Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

27 questions · 41 findings · 6 reviews · All outcomes

No studies found 0 · 0%GRADE not reported 26 · 63.4%Very low 0 · 0%Low 1 · 2.4%Moderate 4 · 9.8%High 10 · 24.4%

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

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% 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% 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% 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

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

Secondary caries prevention in young permanent first molars · Children with deep occlusal caries in young permanent first molars (indirect pulp capping)

SDF and RMGIC did not differ significantly for secondary caries prevention in young permanent molars (no events; p>0.05; ungraded).

1 finding from 1 review

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

Secondary caries prevention in young permanent first molars · Children with deep occlusal caries in young permanent first molars (indirect pulp capping)

SDF+KI and RMGIC did not differ significantly for secondary caries prevention (p>0.05; ungraded).

1 finding from 1 review

38% SDF plus potassium iodide (KI) (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) vs Other methods (pooled: ART/glass ionomer cement, nano-silver fluoride, placebo)

Caries arrestment at the individual (patient) level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

Compared with other caries-management methods, SDF may increase caries arrestment at the individual level, but the pooled estimate is very imprecise (low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART) with glass ionomer cement (GIC) or glass ionomer material

Caries arrestment at the individual (patient) level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

In one trial, SDF greatly increased individual-level caries arrestment versus ART/glass ionomer cement (OR 18.03); this subgroup was not separately GRADE-rated.

1 finding from 1 review

Silver diamine fluoride (SDF) vs Fluoride varnish

Caries arrestment at the tooth level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

In one trial, SDF increased tooth-level caries arrestment versus 5% sodium fluoride varnish (OR 4.75; ungraded subgroup).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Fluoride varnish

Caries arrestment at the surface level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

Pooling two highly heterogeneous trials, SDF showed no significant difference versus 5% sodium fluoride varnish in surface-level caries arrestment (OR 1.46; ungraded subgroup).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Nano-silver fluoride (NSF; with or without green tea extract)

Caries arrestment at the surface level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

In one trial, nano-silver fluoride arrested more surfaces than SDF (OR 0.52 favoring the comparator; ungraded subgroup).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Nano-silver fluoride (NSF; with or without green tea extract)

Caries arrestment at the individual (patient) level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

Pooling two trials, nano-silver fluoride achieved higher individual-level caries arrestment than SDF (OR 0.39 favoring the comparator; ungraded subgroup).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Other methods (pooled: ART/glass ionomer cement, nano-silver fluoride, sodium fluoride varnish)

Caries arrestment at the tooth level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

SDF probably results in a slight increase in tooth-level caries arrestment versus other methods (moderate certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs placebo control

Caries arrestment at the individual (patient) level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

Pooling two trials, SDF markedly increased individual-level caries arrestment versus placebo (OR 18.10; ungraded subgroup).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Other methods (pooled: nano-silver fluoride, sodium fluoride varnish)

Caries arrestment at the surface level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

SDF probably makes little to no difference to surface-level caries arrestment versus other methods (moderate certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Other methods (pooled: ART/glass ionomer cement, nano-silver fluoride, sodium fluoride varnish, placebo)

Adverse effects (tooth staining and other side effects) · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

SDF commonly causes black staining of arrested lesions; only mild, transient adverse events were reported, with no major adverse events (ungraded).

1 finding from 1 review