October 17, 2022
This is a major milestone in advancing an integrated approach to oral health equity and expanding access to person-centered care.
October 17, 2022 (Boston, MA) — Last month, the American Medical Association (AMA) approved a new category III CPT code for the application of silver diamine fluoride (SDF) by medical teams to arrest dental decay without a dental filling. The addition of this code is a milestone in improving access to dental care and, ultimately, helping more people achieve better oral health.
Previously only dental care providers could apply SDF, but now primary care team members will be able to apply SDF to treat cavities and be reimbursed for it. The CPT code approval for SDF will benefit patients by providing many new points of access for treating tooth decay.
“To achieve oral health equity, we need the participation of the entire health system,” said Myechia Minter-Jordan, MD, MBA, president and CEO of CareQuest Institute for Oral Health®. “The inclusion of a new CPT code for medical professionals to offer critical non-invasive therapeutic oral health care to their patients is a key step toward a more accessible, equitable, and integrated health system that meets the needs of everyone.”
SDF is a brush-on liquid that stops cavities by strengthening affected tooth structures and keeping bacteria from growing on them. It prevents dental decay from progressing and spreading to other teeth. Unlike traditional treatments such as drilling and filling a cavity, SDF is quick, painless, and does not require local anesthesia or sedation.
“Accompanied by a bolstering of Medicaid medical program benefits and coverage by commercial carriers, physicians and other qualified health professionals can finally help tame the scourge of tooth decay using a simple, inexpensive clinical strategy,” said Peter Milgrom, DDS, Member of Advantage Silver Dental Arrest, LLC and advocate for the approval of the SDF code. “This change should also serve as a guidepost along the road to the long sought, and badly needed, Medicare dental benefit that could help countless more millions of people in the US.”
Tooth decay is the most common noncommunicable disease worldwide and can lead to serious health problems, including brain or heart infections, if left untreated. Now, medical teams are empowered to administer SDF as a tool to impact the overall health of their patients, especially those at higher risk of dental disease and lower access to regular dental care including those living in poverty, minority populations, and those living in dental "deserts" or health professional shortage areas.
The code proposal was supported by a diverse group of dental and medical care professionals and advocates including The American Dental Association (ADA), American Dental Hygienists Association (ADHA), National Dental Association (NDA), Society of American Indian Dentists, Children's Health Alliance of Wisconsin, National Coalition of Dentists for Health Equity, NorthWest Health Law Advocates, Community Catalyst, and the Center for Medicare Advocacy.
“Medical and public health professionals care for children and adults with tooth decay who cannot get care from a dentist,” said Karen Sokal-Gutierrez, MD, MPH, clinical professor at UC Berkeley and fellow of the American Academy of Pediatrics. “This initiative offers us a pathway to get training and support to join the oral health care team and provide effective, safe, and fear-free treatment to stop tooth decay. It’s a critical opportunity to expand access to care and improve health, well-being, and equity.”
The newly approved CPT code is expected to be inputted into code sets by electronic health records (EHR) vendors in July 2023. CareQuest Institute will partner with Smiles for Life Oral Health to develop training and educational materials on dental cavities identification and SDF application for medical professionals.
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About CareQuest Institute for Oral Health®
CareQuest Institute for Oral Health® is a national nonprofit championing a more equitable future where every person can reach their full potential through excellent health. We do this through our work in grantmaking, research, health improvement programs, policy and advocacy, and education as well as our leadership in dental benefits and innovation advancements. We collaborate with thought leaders, health care providers, patients, and local, state, and federal stakeholders, to accelerate oral health care transformation and create a system designed for everyone. To learn more, visit carequest.org and follow us on Twitter, LinkedIn, Facebook, and Instagram.