Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

38 questions · 45 findings · 9 reviews

No studies found 5 · 11.1%GRADE not reported 23 · 51.1%Very low 7 · 15.6%Low 5 · 11.1%Moderate 5 · 11.1%High 0 · 0%

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

Caries arrest · Children and adults (with or without carious lesions)

Silver diamine fluoride (SDF) showed no clear difference in caries arrest compared with silver nitrate plus fluoride varnish (low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs placebo or no treatment

Caries arrest · Children and adults (with or without carious lesions)

It is very uncertain whether silver diamine fluoride (SDF) changes caries arrest compared with placebo or no treatment (very low certainty).

3 findings from 1 review

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

Caries arrest · Children and adults (with or without carious lesions)

It is very uncertain whether silver diamine fluoride (SDF) changes caries arrest compared with restoration (restorative treatment) (very low certainty).

1 finding from 1 review

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

Caries arrest · Children and adults (with or without carious lesions)

It is very uncertain whether silver diamine fluoride (SDF) changes caries arrest compared with glass ionomer cement (GIC) plus fluoride varnish (very low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Fluoride varnish

Caries arrest · Children and adults (with or without carious lesions)

The review found no eligible studies for this question.

3 findings from 1 review

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

Caries arrest · Children and adults (with or without carious lesions)

The review found no eligible studies for this question.

2 findings from 1 review

Silver diamine fluoride (SDF; 30% or 38%) vs No treatment or another non-invasive/minimally-invasive treatment (ART, sodium fluoride or silver-based varnish, or 12% SDF)

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

SDF is effective in arresting caries progression in cavitated primary molars overall (pooled ES 0.33, 95% CI 0.26-0.40; ungraded).

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) plus fluoride varnish vs Sealants plus fluoride varnish (with or without restorations)

Caries arrest · Children and adults (with or without carious lesions)

Silver diamine fluoride (SDF) plus fluoride varnish showed no clear difference in caries arrest compared with sealants plus fluoride varnish (with or without restorations) (low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Placebo, control, and/or other interventions

Caries arrestment at the tooth level · Children and adults without systemic diseases affecting dental health

SDF showed a higher caries-free proportion at the tooth level, but the reported difference was not statistically significant.

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 Nano-silver fluoride (NSF; with or without green tea extract)

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

Pooling two trials, SDF and nano-silver fluoride showed no significant difference in tooth-level caries arrestment (OR 1.47; 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 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

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

Silver diamine fluoride (SDF) vs Placebo, control, and/or other interventions

Caries arrestment at the individual (patient) level · Children and adults without systemic diseases affecting dental health

SDF showed a higher caries-arrestment proportion at the individual level, but the reported difference was not statistically significant.

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