Proposal to fund silver diamine fluoride for hospital and paediatric regional dental services

What we’re proposing

We are proposing to fund silver diamine fluoride for people accessing dental services through Health New Zealand public hospitals, and the ‘Health New Zealand Community Oral Health Service’ for children and some adolescents.

Consultation closes at 5pm, Thursday 30 October 2025 and feedback can be emailed to consult@pharmac.govt.nz.  

What would the effect be?

From 1 December 2025 silver diamine fluoride would be listed in Part II of Section H of the Pharmaceutical Schedule (hospital). 

This proposal would enable access to silver diamine fluoride for people accessing dental services through Health New Zealand public hospitals, and the ‘Health New Zealand Community Oral Health Service’ for children and some adolescents.

Who we think will be interested

• Parents and guardians of children who are treated under ‘Health New Zealand Community Oral Health Service’
• People of all ages who access public hospital dental services
• Oral health practitioners
• Health New Zealand
• Suppliers of dental products

About silver diamine fluoride

Silver diamine fluoride is a dental treatment that is applied to the decayed surface of teeth to halt the progression of tooth decay and manage tooth sensitivity. Silver diamine fluoride liquid is applied to the affected teeth by an oral health specialist using a small brush or applicator.

It can be especially helpful for children, elderly patients, and those who may find some traditional dental procedures challenging, such as people who are sensitive to noise. It is used in both hospitals and community dental clinics and can only be administered by a registered oral health professional.

Why we’re proposing this

This proposal follows an application(external link) to Pharmac for funding silver diamine fluoride in the Community Schedule (Section B) and Hospital Schedule (Section H).

Our clinical advisors have told us that silver diamine fluoride is an effective treatment that would reduce the need for more invasive dental treatments, such as drilling and restoration of teeth. In some cases, it would prevent people from needing a general anaesthetic and hospital admission. 

Funding sliver diamine fluoride would be expected to improve the oral health of New Zealanders by providing a less invasive option to treat tooth decay, reduce the need for more uncomfortable dental procedures, and provide cost savings to the health sector.

Listing silver diamine fluoride in Section H of the Pharmaceutical Schedule would enable access to this treatment for people accessing dental services through Health New Zealand public hospitals, and the ‘Health New Zealand Community Oral Health Service’ for children and some adolescents.

As silver diamine fluoride can only be applied by a registered oral health professional, there would be no circumstances where silver diamine fluoride would be dispensed directly to the public. 

It is proposed that the part of the application relating to listing on Section B of the Pharmaceutical Schedule be declined. This is because there is a different funding mechanism for medicines used in dental services that are contracted for by Health New Zealand, and these sit outside of the ‘Community Oral Health Services’ for children and some adolescents, which is delivered directly by Health New Zealand.

Details about our proposal

From 1 December 2025, silver diamine fluoride, brand name Topamine, would be listed in Part II of Section H of the Pharmaceutical Schedule as follows:

To provide feedback

Your feedback can be emailed to consult@pharmac.govt.nz. Consultation is open until 5pm, Thursday 30 October 2025.

All feedback received before the closing date will be considered by the Pharmac Board (or its delegate) prior to making a decision on this proposal.

Your feedback may be shared

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