Bulletin of Stomatology and Maxillofacial Surgery
ISSN 1829-006X
2025; 18–193
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STANDARDIZING SILVER DIAMINE (SDF) FLUORIDE PROTOCOLS FOR PEDIATRIC CARIES MANAGEMENT IN MEDICAID POPULATIONS

Received: 2025-12-25 · Published: 2025-12-07

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Original title
STANDARDIZING SILVER DIAMINE (SDF) FLUORIDE PROTOCOLS FOR PEDIATRIC CARIES MANAGEMENT IN MEDICAID POPULATIONS
Author
Sowjanya Gunukula
Source journal
Bulletin of Stomatology and Maxillofacial Surgery
Published
2025-12-07
Licence
Creative Commons Attribution-NonCommercial 4.0 International
Original
https://doi.org/10.58240/1829006X-2025.21.11-181

Abstract

Caries in early childhood (ECC) is a condition that affects children who are on Medicaid at a disproportionate rate, which contributes to more children not receiving care and preventive treatment. The minimally invasive and low-cost intervention, silver diamine fluoride (SDF), has been established to halt the development of caries. Inconsistent outcomes have also been caused by variability in its clinical use functionality, such as frequency, technique, and Medicaid reimbursement. The current review summarizes available findings on the applications of SDF among the pediatric population, including the detection of protocol differences, and the potential for uniformity in Medicaid programs. PubMed, Scopus, and Google Scholar were used to conduct a narrative literature review based on the studies concerning the efficacy, safety, and application of SDF to underserved pediatric populations. Results indicate that SDF is always extremely efficient in caries arrest, but there exists considerable variation in the guidelines of application. There are studies that prescribe applying it annually, whereas some studies prove to be twice-yearly in order to achieve better results. Major challenges during the implementation process are staff training, workflow integration, and Medicaid billing issues. Though SDF has proven to be an efficient and fair instrument regarding the management of caries in children, it is not a mainstream practice due to the absence of a standardized procedure unique to the Medicaid system. The review suggests a necessity to develop coherent, evidence-based instructions to facilitate SDF delivery in a Medicaid environment that would eventually enhance patient outcomes and decrease disparities in child oral health care.
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