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Evidence found and GRADE certainty

100 questions · 127 findings · 13 reviews · Dental caries

No studies found 1 · 0.8%GRADE not reported 83 · 65.4%Very low 7 · 5.5%Low 3 · 2.4%Moderate 15 · 11.8%High 18 · 14.2%

Silver diamine fluoride (SDF) vs placebo

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

Silver diamine fluoride (SDF) vs Placebo, control, and/or other interventions

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

Silver diamine fluoride (SDF) vs Placebo, control, and/or other interventions

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

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

SDF plus potassium iodide vs Split into two contrasts: (1) TCS paste (arrest 100%); (2) CPP-ACP (arrest 100%); SDF+KI arrest 54.8% at 24 months, p<.001

Caries arrest · Patients with early enamel carious lesions on permanent molars

SDF plus potassium iodide arrested 54.8% of early enamel lesions at 24 months; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

38% silver diamine fluoride vs Glass ionomer cement (GIC) plus fluoride varnish

Caries prevention (preventive fraction, SDF vs GIC+5% fluoride varnish) · intellectually disabled individuals with caries in permanent posterior teeth

SDF had a 45% preventative fraction versus glass ionomer cement plus fluoride varnish; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

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

restoration and caries status · children with caries in permanent molars

The review reported SDF was beneficial for arresting caries; no effect estimate or GRADE rating was reported.

1 finding from 1 review

38% SDF + potassium iodide solution (applied annually) vs CPP-ACP

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 CPP-ACP (54.8% vs 100% arrested; p<0.001; ungraded).

1 finding from 1 review

38% SDF (every 6 months) vs no treatment

Inactive (arrested) carious lesions on permanent first molars · Children with dental caries in permanent (first) molars

Six-monthly SDF produced significantly more inactive (arrested) lesions than no treatment in children's permanent molars (0.3 vs 0.1; p<0.05; ungraded).

1 finding from 1 review

38% SDF every 12 months vs water every 12 months

new carious lesions or fillings at fissure-site level · children with caries in permanent molars

SDF had a 52% preventative fraction at fissure-site level; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

Silver diamine fluoride (SDF) vs Any (current minimally invasive techniques)

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

Silver diamine fluoride (SDF) vs placebo

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

Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART)

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

38% silver diamine fluoride vs placebo

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

38% silver diamine fluoride vs placebo

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