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What do systematic reviews say?

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Evidence found and GRADE certainty

41 questions · 49 findings · 9 reviews

No studies found 5 · 10.2%GRADE not reported 25 · 51%Very low 7 · 14.3%Low 5 · 10.2%Moderate 7 · 14.3%High 0 · 0%

Silver diamine fluoride (SDF) vs Nano-silver fluoride (NSF; with or without green tea extract)

Caries arrestment at the individual (patient) level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

Pooling two trials, nano-silver fluoride achieved higher individual-level caries arrestment than SDF (OR 0.39 favoring the comparator; ungraded subgroup).

1 finding from 1 review

Silver diamine fluoride (SDF) vs placebo control

Caries arrestment at the individual (patient) level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)

Pooling two trials, SDF markedly increased individual-level caries arrestment versus placebo (OR 18.10; ungraded subgroup).

1 finding from 1 review

30% silver diamine fluoride vs Not specified

Arrest of dentine caries · Children with active dentine caries in primary teeth

One study reported 30% silver diamine fluoride effectively arrested dentine caries in primary teeth; ungraded.

1 finding from 1 review

12% silver diamine fluoride (SDF), single (one-off) application vs Not specified

Arrest of dentine caries · Children with active dentine caries

One trial found a single application of 12% silver diamine fluoride did not arrest dentine caries; ungraded.

1 finding from 1 review

Silver diamine fluoride (SDF) vs placebo or no treatment

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

Silver diamine fluoride (SDF) vs Restoration (restorative treatment)

Caries arrest · Children and adults (with or without carious lesions)

It is very uncertain whether silver diamine fluoride (SDF) changes caries arrest compared with restoration (restorative treatment) (very low certainty).

1 finding from 1 review

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

Caries arrest · Children and adults (with or without carious lesions)

It is very uncertain whether silver diamine fluoride (SDF) changes caries arrest compared with glass ionomer cement (GIC) plus fluoride varnish (very low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Fluoride varnish

Caries arrest · Children and adults (with or without carious lesions)

The review found no eligible studies for this question.

3 findings from 1 review

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

Caries arrest · Children and adults (with or without carious lesions)

Silver diamine fluoride (SDF) showed no clear difference in caries arrest compared with silver nitrate plus fluoride varnish (low certainty).

1 finding from 1 review

Silver diamine fluoride (SDF) vs Atraumatic restorative treatment (ART) with glass ionomer cement (GIC) or glass ionomer material

Caries arrest · Children and adults (with or without carious lesions)

The review found no eligible studies for this question.

2 findings from 1 review

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

Caries arrest · Children and adults (with or without carious lesions)

Silver diamine fluoride (SDF) plus fluoride varnish showed no clear difference in caries arrest compared with sealants plus fluoride varnish (with or without restorations) (low certainty).

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

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

38% SDF solution (applied biannually) vs 38% SDF solution (applied annually)

Caries arrest · Children with dentine carious lesions (ICDAS 4-5) in primary teeth

Twice-yearly 38% SDF was reported to arrest more caries than once-yearly application (24-month rates 91% vs 79%; ungraded).

1 finding from 1 review

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

38% silver diamine fluoride vs No treatment / other preventive agents (GIC, 5% NaF varnish)

Caries arrest · Children with dentine carious lesions (ICDAS 4-5) in primary teeth

A second meta-analysis reported odds ratios of 2.44 to 3.63 favouring 38% SDF over fluoride varnish/water for caries arrest (ungraded).

2 findings from 1 review

Hall technique vs Silver diamine fluoride

Treatment success (caries lesion arrest or restoration survival) · Children (aged 3-11 y) with cavitated caries lesions in primary teeth

At 12 months, the Hall technique had significantly higher treatment success than SDF (OR 3.23; moderate certainty).

2 findings from 1 review