Non-Cochrane · intervention · PM30765785
Silver diamine fluoride versus sodium fluoride for arresting dentine caries in children: a systematic review and meta-analysis.
Trieu Alice, Mohamed Ahmed, Lynch Edward · Scientific reports · 2019 · PubMed · doi:10.1038/s41598-019-38569-9
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
2
current version
GRADE rated
0
No studies
0
Included studies
6
linked below
No studies 0 · 0%Ungraded 2 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Humans, children (adults over 12 years excluded); in vivo dentine/dental caries; cohort, case-control, controlled or randomized study designs; English language | Preschool children with dentine caries in primary teeth, mean age 3.4-4.0 years (746 children across 6 included articles representing 2 unique RCT populations of 375 and 304) |
| Intervention | Silver diamine fluoride (SDF) | SDF 30% or 38%, applied annually or in three weekly applications (n=2 trials) |
| Comparison | Sodium fluoride (NaF) / fluoride varnish | 5% NaF varnish, applied at day 0 then every 3 months or in three weekly applications (n=2 trials) |
| Outcomes | Dentine caries arrest (caries activity; decayed, missing, filled [DMF]) | Arrested caries surfaces (dentine caries arrest); pooled odds ratios at 18 and 30 months (n=6 articles; 4 in meta-analysis) |
| Study designs | Not specified | Community/kindergarten-based; Hong Kong and Guangzhou, Southern China (n=2 trials) |
| Timing | Not specified | Follow-up 6, 12, 18, 24, 30 months; meta-analyses at 18 and 30 months |
Search date: March 31, 2018. Databases: PubMed; Web of Science; Ovid; Cochrane Library; hand-searched journals (Caries Research, Journal of Dentistry, Journal of Dental Research, Journal of Oral Health and Preventive Dentistry, Pediatric Dentistry) and reference lists
Questions and results
Silver diamine fluoride (SDF; 30% or 38%) vs 5% sodium fluoride (NaF) varnish
Population: Preschool children with active dentine caries in primary teeth (mean age 3.4-4.0 years)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Arrested dentine caries (arrested caries surfaces) 18 months Silver diamine fluoride was about 2.5 times more likely than sodium fluoride to arrest dentine caries surfaces at 18 months (pooled OR 2.51, 95% CI 1.25 to 5.10; 2 RCTs), although between-study heterogeneity was high (I2=90.3%); certainty of evidence was not formally graded. Source: Statistical meta-analysis; Figure 3; Heterogeneity analysis · same question in other reviews | OR 2.51 [1.25, 5.10] | 2 studies | Ungraded |
Arrested dentine caries (arrested caries surfaces) 30 months Silver diamine fluoride was about twice as likely as sodium fluoride to arrest dentine caries surfaces at 30 months (pooled OR 2.03, 95% CI 1.51 to 2.77; 2 RCTs; I2=44.3%); certainty of evidence was not formally graded. Source: Statistical meta-analysis; Figure 4; Heterogeneity analysis · same question in other reviews | OR 2.03 [1.51, 2.77] | 2 studies | Ungraded |
AMSTAR 2 appraisal
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Yes | Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Partial Yes · NRSI: N/A | NRSI: N/A · RCT: No | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | No | no |
| 15Publication bias investigatedcritical | Yes | No | no |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |
Included primary studies 6
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Chu 2002 Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Arresting Dentin Caries in Chinese Pre-school Children DOI:10.1177/0810767 | 1 other review | Arrested dentine caries (arrested caries surfaces) | not extracted yet | not extracted yet |
| Duangthip 2018 Caries arrest by topical fluorides in preschool children: 30-month results DOI:10.1016/j.jdent.2017.12.013 | 1 other review | Arrested dentine caries (arrested caries surfaces) | not extracted yet | not extracted yet |
| Duangthip 2016 A randomized clinical trial on arresting dentine caries in preschool children by topical fluorides—18 month results DOI:10.1016/j.jdent.2015.05.006 | this review only | Arrested dentine caries (arrested caries surfaces) | not extracted yet | not extracted yet |
| Lo 2001 A Community-based Caries Control Program for Pre-school Children Using Topical Fluorides: 18-month Results DOI:10.1177/00220345010800120901 | this review only | Arrested dentine caries (arrested caries surfaces) | not extracted yet | not extracted yet |
| Wong 2005 Bayesian Analysis of Clustered Interval-censored Data DOI:10.1177/154405910508400907 | this review only | not stated | not extracted yet | not extracted yet |
| Wong 2011 Analysis of multilevel grouped survival data with time‐varying regression coefficients DOI:10.1002/sim.4094 | this review only | not stated | not extracted yet | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match).
| Review | Shared studies | Jaccard |
|---|---|---|
| Comparative success of minimally invasive treatments for cavitated caries in primary teeth: a network meta-analysis. (2025) | 2 | 0.02 |