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
Aesthetics · Children and adults (with or without carious lesions)
The review found no eligible studies for this question.
1 finding from 1 review
Adverse effects · Children and adults (with or without carious lesions)
1 finding from 1 review
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
Dental pain or sensitivity · Children and adults (with or without carious lesions)
The review found no eligible studies for this question.
1 finding from 1 review
Secondary prevention of caries · Children and adults (with or without carious lesions)
The review found no eligible studies for this question.
1 finding from 1 review
Primary caries prevention · Children and adults (with or without carious lesions)
The review found no eligible studies for this question.
1 finding from 1 review
Oral health-related quality of life · Children with dental caries
SDF plus fluoride varnish did not significantly differ from ART plus fluoride varnish for oral health-related quality of life (MD 0.16, 95% CI -0.1 to 0.42; ungraded).
1 finding from 1 review
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
OR (caries arrest) OR 2.44-3.63 (range); 2.44 = Chu estimate including 30% SDF
3 studies
GRADE not reported
Proportion (caries arrest) 81 [68, 89]
12 studies
GRADE not reported
Arrest of dentine caries · Children with active dentine caries in primary teeth
One study reported 30% silver diamine fluoride effectively arrested dentine caries in primary teeth; ungraded.
1 finding from 1 review
Remineralisation of early enamel caries · Children with early enamel caries in erupting permanent first molars
One pilot study found 10% silver diamine fluoride worked about as well as glass ionomer restoration and tooth-brushing for remineralising early enamel caries; ungraded.
1 finding from 1 review
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
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
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
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
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 ART/glass ionomer cement showed no clear difference in tooth-level caries arrestment (OR 1.22, wide CI; ungraded subgroup).
1 finding from 1 review
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
Caries lesion arrestment · Primary teeth with dentin caries lesions on occlusal and smooth surfaces
Silver diamine fluoride twice annually ranked first for caries lesion arrestment in the occlusal- and smooth-surface network (moderate certainty).
1 finding from 1 review
Immediate bond strength (MPa) · Dental adhesives/resin composite bonded to dentin (in vitro), sound or caries-affected
Prior SDF application significantly reduces the immediate bond strength of adhesives to dentin overall (MD 7.12 MPa favoring untreated dentin, 95% CI 1.38 to 12.85; ungraded), with very high heterogeneity (I2=98%).
1 finding from 1 review
Immediate bond strength (MPa) · Glass-ionomer cement bonded to dentin (in vitro), sound or caries-affected
Prior SDF application does not influence the immediate bond strength of glass-ionomer cement to dentin (MD -0.11 MPa, 95% CI -0.54 to 0.31; ungraded).
1 finding from 1 review
Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)
Only one in vitro study assessed a Self-Etch adhesive with the biological ACAD protocol; it was insufficient for network meta-analysis, so no pooled effect estimate is available (ungraded).
1 finding from 1 review