Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

94 questions · 111 findings · 4 reviews · Oral Health

No studies found 35 · 31.5%GRADE not reported 31 · 27.9%Very low 34 · 30.6%Low 6 · 5.4%Moderate 5 · 4.5%High 0 · 0%

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

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, nano-silver fluoride achieved higher individual-level caries arrestment than SDF (OR 0.39 favoring the comparator; 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 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

38% silver diamine fluoride vs Atraumatic restorative treatment (ART)

Caries/restoration status in permanent molars · Children with dental caries in permanent (first) molars

SDF gave significantly better caries/restoration outcomes than ART over 9 months in children's permanent molars (p=0.004; ungraded).

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

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

Dental pain or sensitivity · Children and adults (with or without carious lesions)

It is very uncertain whether silver diamine fluoride (SDF) changes dental pain or sensitivity compared with atraumatic restorative treatment (ART) with glass ionomer cement… (very low certainty).

1 finding from 1 review

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

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

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

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

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

38% SDF one-time application without brushing programme vs no treatment without brushing programme

new carious lesions or fillings · Children with dental caries in permanent (first) molars

The review reported no significant result for SDF; no effect estimate or GRADE rating was reported.

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

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

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

Silver diamine fluoride (SDF) vs 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)

In one trial, SDF increased tooth-level caries arrestment versus 5% sodium fluoride varnish (OR 4.75; ungraded subgroup).

1 finding from 1 review

Silver diamine fluoride (SDF) vs 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)

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

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 placebo control

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

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

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

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

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