Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

163 questions · 197 findings · 15 reviews · All outcomes

No studies found 36 · 18.3%GRADE not reported 111 · 56.3%Very low 34 · 17.3%Low 6 · 3%Moderate 10 · 5.1%High 0 · 0%

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 varnish plus oral health instruction vs oral health instruction plus water

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

Sodium fluoride (NaF) varnish, applied every 3 months, plus OHI vs inactive control

Root carious lesions prevention · Older adults with root caries (community-dwelling or residential elders)

In elders, sodium fluoride varnish gave a 64% prevented fraction for root caries vs water, lower than SDF (71%) (p<0.01; 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

38% SDF one-time application without brushing programme vs no treatment without brushing programme

new carious lesions or fillings · Children with dental caries in permanent (first) molars

The review reported no significant result for SDF; no effect estimate or GRADE rating was reported.

1 finding from 1 review

38% SDF (one-time application) vs Information unavailable

New coronal carious lesions or fillings on permanent (first) molars (caries prevention) · Children with dental caries in permanent (first) molars

One-time 38% SDF gave a 57% prevented fraction for caries in children's permanent first molars (single study; ungraded).

1 finding from 1 review

OHI + 38% SDF (applied every 12 months) vs oral health instruction plus water

new root-surface carious lesions or restorations · community-dwelling older adults with root caries

SDF had a 28% preventative fraction at 24 months; no pooled estimate or GRADE rating was reported.

1 finding from 1 review

Prior SDF application without a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Glass-ionomer cement bonded to caries-affected dentin (in vitro)

SDF pretreatment without a rinsing step does not affect glass-ionomer cement bond strength to caries-affected dentin (MD 0.26 MPa, 95% CI -0.30 to 0.82; ungraded).

1 finding from 1 review

Prior SDF application without a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Dental adhesives bonded to sound dentin (in vitro)

Prior SDF without a rinsing step significantly reduces adhesive bond strength to sound dentin (MD 17.52 MPa favoring untreated dentin, 95% CI 5.81 to 29.22; ungraded).

1 finding from 1 review

Atraumatic restorative treatment vs placebo

Oral health-related quality of life · Children with dental caries

ART and placebo did not differ for oral health-related quality of life, based on an indirect network estimate with no direct trials (MD -0.01, 95% CI -0.40 to 0.38; ungraded).

3 findings from 1 review

Prior SDF application with a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Glass-ionomer cement bonded to sound dentin (in vitro)

SDF pretreatment with a rinsing step does not affect glass-ionomer cement bond strength to sound dentin (MD -1.11 MPa, 95% CI -3.47 to 1.25; ungraded).

1 finding from 1 review

SDF applied biannually (every 6 months) vs Other non/minimally-invasive treatment (ART or 5% NaF varnish)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

Biannual SDF application significantly arrested caries (pooled ES 0.39, 95% CI 0.19-0.60; ungraded).

1 finding from 1 review

Prior SDF application with a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Glass-ionomer cement bonded to caries-affected dentin (in vitro)

SDF pretreatment with a rinsing step does not affect glass-ionomer cement bond strength to caries-affected dentin (MD -0.36 MPa, 95% CI -1.07 to 0.35; ungraded).

1 finding from 1 review

Prior SDF application without a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Glass-ionomer cement bonded to sound dentin (in vitro)

SDF pretreatment without a rinsing step does not affect glass-ionomer cement bond strength to sound dentin (MD 0.26 MPa, 95% CI -0.20 to 0.73; ungraded).

1 finding from 1 review

Prior SDF application with a rinsing step vs No prior SDF application (untreated dentin control)

Immediate bond strength (MPa) · Dental adhesives bonded to sound dentin (in vitro)

A rinsing step after SDF eliminates the negative effect on adhesive bond strength to sound dentin (MD 7.11 MPa, 95% CI -0.57 to 14.79, non-significant; ungraded).

1 finding from 1 review

38% SDF (applied every 6 or 12 months) vs 12% SDF solution (applied annually)

Caries arrest · Children (age 1-10 years) with active cavitated dentin caries lesions in primary molars

38% SDF arrested more caries than 12% SDF (pooled ES 0.37, 95% CI 0.27-0.47; single study; ungraded).

1 finding from 1 review