Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth
At 6 months, SDF had significantly higher treatment success than placebo (OR 33.62).
1 finding from 1 review
OR 33.62 [3.01, 375.92]
44 studies
GRADE not reported
Caries arrestment at the surface level · Children and adults without systemic diseases affecting dental health
SDF showed no clear advantage for caries arrestment at the surface level.
1 finding from 1 review
Caries arrest · Children and adults (with or without carious lesions)
It is very uncertain whether silver diamine fluoride (SDF) changes caries arrest compared with placebo or no treatment (very low certainty).
3 findings from 1 review
MD 0.20 [0.00, 0.40]
1 study · 373 participants
Very low
MD 0.24 [0.12, 0.36]
1 study · 158 participants
Very low
MD 0.86 [0.39, 1.33]
2 studies · 841 participants
Low
Secondary prevention of caries · Children and adults (with or without carious lesions)
The review found no eligible studies for this question.
3 findings from 1 review
No studies measured this outcome for root surfaces
0 studies
No studies found
Peto OR 44.22 [33.12, 59.04]
1 study · 663 participants
Very low
OR 1.08 [0.52, 2.23]
1 study · 128 participants
Very low
Primary caries prevention · Children and adults (with or without carious lesions)
It is very uncertain whether silver diamine fluoride (SDF) changes primary caries prevention compared with placebo or no treatment (very low certainty).
3 findings from 1 review
MD -1.14 [-1.58, -0.70]
1 study · 373 participants
Very low
MD -0.79 [-1.40, -0.17]
3 studies · 439 participants
Moderate
MD -0.69 [-0.97, -0.41]
1 study · 373 participants
Very low
Caries arrestment at the individual (patient) level · Children and adults without systemic diseases affecting dental health
SDF showed a higher caries-arrestment proportion at the individual level, but the reported difference was not statistically significant.
1 finding from 1 review
Caries arrestment at the tooth level · Children and adults without systemic diseases affecting dental health
SDF showed a higher caries-free proportion at the tooth level, but the reported difference was not statistically significant.
1 finding from 1 review
Adverse effects · Children and adults (with or without carious lesions)
2 findings from 1 review
1 study reported no adverse effects. 1 study reported a white discolouration of the gingiva adjacent to surfaces treated with SDF (116 surfaces) as well as redness (4 surfaces), and mild ulceration (2 surfaces). In…
2 studies · 316 participants
Very low
1 study reported 3 adverse effects in the first 48 hours. Of these, 1 effect in SDF group was possibly related to treatment (spot on corner of lip that looked like a burn), and 2 effects in placebo group were possibly…
3 studies · 983 participants
Very low
Aesthetics · Children and adults (with or without carious lesions)
1 finding from 1 review
1 study reported that "only 19 (7%) [older adult participants] raised a complaint about the interventions at the 30-mo [month] examination, and half of them complained of black stain on the treated root surfaces." No…
1 study · 43 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
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
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
One systematic review found that SDF can be efficacious to decrease progression of root carious lesions (no numeric results reported) [24].
Studies not reported
GRADE not reported
Prevented Fraction 100–725
2 studies
GRADE not reported
One low risk of bias systematic review reported that 38% SDF was significantly more effective than placebo in arresting root carious lesions (pooled results were not calculated) [31].
Studies not reported
GRADE not reported
Coronal carious lesions arrest · Children with dental caries in permanent (first) molars
One review reported a 100% prevented fraction for 38% SDF for arresting coronal caries in permanent first molars (one study; ungraded).
1 finding from 1 review
Prevented Fraction 100
1 study
GRADE not reported
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
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
Prevented Fraction 55–96
2 studies
GRADE not reported
Coronal carious lesions arrest · Children with coronal carious lesions (primary dentition)
One review reported a risk ratio of 2.54 favouring SDF over placebo/no treatment for arresting coronal caries in primary teeth (no CI; ungraded).
1 finding from 1 review
RR 2.54
2 studies
GRADE not reported
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
Arrest rate 65–91
6 studies
GRADE not reported
Coronal carious lesions prevention · Children with coronal carious lesions (primary dentition)
Reported prevented fractions for 38% SDF versus placebo for coronal-caries prevention in primary teeth ranged 70 to 78% (two reviews, two studies; ungraded).
1 finding from 1 review
Prevented Fraction 70–78
2 studies
GRADE not reported
Coronal carious lesions prevention · Children with dental caries in permanent (first) molars
One review reported a 64% prevented fraction for 38% SDF versus placebo for preventing coronal caries in permanent first molars (one study; ungraded).
1 finding from 1 review
Prevented Fraction 64
1 study
GRADE not reported
Prevention of new caries (caries development/increment) · Preschool children (primary dentition) at risk of new caries
Limited evidence from two trials suggests SDF may help prevent new caries, but preventive efficacy was not meta-analyzed and remains uncertain (ungraded).
1 finding from 1 review