37 - What’s New in Prevention: Silver Diamine Fluoride and Povidone Iodine Updates

Silver Diamine Fluoride (SDF) has been used for decades throughout the world. It became available for use in the United States in April of 2015. There are many clinical uses of SDF including hypersensitivity relief, caries arrest, liner under new restorations, an occlusal barrier, and for prevention for moderate to high-risk sites. Since 2016, there has been a CDT code available (D1354) for use as a caries arresting medicament to be applied to asymptomatic, carious lesions without the removal of sound tooth structure to arrest active decay. However, on January 1, 2021, an additional CDT billing code was approved- D1355. D1355 is described as a caries preventive medicament application for primary prevention or remineralization. This code can be used for site specific application of SDF, but also for the in-office application of Povidone Iodine, among other things. Povidone Iodine is an antiseptic agent that is typically designed for surface use on the skin to prevent infections. However, it also has significant oral applications. In this roundtable, we will discuss the prevention protocol, based on the ADA Evidence Based Guidelines, CAMBRA principles, and the research that provides evidence on how clinicians can and should use Silver Diamine Fluoride and Povidone Iodine for prevention for moderate to high-risk patients.