Caries arrestment at the tooth level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)
In one trial, SDF increased tooth-level caries arrestment versus 5% sodium fluoride varnish (OR 4.75; ungraded subgroup).
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)
Pooling two highly heterogeneous trials, SDF showed no significant difference versus 5% sodium fluoride varnish in surface-level caries arrestment (OR 1.46; ungraded subgroup).
1 finding from 1 review
Caries arrestment at the tooth level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)
SDF probably results in a slight increase in tooth-level caries arrestment versus other methods (moderate 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)
SDF probably makes little to no difference to surface-level caries arrestment versus other methods (moderate certainty).
1 finding from 1 review
Adverse effects (tooth staining and other side effects) · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)
SDF commonly causes black staining of arrested lesions; only mild, transient adverse events were reported, with no major adverse events (ungraded).
1 finding from 1 review
Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars
SDF is effective in arresting caries progression in cavitated primary molars overall (pooled ES 0.33, 95% CI 0.26-0.40; ungraded).
1 finding from 1 review
Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars
The pooled caries arrest rate with SDF (>=30%, applied annually/biannually) was 51.62% (622/1205 lesions arrested) at >=12 months follow-up.
1 finding from 1 review
Radiographic proximal caries lesion progression · Children and adults with non-cavitated proximal (interproximal) caries lesions in primary and/or permanent teeth (ages 3-45)
Pooling 2 trials, resin-based sealants reduced radiographic proximal caries progression versus non-invasive measures (OR 0.24; ungraded subgroup).
1 finding from 1 review
Radiographic proximal caries lesion progression · Children with non-cavitated proximal caries lesions in primary teeth (ages 3-9)
In primary teeth (5 trials), microinvasive techniques reduced radiographic proximal caries progression versus non-invasive measures (OR 0.38; ungraded subgroup).
1 finding from 1 review
Adverse events and periodontal/secondary outcomes (gingival bleeding, gingival bleeding index, visible plaque index) · Children and adults with non-cavitated proximal (interproximal) caries lesions in primary and/or permanent teeth (ages 3-45)
Only three trials reported secondary/adverse outcomes; no adverse events were attributed to microinvasive treatment and periodontal findings were mixed and not pooled (ungraded).
1 finding from 1 review
Microinvasive interventions in the management of proximal caries lesions in primary and permanent teeth- systematic… 2025 All outcomesBaseline 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
Radiographic proximal caries lesion progression · Children and adults with non-cavitated proximal (interproximal) caries lesions in primary and/or permanent teeth (ages 3-45)
Microinvasive techniques probably reduce radiographic progression of non-cavitated proximal caries lesions compared with non-invasive measures (moderate certainty).
1 finding from 1 review
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
OR (caries arrest) OR 2.44-3.63 (range); 2.44 = Chu estimate including 30% SDF
3 studies
GRADE not reported
Proportion (caries arrest) 81 [68, 89]
12 studies
GRADE not reported
DMFS (decayed, missing, filled surfaces) increment, occlusal surfaces · Schoolchildren aged 6-12 years with sound occlusal surfaces of the first permanent molars
Pit and fissure sealant and fluoride varnish showed no statistically significant difference in DMFS increment at 24 months (SMD -0.13, 95% CI -0.67 to 0.40; I2=92%; not GRADE-rated).
1 finding from 1 review
Caries incidence of first permanent molars (FPMs) · Schoolchildren aged 6-12 years with sound occlusal surfaces of the first permanent molars
Pit and fissure sealant and fluoride varnish showed no statistically significant difference in caries incidence of first permanent molars at 24 months (RR 0.65, 95% CI 0.31 to 1.38; I2=89%; not GRADE-rated).
1 finding from 1 review
new root-surface carious lesions or restorations · Older adults with root caries in permanent (mature) teeth (mean age 75 years)
SDF had a 71% preventative fraction at 36 months; no pooled estimate or GRADE rating was reported.
1 finding from 1 review
Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars
A single (one-time) SDF application did not significantly arrest caries (pooled ES -0.09, 95% CI -0.48 to 0.29; ungraded).
1 finding from 1 review
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 sodium fluoride varnish (OR 6.38; moderate certainty).
2 findings from 1 review
OR 6.38 [1.41, 28.96]
43 studies
Moderate
OR 8.19 [1.44, 46.63]
44 studies
Moderate
Radiographic proximal caries lesion progression · Children and adults with non-cavitated proximal (interproximal) caries lesions in primary and/or permanent teeth (ages 3-45)
Pooling 10 trials, resin infiltration reduced radiographic proximal caries progression versus non-invasive measures (OR 0.23); this subgroup was not separately GRADE-rated.
1 finding from 1 review
Radiographic proximal caries lesion progression · Children and adults with non-cavitated proximal caries lesions in permanent teeth (ages 11-45)
In permanent teeth (7 trials), microinvasive techniques reduced radiographic proximal caries progression versus non-invasive measures (OR 0.18; ungraded subgroup).
1 finding from 1 review
Remineralization / reduction in lesion severity (change in QLF, laser fluorescence, or lesion area) · Patients with white spot lesions / early caries lesions (WSLs/ECLs), including orthodontic and non-orthodontic lesions, active caries…
Resin infiltration was significantly better than fluoride varnish (SMD -0.70, 95% CI -1.18 to -0.21); certainty of evidence not assessed (no GRADE).
1 finding from 1 review