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Evidence found and GRADE certainty

160 questions · 203 findings · 14 reviews · Dental caries

No studies found 36 · 17.7%GRADE not reported 85 · 41.9%Very low 41 · 20.2%Low 7 · 3.4%Moderate 16 · 7.9%High 18 · 8.9%

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

Silver diamine fluoride (SDF) vs Any (current minimally invasive techniques)

Not applicable (no eligible studies) · Adults with coronal (crown) dental caries in permanent teeth

No eligible studies assessed SDF for coronal caries in adults; this is an evidence gap identified by the review.

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

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

Silver diamine fluoride (SDF) vs Not applicable (single-arm safety outcome)

Serious adverse events · Children and older adults treated with SDF for carious lesions

No serious adverse events (e.g., allergic reactions or toxicity) were reported for SDF across the reviews (ungraded).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Not applicable (single-arm safety outcome)

Adverse events: black staining of arrested lesions · Children and older adults treated with SDF for carious lesions

Black staining of arrested lesions was the main adverse event of SDF (reported by seven reviews); it was generally acceptable to patients (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

30% silver diamine fluoride vs Glass ionomer cement (GIC)

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

One review reported glass ionomer cement was more effective than 30% SDF at 12 months (PF −6%), but the difference was not statistically significant (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

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