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What do systematic reviews say?

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Evidence found and GRADE certainty

63 questions · 79 findings · 8 reviews · Dental caries

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% silver diamine fluoride vs Atraumatic restorative treatment (ART)

Caries/restoration status in permanent molars · Children with dental caries in permanent (first) molars

SDF gave significantly better caries/restoration outcomes than ART over 9 months in children's permanent molars (p=0.004; ungraded).

1 finding from 1 review

38% silver diamine fluoride vs Glass ionomer cement (GIC) plus fluoride varnish

Caries prevention (preventive fraction, SDF vs GIC+5% fluoride varnish) · intellectually disabled individuals with caries in permanent posterior teeth

SDF had a 45% preventative fraction versus glass ionomer cement plus fluoride varnish; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

38% silver diamine fluoride vs Atraumatic restorative treatment (ART)

restoration and caries status · children with caries in permanent molars

The review reported SDF was beneficial for arresting caries; no effect estimate or GRADE rating was reported.

1 finding from 1 review

38% SDF + potassium iodide solution (applied annually) vs CPP-ACP

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 CPP-ACP (54.8% vs 100% arrested; p<0.001; ungraded).

1 finding from 1 review

38% SDF (every 6 months) vs no treatment

Inactive (arrested) carious lesions on permanent first molars · Children with dental caries in permanent (first) molars

Six-monthly SDF produced significantly more inactive (arrested) lesions than no treatment in children's permanent molars (0.3 vs 0.1; p<0.05; ungraded).

1 finding from 1 review

38% SDF every 12 months vs water every 12 months

new carious lesions or fillings at fissure-site level · children with caries in permanent molars

SDF had a 52% preventative fraction at fissure-site level; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

38% silver diamine fluoride vs placebo

Root carious lesions arrest · Older adults with root carious lesions (exposed root surfaces)

One review reported SDF may reduce progression of root caries, with no numeric result (ungraded).

3 findings from 1 review

38% silver diamine fluoride vs placebo

Root carious lesions prevention · Older adults with root carious lesions (exposed root surfaces)

38% silver diamine fluoride reduced root-caries increment (DMFRS/DFRS) versus placebo, MD −0.33 (95% CI −0.39 to −0.28) (ungraded).

3 findings from 1 review

38% silver diamine fluoride vs Fluoride varnish or placebo

Coronal carious lesions arrest · Children with coronal carious lesions (primary dentition)

One review reported prevented fractions of 55 to 96% favouring 38% SDF over fluoride varnish or placebo for arresting coronal caries in primary teeth (two studies; ungraded).

1 finding from 1 review

38% silver diamine fluoride vs Fluoride varnish, glass ionomer cement, or placebo

Coronal carious lesions arrest · Children with coronal carious lesions (primary dentition)

Across three reviews, 38% SDF arrested 65 to 91% of coronal lesions in primary teeth, outperforming fluoride varnish (38 to 44%), glass ionomer cement (39 to 82%), and placebo (34%) (ungraded).

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 · Primary teeth with advanced cavitated carious lesions on any coronal surface

38% SDF solution biannually compared with 12% SDF solution biannually: RR 1.29 (95% CI 1.21 to 1.38); High certainty.

1 finding from 1 review

38% SDF (one-time application) vs inactive control

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

One-time SDF within a brushing programme did not significantly reduce caries vs control (p>0.05; ungraded).

2 findings from 1 review