What do systematic reviews say?

Silver diamine fluoride (SDF) vs Silver nitrate plus fluoride varnish

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes

  18 months · Children
  Gao 2019 noted that "arrested lesions were stained black" (reported with no associated data). No other adverse effects observed, and no reports from parents of systemic disease.
  1 study · 1070 participants
  Very low

Silver diamine fluoride (SDF) vs Restoration (restorative treatment)

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes

  12 months · Children
  Cleary 2022 reported that there were no unanticipated adverse events; adverse events were not defined.
  1 study
  Very low

Silver diamine fluoride (SDF) vs Sealants or resin infiltration

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes

  24 months · Children
  In 1 study, people complained about a transient bitter taste associated with SDF (with no associated data), with no other adverse effects. In another study, there were no adverse effects. No studies reported this…
  2 studies · 336 participants
  Very low

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

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes

  48 hours to 24 months · Children
  In 1 study, 115 of 118 children had black stains on teeth treated with SDF; there were no other adverse effects or allergic reactions. In 1 study, the rate of adverse effects reported by caregiver and person who…
  3 studies · 482 participants
  Very low

Silver diamine fluoride (SDF) vs Glass ionomer cement (GIC) plus fluoride varnish

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes

  6 months
  Parents were asked if any harm was noticed due to the use of SDF, but the results were not reported in the study report; we could not determine whether there were any associated harms with either treatment (Mendiratta…
  1 study
  GRADE not reported

Silver diamine fluoride (SDF) vs placebo or no treatment

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes

  12 to 30 months · Adults
  1 study reported no adverse effects. 1 study reported a white discolouration of the gingiva adjacent to surfaces treated with SDF (116 surfaces) as well as redness (4 surfaces), and mild ulceration (2 surfaces). In…
  2 studies · 316 participants
  Very low
• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes

  48 hours to 30 months · Children
  1 study reported 3 adverse effects in the first 48 hours. Of these, 1 effect in SDF group was possibly related to treatment (spot on corner of lip that looked like a burn), and 2 effects in placebo group were possibly…
  3 studies · 983 participants
  Very low

Silver diamine fluoride (SDF) vs Fluoride varnish

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes

  24 hours to 30 months · Children
  In 1 study, black or brown staining on treated lesions was more common after SDF (OR 3.19, 95% CI 1.95 to 5.23), with no other adverse effects. 1 study reported complaints of a transient bitter taste with SDF use (with…
  3 studies · 980 participants
  Very low

Silver diamine fluoride (SDF) vs Chlorhexidine varnish

The review found no eligible studies for this question.

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes
  No studies reported data for this outcome in this comparison
  0 studies
  No studies found

Silver diamine fluoride (SDF) plus fluoride varnish vs Sealants plus fluoride varnish (with or without restorations)

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes

  Study period (24 months) · Children
  Ruff 2022 reported that there were no adverse events during the study period; adverse events were not defined by the study authors. Assumed data available for 1398 participants.
  1 study · 1398 participants
  Very low

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

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

• The role of silver diamine fluoride as dental caries preventive and arresting agent: a systematic review and… 2024 All outcomes

  up to 30 months · Children/adults with dental caries; multiple countries; community/clinic care setting not clearly specified
  Black staining of arrested lesions reported in most studies; 4 studies reported mild transient events (gingival blenching/pain; diarrhea/stomachache; burning, bad taste, pain, mouth injury, dissatisfaction with…
  Studies not reported
  GRADE not reported

SDF (given at a particular frequency, concentration, or duration) vs SDF (given at a different frequency, concentration, or duration)

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes

  24 to 30 months · Children
  1 study (203 children) reported that black or brown staining on treated lesions was commonly found in both groups, with little or no difference according to whether SDF treatment was given in 3 applications at…
  3 studies · 1121 participants
  Very low