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

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.