Silver Diamine Fluoride is Now a Covered Benefit
We’re pleased to announce that, effective January 1, 2024, code D1354 (interim caries arresting medicament application-per tooth) will become a covered benefit for most BlueDental plans. The treatment commonly used in this procedure is silver diamine fluoride (SDF).
SDF is a colorless antimicrobial liquid that, at pH 10, is 24.4% to 28.8% (weight/volume) silver and 5.0% to 5.9% fluoride. It’s applied directly to cavities with a small brush to decrease caries risk. It’s referred to as 38% SDF.
SDF offers the possibility of stopping the progression or arresting caries lesions without removing sound tooth tissue. In addition, SDF appears to remineralize dentin. SDF has also shown efficacy in managing root caries in seniors. It has additional applicability as an interim approach for managing caries in individuals currently unable to tolerate more involved dental treatment, including kids, elderly patients, and special needs populations.
The table below outlines coverage information. To verify benefits, please contact customer service or access our online portal.
| Procedure Code and Frequency Limitations | In Network Member Pays | Out of Network |
Preventive (Diagnostic) | No waiting period | ||
Periodic Oral Evaluations | D0120 and D0140 2 per calendar year | 0% | Not covered |
Bitewings | D0270, D0272, D0273, D0274, or D0277 1 per calendar year | 0% | Not covered |
Cleanings – adult | D1110 2 per calendar year | 0% | Not covered |
Please contact your dental network manager if you have any questions or email us at dentalproviderrelations@fclife.com.