Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

108 questions · 125 findings · 5 reviews

No studies found 36 · 28.8%GRADE not reported 44 · 35.2%Very low 34 · 27.2%Low 6 · 4.8%Moderate 5 · 4%High 0 · 0%

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

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

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

Caries arrest · Children and adults (with or without carious lesions)
1 finding from 1 review

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

Secondary prevention of caries · Children and adults (with or without carious lesions)

It is very uncertain whether SDF (given at a particular frequency, concentration, or duration) changes secondary prevention of caries compared with SDF (given at a different frequency, concentration, or duration) (very low certainty).

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

Silver diamine fluoride (SDF, including SDF + fluoride varnish) vs Other standard-of-care caries treatments pooled (placebo, ART, or ART + fluoride varnish)

Oral health-related quality of life · Children with dental caries

SDF had no significant effect on oral health-related quality of life versus pooled standard-of-care caries treatments (SMD -0.06, 95% CI -0.20 to 0.08; 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% 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% 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

Silver diamine fluoride (SDF) vs placebo

Oral health-related quality of life · Children with dental caries

SDF did not significantly differ from placebo for oral health-related quality of life in children (MD 0.03, 95% CI -0.16 to 0.22; ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART)

Oral health-related quality of life · Children with dental caries

SDF did not significantly differ from atraumatic restorative treatment for oral health-related quality of life (MD 0.02, 95% CI -0.32 to 0.36; 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 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