Informed Consent for Silver Diamine Fluoride Template - DHCS 2025

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The document provides informed consent information for the use of Silver Diamine Fluoride (SDF), an antibacterial treatment for tooth sensitivity and decay. It outlines the procedure, benefits, risks, and alternatives to SDF treatment. Key points include the need for repeated applications, potential staining of teeth, and that SDF does not replace traditional dental repairs. Patients must acknowledge understanding before consenting to treatment.

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What is the ADA code for SDF?

D1354 Silver diamine fluoride (SDF) treatment. D1355 Alternative to sealants for site specific prevention.

What is the controversy with silver diamine fluoride?

Its potential downsides include a reportedly unpleasant metallic taste, potential to irritate gingival and mucosal surfaces, and the characteristic black staining of the tooth surfaces to which it is applied.

What is the ADA code for silver diamine fluoride?

ing SDF guidelines, dentists and registered dental hygienists are permitted to apply SDF under the same authorization or restriction as other topical fluorides.

What is the code for silver diamine fluoride?

D1354 Interim caries arresting medicament application-per tooth *Conservative treatment of an active, non-symptomatic carious lesion by topical application of a caries arresting or inhibiting medicament and without mechanical removal of sound tooth structure.