring dental students of color and raise the profile of the profession in our communities. 


1 SDF is cleared for treatment of dental hypersensitivity in adults and lawfully used off-label to manage caries in all ages. 

1 Raskin SE, Tranby EP, Ludwig S, et al: Survival of silver diamine fluoride among patients treated in community dental clinics: A Naturalistic Study. BMC Oral Health 21:35, 2021 


Position Paper – PDF Version


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