CDA sponsored SB 154 (Pan) in 2019 to add silver diamine fluoride (SDF) as a Medi-Cal benefit for treatment of dental decay when applied as part of a comprehensive treatment plan. SDF is a topical medication used to slow down or stop cavities in both primary and permanent teeth. The use of SDF is a nonsurgical approach to treating dental decay, as it does not require local anesthetic and can be applied quickly and painlessly. SDF is a colorless liquid that contains both silver and fluoride; although it stains the decayed portion of a tooth, it is becoming more widely used, especially in posterior and primary teeth. In California, Medi-Cal is already using SDF as part of a broader pilot project in 29 counties to manage dental decay in children younger than 6 years old.

Recent studies of Medicaid expenditures in six states show an average savings of $100 to $350 per child treated with SDF. This could translate to $10 million to $30 million in annual savings for California’s Medi-Cal program. SDF is a proven effective tool worldwide in managing cavities and the serious health problems associated with unmanaged dental decay and is now being shown to provide significant cost savings for public health insurance programs. While SDF may not fully eliminate the need for additional care, it gives Medi-Cal providers a new and effective tool to treat dental decay among the growing Medi-Cal population. SB 154 passed out of the legislature with unanimous support but was vetoed by Gov. Newsom due to its costs to the state. CDA is continuing to work with his administration to secure budget funding for this effective, non-invasive and low-cost tool to treat dental decay.