CDA bill makes silver diamine fluoride a covered Medi-Cal benefit

CDA is sponsoring legislation that would expand treatment options for dentists and their patients.

Silver diamine fluoride would become a covered benefit as a treatment option for tooth decay for specified Medi-Cal Dental Program enrollees under a new bill authored by Sen. Richard Pan (D-Sacramento). Senate Bill 154 would make SDF a covered benefit if applied as part of a patient’s comprehensive treatment plan and with the patient’s written informed consent.

The Medi-Cal Dental Program provides dental coverage to over 13 million beneficiaries, including 5.5 million children, and while it covers dental services for preventing and treating tooth decay, it does not currently cover the use of SDF for tooth decay.

Sen. Pan, a pediatrician, wanted to change that and make SDF more widely available. He introduced a nearly identical bill in 2018 — SB 1148. That bill unanimously passed the Legislature but was vetoed by then-Gov. Jerry Brown who said the bill would require “significant, ongoing general fund commitments” and should be part of the budgetary process.

Sen. Pan’s new legislation addresses this cost concern by limiting the SDF benefit to children ages 6 and under, persons with disabilities or other underlying conditions for whom nonrestorative caries treatment may be optimal, and adults who live in a licensed skilled nursing facility or licensed intermediate care facility.

Composed of silver and fluoride, SDF can be used to stop the progression of tooth decay and to stabilize the tooth until the dentist determines further dental treatment is needed. The medication’s advantages include its ability to kill the cariogenic bacteria and arrest caries in the tooth. Since the treatment does not require the use of local anesthesia or caries excavation, the option is particularly beneficial to patients for whom traditional treatment presents challenges, whether due to age, behavioral issues or medical conditions. 

Because tooth decay is the most common chronic condition experienced by children, pediatric dentists are especially excited about SDF’s potential. Gary D. Sabbadini, DDS, in a February 2018 CDA Journal article explains how he has incorporated SDF into his practice.

“The public is looking for low-cost, safe, nonsurgical methods to treat children’s teeth. While SDF is not a remedy for all dental caries, I am glad that I have a nonsurgical option to offer to parents,” Dr. Sabbadini said.

(The January and February 2018 issues of the Journal of the California Dental Association are dedicated to SDF; read them at cda.org/journal.)

CDA, the bill’s author and other stakeholders are optimistic that Gov. Gavin Newsom will sign SB 154 into law.

CDA will inform members about the status of this bill in the Update and on cda.org.

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