What do systematic reviews say?

Silver diamine fluoride (SDF) plus fluoride varnish vs Sealants plus fluoride varnish (with or without restorations)

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes

  Study period (24 months) · Children
  Ruff 2022 reported that there were no adverse events during the study period; adverse events were not defined by the study authors. Assumed data available for 1398 participants.
  1 study · 1398 participants
  Very low

Fluoride varnish vs Non-fluoride (placebo) varnish

• Fluorides for preventing early tooth decay (demineralised lesions) during fixed brace treatment 2019 · Cochrane All outcomes

  At debond; follow-up 1.7 years
  SoF 1. Adverse effects: no evidence that the intervention had adverse effects; only 1 participant with an adverse event and unclear if directly related to the intervention. 148 participants (1 RCT, Sonesson 2019);…
  1 study · 148 participants
  Low

Fluoride varnish vs placebo or no treatment

• Fluoride varnishes for preventing dental caries in children and adolescents 2013 · Cochrane All outcomes

  At least 1 year
  Three trials (Salazar 2008; Skold 2005; Weintraub 2006) provided data reporting no adverse effects. There was little information concerning possible adverse effects; no pooled estimate was possible.
  3 studies
  GRADE not reported

Fluoride mouthrinse, gel or varnish combined with fluoride toothpaste (any combined regimen) vs Fluoride toothpaste alone

• Combinations of topical fluoride (toothpastes, mouthrinses, gels, varnishes) versus single topical fluoride for… 2004 · Cochrane All outcomes
  Adverse-effect data scarcely reported: a stain score in one trial and 'any side effects' in one trial without complete or useable data (stated 'no side effects observed in both groups'). No useful information on tooth…
  Studies not reported
  GRADE not reported

Silver diamine fluoride (SDF) vs Glass ionomer cement (GIC) plus fluoride varnish

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes

  6 months
  Parents were asked if any harm was noticed due to the use of SDF, but the results were not reported in the study report; we could not determine whether there were any associated harms with either treatment (Mendiratta…
  1 study
  GRADE not reported

Silver diamine fluoride (SDF) vs Silver nitrate plus fluoride varnish

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes

  18 months · Children
  Gao 2019 noted that "arrested lesions were stained black" (reported with no associated data). No other adverse effects observed, and no reports from parents of systemic disease.
  1 study · 1070 participants
  Very low

Silver diamine fluoride (SDF) vs Fluoride varnish

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes

  24 hours to 30 months · Children
  In 1 study, black or brown staining on treated lesions was more common after SDF (OR 3.19, 95% CI 1.95 to 5.23), with no other adverse effects. 1 study reported complaints of a transient bitter taste with SDF use (with…
  3 studies · 980 participants
  Very low

Topical fluoride therapy (toothpaste, mouthrinse, gel or varnish; any fluoride agent/concentration; frequency at least once a year) vs placebo or no treatment

• Topical fluoride (toothpastes, mouthrinses, gels or varnishes) for preventing dental caries in children and adolescents 2003 · Cochrane All outcomes
  Data on adverse effects (stain score, proportion of children with tooth staining, signs of sensitivity in oral soft tissue, adverse symptoms such as nausea/vomiting, etching of enamel) were reported in only a few…
  Studies not reported
  GRADE not reported

Silver diamine fluoride (SDF) vs Chlorhexidine varnish

The review found no eligible studies for this question.

• Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults 2024 · Cochrane All outcomes
  No studies reported data for this outcome in this comparison
  0 studies
  No studies found

Silver diamine fluoride (SDF) vs Other methods (pooled: ART/glass ionomer cement, nano-silver fluoride, sodium fluoride varnish, placebo)

SDF commonly causes black staining of arrested lesions; only mild, transient adverse events were reported, with no major adverse events (ungraded).

• The role of silver diamine fluoride as dental caries preventive and arresting agent: a systematic review and… 2024 All outcomes

  up to 30 months · Children/adults with dental caries; multiple countries; community/clinic care setting not clearly specified
  Black staining of arrested lesions reported in most studies; 4 studies reported mild transient events (gingival blenching/pain; diarrhea/stomachache; burning, bad taste, pain, mouth injury, dissatisfaction with…
  Studies not reported
  GRADE not reported