What do systematic reviews say?

Resin-based fissure sealant vs Fluoride varnish

• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes
  Five studies (Bravo 2005; Chestnutt 2017; Kalnina 2016; Liu 2012; Tagliaferro 2011) considered adverse events; participants detected and reported no adverse events.
  5 studies
  GRADE not reported

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

Microinvasive techniques (resin infiltration, resin/GIC sealant, or glass ionomer varnish) vs Non-invasive measures (fluoride varnish/toothpaste, flossing, oral hygiene instruction, sham/standard of care)

Only three trials reported secondary/adverse outcomes; no adverse events were attributed to microinvasive treatment and periodontal findings were mixed and not pooled (ungraded).

• Microinvasive interventions in the management of proximal caries lesions in primary and permanent teeth- systematic… 2025 All outcomes

  Baseline and follow-up · Multiple countries (Brazil, Saudi Arabia, Netherlands, USA, Turkey, Switzerland, Germany, New Zealand, Chile, Thailand); dental clinic/community settings
  Reported narratively by 3 trials (Arthur 2018, Sarti 2020, Jorge 2019). No adverse events were attributed to microinvasive treatment. Gingival bleeding index: no significant difference in Arthur 2018 and Jorge 2019 but…
  3 studies
  GRADE not reported

Micro-invasive treatment (proximal sealing or resin infiltration): resin sealant, glass ionomer sealant, polyurethane/adhesive patch, or resin infiltration vs Non-invasive / control treatment

• Micro‐invasive interventions for managing proximal dental decay in primary and permanent teeth 2015 · Cochrane All outcomes

  1 to 3 years
  The four studies that measured adverse events reported no adverse events after micro-invasive treatment (no events in either arm)
  4 studies
  GRADE not reported