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Evidence found and GRADE certainty

63 questions · 79 findings · 8 reviews · Oral Health

No studies found 0 · 0%GRADE not reported 56 · 70.9%Very low 6 · 7.6%Low 2 · 2.5%Moderate 4 · 5.1%High 11 · 13.9%

38% SDF (one-time application) vs Information unavailable

New coronal carious lesions or fillings on permanent (first) molars (caries prevention) · Children with dental caries in permanent (first) molars

One-time 38% SDF gave a 57% prevented fraction for caries in children's permanent first molars (single study; ungraded).

1 finding from 1 review

38% SDF (indirect pulp capping) vs Resin-modified glass ionomer cement (RMGIC)

Restoration color, marginal staining and luster (esthetics) · Children with deep occlusal caries in young permanent first molars (indirect pulp capping)

RMGIC gave significantly better restoration esthetics than SDF, which caused black staining (p=0.03; ungraded).

1 finding from 1 review

38% silver diamine fluoride vs No treatment / other preventive agents (GIC, 5% NaF varnish)

Caries arrest · Children with dentine carious lesions (ICDAS 4-5) in primary teeth

A second meta-analysis reported odds ratios of 2.44 to 3.63 favouring 38% SDF over fluoride varnish/water for caries arrest (ungraded).

2 findings from 1 review

38% SDF + potassium iodide solution (applied annually) vs Tricalcium silicate (TCS) paste (applied twice daily)

Remineralization/arrest of early enamel carious lesions · Patients with early enamel carious lesions on permanent molars

For early enamel lesions, annual SDF+KI was significantly LESS effective than twice-daily tricalcium silicate paste (54.8% vs 100% arrested; p<0.001; ungraded).

1 finding from 1 review

38% SDF plus oral health education vs oral health instruction plus water

new root-surface carious lesions or restorations · community-dwelling older adults with root caries

SDF plus oral health education had a 33% preventative fraction at 24 months; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

38% silver diamine fluoride vs Fluoride varnish

Arrest or reversal of noncavitated and cavitated root carious lesions · Adults (including institutionalized/older adults) with noncavitated and cavitated carious lesions on root surfaces (permanent teeth)

38% SDF solution (applied annually) may not differ from 5% NaF varnish for arrest or reversal of root carious lesions (RR 0.64, 95% CI 0.04 to 9.66; very low certainty).

1 finding from 1 review

38% silver diamine fluoride vs no treatment

Arrest or reversal of noncavitated and cavitated root carious lesions · Adults (including institutionalized/older adults) with noncavitated and cavitated carious lesions on root surfaces (permanent teeth)

38% SDF solution (applied annually) may not differ from no treatment for arrest or reversal of root carious lesions (RR 1.92, 95% CI 0.52 to 6.87; very low certainty).

1 finding from 1 review

38% silver diamine fluoride vs 12% SDF solution (applied annually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied annually) was more effective than 12% SDF solution (applied annually) for arrest or reversal of cavitated coronal carious lesions (RR 1.27, 95% CI 1.16 to 1.4; high certainty).

4 findings from 1 review
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38% silver diamine fluoride vs 5,000-ppm F (1.1% NaF) toothpaste or gel

Arrest or reversal of noncavitated and cavitated root carious lesions · Adults (including institutionalized/older adults) with noncavitated and cavitated carious lesions on root surfaces (permanent teeth)

38% SDF solution (applied annually) may not differ from 5,000-ppm F (1.1% NaF) toothpaste or gel for arrest or reversal of root carious lesions (RR 0.72, 95% CI 0.18 to 2.95; very low certainty).

1 finding from 1 review

38% silver diamine fluoride vs 38% SDF + potassium iodide solution (applied annually)

Arrest or reversal of noncavitated and cavitated root carious lesions · Adults (including institutionalized/older adults) with noncavitated and cavitated carious lesions on root surfaces (permanent teeth)

38% SDF solution (applied annually) may not differ from 38% SDF + potassium iodide solution (applied annually) for arrest or reversal of root carious lesions (RR 0.8, 95% CI 0.25 to 2.61; low certainty).

1 finding from 1 review

38% SDF plus oral health education vs oral health instruction plus tonic water

new root-surface carious lesions or restorations · community-dwelling older adults with root caries

SDF had a 62% preventative fraction; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

38% SDF solution (applied biannually) vs 12% SDF solution (applied biannually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied biannually) was more effective than 12% SDF solution (applied biannually) for arrest or reversal of cavitated coronal carious lesions (RR 1.3, 95% CI 1.21 to 1.41; high certainty).

4 findings from 1 review
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38% SDF solution (applied biannually) vs 38% SDF solution (applied annually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied biannually) was more effective than 38% SDF solution (applied annually) for arrest or reversal of cavitated coronal carious lesions (RR 1.21, 95% CI 1.12 to 1.3; high certainty).

4 findings from 1 review
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38% SDF (applied every 6 or 12 months) vs 12% SDF solution (applied annually)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

38% SDF arrested more caries than 12% SDF (pooled ES 0.37, 95% CI 0.27-0.47; single study; ungraded).

1 finding from 1 review

OHI + 38% SDF (applied every 12 months) vs oral health instruction plus water

new root-surface carious lesions or restorations · community-dwelling older adults with root caries

SDF had a 28% preventative fraction at 24 months; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

38% SDF solution (applied biannually) vs 38% SDF solution (applied annually)

Caries arrest · Children with dentine carious lesions (ICDAS 4-5) in primary teeth

Twice-yearly 38% SDF was reported to arrest more caries than once-yearly application (24-month rates 91% vs 79%; ungraded).

1 finding from 1 review

38% SDF (indirect pulp capping) vs Resin-modified glass ionomer cement (RMGIC)

Secondary prevention of caries · children with deep occlusal carious lesions in permanent molars

No significant difference in secondary caries prevention was reported; no effect estimate or GRADE rating was reported.

1 finding from 1 review

Silver diamine fluoride (SDF; 30% or 38%) vs Atraumatic restorative treatment (ART)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

SDF was not significantly better than ART at arresting caries (pooled ES 0.05, 95% CI -0.42 to 0.51; ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF; 30% or 38%) vs Fluoride varnish

Arrest of dentine caries · Preschool children with active dentine caries in primary teeth (mean age 3.4-4.0 years)

Silver diamine fluoride was about 2.5 times more likely than sodium fluoride to arrest dentine caries surfaces at 18 months (pooled OR 2.51, 95% CI 1.25 to 5.10; 2 RCTs), although between-study heterogeneity was high (I2=90.3%); certainty of evidence was not formally graded.

2 findings from 1 review

38% SDF varnish plus oral health instruction vs oral health instruction plus water

new root-surface carious lesions or restorations · Older adults with root caries in permanent (mature) teeth (mean age 75 years)

SDF had a 71% preventative fraction at 36 months; no pooled estimate or GRADE rating was reported.

1 finding from 1 review