Primary caries prevention · Children and adults (with or without carious lesions)
The review found no eligible studies for this question.
1 finding from 1 review
Dental pain or sensitivity · Children and adults (with or without carious lesions)
The review found no eligible studies for this question.
1 finding from 1 review
Adverse effects · Children and adults (with or without carious lesions)
1 finding from 1 review
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
Secondary prevention of caries · Children and adults (with or without carious lesions)
The review found no eligible studies for this question.
1 finding from 1 review
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
Aesthetics · Children and adults (with or without carious lesions)
The review found no eligible studies for this question.
1 finding from 1 review
Caries arrestment at the individual (patient) level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)
Compared with other caries-management methods, SDF may increase caries arrestment at the individual level, but the pooled estimate is very imprecise (low 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)
In one trial, nano-silver fluoride arrested more surfaces than SDF (OR 0.52 favoring the comparator; ungraded subgroup).
1 finding from 1 review
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
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 arrestment at the tooth level · Children and adults with active dental caries (aged 1-50; mostly preschool/school children with primary dentition)
Pooling two trials, SDF and nano-silver fluoride showed no significant difference in tooth-level caries arrestment (OR 1.47; ungraded subgroup).
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
Serious adverse events · Children and older adults treated with SDF for carious lesions
No serious adverse events (e.g., allergic reactions or toxicity) were reported for SDF across the reviews (ungraded).
1 finding from 1 review
Adverse events: black staining of arrested lesions · Children and older adults treated with SDF for carious lesions
Black staining of arrested lesions was the main adverse event of SDF (reported by seven reviews); it was generally acceptable to patients (ungraded).
1 finding from 1 review
Root carious lesions arrest · Older adults with root carious lesions (exposed root surfaces)
One review reported SDF may reduce progression of root caries, with no numeric result (ungraded).
3 findings from 1 review
One systematic review found that SDF can be efficacious to decrease progression of root carious lesions (no numeric results reported) [24].
Studies not reported
GRADE not reported
Prevented Fraction 100–725
2 studies
GRADE not reported
One low risk of bias systematic review reported that 38% SDF was significantly more effective than placebo in arresting root carious lesions (pooled results were not calculated) [31].
Studies not reported
GRADE not reported
Coronal carious lesions arrest · Children with dental caries in permanent (first) molars
One review reported a 100% prevented fraction for 38% SDF for arresting coronal caries in permanent first molars (one study; ungraded).
1 finding from 1 review
Prevented Fraction 100
1 study
GRADE not reported
Root carious lesions prevention · Older adults with root carious lesions (exposed root surfaces)
38% silver diamine fluoride reduced root-caries increment (DMFRS/DFRS) versus placebo, MD −0.33 (95% CI −0.39 to −0.28) (ungraded).
3 findings from 1 review