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Evidence found and GRADE certainty

160 questions · 203 findings · 14 reviews · Oral Health

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 (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% 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

30% silver diamine fluoride vs Atraumatic restorative treatment (ART)

Patient discomfort during treatment (anxiety scale) · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

One study found no significant difference in patient discomfort between SDF and ART (p = 0.15; ungraded).

1 finding from 1 review

30% silver diamine fluoride vs Not specified

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

10% silver diamine fluoride (SDF) vs Glass ionomer restoration and tooth-brushing

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

38% SDF + potassium iodide solution (applied annually) vs Tricalcium silicate (TCS) paste (applied twice daily)

Remineralization/arrest of early enamel carious lesions · Patients with early enamel carious lesions on permanent molars

For early enamel lesions, annual SDF+KI was significantly LESS effective than twice-daily tricalcium silicate paste (54.8% vs 100% arrested; p<0.001; 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% silver diamine fluoride vs Fluoride varnish

Arrest or reversal of noncavitated and cavitated root carious lesions · Adults (including institutionalized/older adults) with noncavitated and cavitated carious lesions on root surfaces (permanent teeth)

38% SDF solution (applied annually) may not differ from 5% NaF varnish for arrest or reversal of root carious lesions (RR 0.64, 95% CI 0.04 to 9.66; very low certainty).

1 finding from 1 review

30% SDF solution (applied annually) vs 30% SDF solution (once weekly for 3 weeks)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

30% SDF solution (applied annually) probably did not differ from 30% SDF solution (once weekly for 3 weeks) for arrest or reversal of cavitated coronal carious lesions (RR 1.13, 95% CI 0.95 to 1.34; moderate certainty).

3 findings from 1 review

38% silver diamine fluoride vs no treatment

Arrest or reversal of noncavitated and cavitated root carious lesions · Adults (including institutionalized/older adults) with noncavitated and cavitated carious lesions on root surfaces (permanent teeth)

38% SDF solution (applied annually) may not differ from no treatment for arrest or reversal of root carious lesions (RR 1.92, 95% CI 0.52 to 6.87; very low certainty).

1 finding from 1 review

30% SDF solution (applied annually) vs Fluoride varnish

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

30% SDF solution (applied annually) was more effective than 5% NaF varnish (once weekly for 3 weeks) for arrest or reversal of cavitated coronal carious lesions (RR 1.41, 95% CI 1.2 to 1.66; high certainty).

3 findings from 1 review

38% silver diamine fluoride vs 12% SDF solution (applied annually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied annually) was more effective than 12% SDF solution (applied annually) for arrest or reversal of cavitated coronal carious lesions (RR 1.27, 95% CI 1.16 to 1.4; high certainty).

4 findings from 1 review
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12% SDF solution (applied annually) vs 12% SDF solution (applied biannually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

12% SDF solution (applied annually) did not differ from 12% SDF solution (applied biannually) for arrest or reversal of cavitated coronal carious lesions (RR 0.94, 95% CI 0.87 to 1.02; high certainty).

4 findings from 1 review
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38% silver diamine fluoride vs 5,000-ppm F (1.1% NaF) toothpaste or gel

Arrest or reversal of noncavitated and cavitated root carious lesions · Adults (including institutionalized/older adults) with noncavitated and cavitated carious lesions on root surfaces (permanent teeth)

38% SDF solution (applied annually) may not differ from 5,000-ppm F (1.1% NaF) toothpaste or gel for arrest or reversal of root carious lesions (RR 0.72, 95% CI 0.18 to 2.95; very low certainty).

1 finding from 1 review

38% silver diamine fluoride vs 38% SDF + potassium iodide solution (applied annually)

Arrest or reversal of noncavitated and cavitated root carious lesions · Adults (including institutionalized/older adults) with noncavitated and cavitated carious lesions on root surfaces (permanent teeth)

38% SDF solution (applied annually) may not differ from 38% SDF + potassium iodide solution (applied annually) for arrest or reversal of root carious lesions (RR 0.8, 95% CI 0.25 to 2.61; low certainty).

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

38% SDF solution (applied biannually) vs 12% SDF solution (applied biannually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied biannually) was more effective than 12% SDF solution (applied biannually) for arrest or reversal of cavitated coronal carious lesions (RR 1.3, 95% CI 1.21 to 1.41; high certainty).

4 findings from 1 review
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38% SDF solution (applied biannually) vs 38% SDF solution (applied annually)

Arrest of advanced cavitated carious lesions on any coronal surface · Preschool children with advanced cavitated carious lesions on any coronal surface (primary teeth)

38% SDF solution (applied biannually) was more effective than 38% SDF solution (applied annually) for arrest or reversal of cavitated coronal carious lesions (RR 1.21, 95% CI 1.12 to 1.3; high certainty).

4 findings from 1 review
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Fluoride agent (e.g., NaF/SDF/KF/CaF2) vs No biomimetic remineralization (control)

Immediate (24 h) resin-dentin bond strength (MPa) · Artificial caries-affected dentin (ACAD) in extracted permanent human teeth (in vitro)

In the Etch-and-Rinse adhesive + biological ACAD protocol network, Fluorine showed 4.197 MPa higher 24 h bond strength than Control (MD 4.197, 95% CI 1.080 to 7.314; Moderate certainty).

3 findings from 1 review

38% SDF (applied every 6 or 12 months) vs 12% SDF solution (applied annually)

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

38% SDF arrested more caries than 12% SDF (pooled ES 0.37, 95% CI 0.27-0.47; single study; ungraded).

1 finding from 1 review