Implementation of a primary care physician-led Cavity Clinic using silver diamine fluoride.

ABSTRACT

OBJECTIVES: Early childhood caries (ECC) disproportionately affects lower socioeconomic status households. In this article, we describe a novel intervention utilizing physician-applied silver diamine fluoride (SDF) in a primary care "Cavity Clinic." METHODS: Building on literature review and expert consultation, Cavity Clinic using SDF for children without dentists was implemented in a family medicine residency setting. Process outcomes were evaluated through chart review and structured field notes. RESULTS: From December 2017 to December 2018, 30 patients have been treated. Their average age is 5.5 years (2-9), 82 percent are African American, and all are insured by Medicaid. Most have severe ECC. Thirty-eight percent have successfully established dental homes through participation. CONCLUSIONS: It is feasible and acceptable for physicians to treat ECC with SDF in a primary care setting. Partnership with an on-site hygienist is helpful but physician-only sessions were still beneficial. This strategy holds potential for addressing the epidemic of ECC.