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
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
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)
One review reported a risk ratio of 1.66 favouring SDF over fluoride varnish or ART for arresting coronal caries in primary teeth (no CI; ungraded).
1 finding from 1 review
RR 1.66
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)
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
Prevented Fraction -6
Studies not reported
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
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 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
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
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
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
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
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