Non-Cochrane · umbrella · PM31299955
Silver diamine fluoride for managing carious lesions: an umbrella review.
Seifo Nassar, Cassie Heather, Radford John R, et al. · BMC oral health · 2019 · PubMed · doi:10.1186/s12903-019-0830-5
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
17
current version
GRADE rated
0
No studies
0
Included studies
15
linked below
No studies 0 · 0%Ungraded 17 · 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 | Children and adults, with or without carious lesions, in primary and/or permanent teeth | Older adults with root caries (n=4 reviews); children with coronal caries (n=7 reviews); 11 reviews citing 30 unique primary studies |
| Intervention | Silver diamine fluoride (any concentration and frequency) | Silver diamine fluoride, principally 30% and 38% |
| Comparison | Active comparators, placebo, or no treatment | Placebo; fluoride varnish; glass ionomer cement; atraumatic restorative treatment; no treatment |
| Outcomes | Arrest or prevention of coronal or root carious lesions; adverse events and side effects | Root and coronal caries prevention and arrest; adverse events (mainly black staining) |
| Study designs | Systematic reviews with or without meta-analysis | Systematic reviews (n=11; 6 with meta-analysis) |
| Timing | Not specified | Not specified |
Search date: June 2018. Databases: PubMed; Embase; Cochrane Database of Systematic Reviews; Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports; PROSPERO
Questions and results
38% silver diamine fluoride vs Placebo
Population: Older adults with root carious lesions (exposed root surfaces)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Root carious lesions arrest One review reported SDF may reduce progression of root caries, with no numeric result (ungraded). Source: Results > Root carious lesions management in adults > Carious lesions arrest · same question in other reviews | One systematic review found that SDF can be efficacious to decrease progression of root carious lesions (no numeric results reported) [24]. | NR | Ungraded |
Root carious lesions arrest Reported prevented fractions for 38% SDF versus placebo for root-caries arrest ranged 100 to 725% (one high-risk review, two studies; ungraded). Source: Results > Root carious lesions management in adults > Carious lesions arrest · same question in other reviews | Prevented Fraction 100–725 | 2 studies | Ungraded |
Root carious lesions prevention 38% silver diamine fluoride reduced root-caries increment (DMFRS/DFRS) versus placebo, MD −0.33 (95% CI −0.39 to −0.28) (ungraded). Source: Results > Root carious lesions management in adults > Carious lesions prevention · same question in other reviews | MD -0.33 [-0.39, -0.28] | 2 studies | Ungraded |
Root carious lesions prevention 38% silver diamine fluoride had a 72% higher root-caries prevention success rate than placebo (one high-risk-of-bias review, one study; ungraded). Source: Results > Root carious lesions management in adults > Carious lesions prevention · same question in other reviews | Relative success-rate difference (% higher, SDF vs placebo) 72 | 1 study | Ungraded |
Root carious lesions arrest A low-risk-of-bias review found 38% SDF significantly more effective than placebo for arresting root caries, with no pooled estimate (ungraded). Source: Results > Root carious lesions management in adults > Carious lesions arrest · same question in other reviews | 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]. | NR | Ungraded |
Root carious lesions prevention Reported prevented fractions for 38% SDF versus placebo for root-caries prevention ranged 25 to 71% across two reviews (four studies; ungraded). Source: Results > Root carious lesions management in adults > Carious lesions prevention · same question in other reviews | Prevented Fraction 25–71 | 4 studies | Ungraded |
38% silver diamine fluoride vs Placebo or no treatment
Population: Children with coronal carious lesions (primary dentition)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Coronal carious lesions arrest Primary dentition One review reported a risk ratio of 2.54 favouring SDF over placebo/no treatment for arresting coronal caries in primary teeth (no CI; ungraded). Source: Results > Coronal carious lesions management in children > Carious lesions arrest · same question in other reviews | RR 2.54 | 2 studies | Ungraded |
Coronal carious lesions prevention Primary dentition Reported prevented fractions for 38% SDF versus placebo for coronal-caries prevention in primary teeth ranged 70 to 78% (two reviews, two studies; ungraded). Source: Results > Coronal carious lesions management in children > Carious lesions prevention · same question in other reviews | Prevented Fraction 70–78 | 2 studies | Ungraded |
38% silver diamine fluoride vs Placebo
Population: Children with coronal carious lesions (permanent first molars)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Coronal carious lesions arrest Permanent first molars One review reported a 100% prevented fraction for 38% SDF for arresting coronal caries in permanent first molars (one study; ungraded). Source: Results > Coronal carious lesions management in children > Carious lesions arrest · same question in other reviews | Prevented Fraction 100 | 1 study | Ungraded |
Coronal carious lesions prevention Permanent first molars One review reported a 64% prevented fraction for 38% SDF versus placebo for preventing coronal caries in permanent first molars (one study; ungraded). Source: Results > Coronal carious lesions management in children > Carious lesions prevention · same question in other reviews | Prevented Fraction 64 | 1 study | Ungraded |
38% silver diamine fluoride vs Fluoride varnish or atraumatic restorative treatment
Population: Children with coronal carious lesions (primary dentition)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Coronal carious lesions arrest Primary dentition One review reported a risk ratio of 1.66 favouring SDF over fluoride varnish or ART for arresting coronal caries in primary teeth (no CI; ungraded). Source: Results > Coronal carious lesions management in children > Carious lesions arrest · same question in other reviews | RR 1.66 | 2 studies | Ungraded |
38% silver diamine fluoride vs Fluoride varnish or placebo
Population: Children with coronal carious lesions (primary dentition)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Coronal carious lesions arrest Primary dentition One review reported prevented fractions of 55 to 96% favouring 38% SDF over fluoride varnish or placebo for arresting coronal caries in primary teeth (two studies; ungraded). Source: Results > Coronal carious lesions management in children > Carious lesions arrest · same question in other reviews | Prevented Fraction 55–96 | 2 studies | Ungraded |
38% silver diamine fluoride vs Fluoride varnish, glass ionomer cement, or placebo
Population: Children with coronal carious lesions (primary dentition)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Coronal carious lesions arrest (arrest rate) Primary dentition Across three reviews, 38% SDF arrested 65 to 91% of coronal lesions in primary teeth, outperforming fluoride varnish (38 to 44%), glass ionomer cement (39 to 82%), and placebo (34%) (ungraded). Source: Results > Coronal carious lesions management in children > Carious lesions arrest · same question in other reviews | Arrest rate 65–91 | 6 studies | Ungraded |
30% silver diamine fluoride vs Glass ionomer cement
Population: Children with coronal carious lesions (primary dentition)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Coronal carious lesions prevention 12 months · Primary dentition One review reported glass ionomer cement was more effective than 30% SDF at 12 months (PF −6%), but the difference was not statistically significant (ungraded). Source: Results > Coronal carious lesions management in children > Carious lesions prevention · same question in other reviews | Prevented Fraction -6 | NR | Ungraded |
Fluoride varnish vs Placebo
Population: Children with coronal carious lesions (primary dentition)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Coronal carious lesions prevention (fluoride varnish vs placebo) Primary dentition One review reported a 54% prevented fraction for fluoride varnish versus placebo for preventing coronal caries in primary teeth (one study; ungraded; comparator intervention, not SDF). Source: Results > Coronal carious lesions management in children > Carious lesions prevention · same question in other reviews | Prevented Fraction 54 | 1 study | Ungraded |
Silver diamine fluoride vs Not applicable (single-arm safety outcome)
Population: Children and older adults treated with SDF for carious lesions
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Adverse events: black staining of arrested lesions Black staining of arrested lesions was the main adverse event of SDF (reported by seven reviews); it was generally acceptable to patients (ungraded). Source: Results > Adverse events and side effects · same question in other reviews | Eight systematic reviews reported adverse events; seven reported black staining of arrested carious lesions. Older adults rarely complained; discoloration was acceptable in children, concerning 7% of participants in… | NR | Ungraded |
Serious adverse events No serious adverse events (e.g., allergic reactions or toxicity) were reported for SDF across the reviews (ungraded). Source: Results > Adverse events and side effects · same question in other reviews | No serious adverse events, such as allergic reactions or toxicity, were reported. A metallic taste or burning sensation was not reported in any of the studies. | NR | Ungraded |
Included primary studies 15
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| dos Santos 2014 A new "silver-bullet" to treat caries in children--nano silver fluoride: a randomised clinical trial. PMID:24930870 | 2 other reviews | not stated | not extracted yet | not extracted yet |
| Llodra 2005 Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical… PMID:16040729 | 2 other reviews | not stated | not extracted yet | not extracted yet |
| Braga 2009 Effect of silver diammine fluoride on incipient caries lesions in erupting permanent first molars: a pilot study. PMID:19341576 | 1 other review | not stated | not extracted yet | not extracted yet |
| Chibinski 2017 Silver Diamine Fluoride Has Efficacy in Controlling Caries Progression in Primary Teeth: A Systematic Review and Meta-Analysis. PMID:28972954 | this review only | not stated | not extracted yet | not extracted yet |
| Chu 2002 DOI:10.1177/081076712407092 | this review only | not stated | not extracted yet | not extracted yet |
| Contreras 2017 Effectiveness of silver diamine fluoride in caries prevention and arrest: a systematic literature review. PMID:28475081 | this review only | not stated | not extracted yet | not extracted yet |
| Duangthip 2015 Non-surgical treatment of dentin caries in preschool children--systematic review. PMID:25888484 | this review only | not stated | not extracted yet | not extracted yet |
| Gao 2016 Caries remineralisation and arresting effect in children by professionally applied fluoride treatment - a systematic review. PMID:26831727 | this review only | not stated | not extracted yet | not extracted yet |
| Gao 2016 Clinical Trials of Silver Diamine Fluoride in Arresting Caries among Children: A Systematic Review. PMID:30931743 | this review only | not stated | not extracted yet | not extracted yet |
| Gluzman 2013 Prevention of root caries: a literature review of primary and secondary preventive agents. PMID:23600985 | this review only | not stated | not extracted yet | not extracted yet |
| Hendre 2017 A systematic review of silver diamine fluoride: Effectiveness and application in older adults. PMID:28812312 | this review only | not stated | not extracted yet | not extracted yet |
| Oliveira 2018 Controlling caries in exposed root surfaces with silver diamine fluoride: A systematic review with meta-analysis. PMID:29805039 | this review only | not stated | not extracted yet | not extracted yet |
| Oliveira 2019 The Effect of Silver Diamine Fluoride in Preventing Caries in the Primary Dentition: A Systematic Review and Meta-Analysis. PMID:29874642 | this review only | not stated | not extracted yet | not extracted yet |
| Rosenblatt 2009 Silver diamine fluoride: a caries "silver-fluoride bullet". PMID:19278981 | this review only | not stated | not extracted yet | not extracted yet |
| Wierichs 2015 Systematic review on noninvasive treatment of root caries lesions. PMID:25398366 | 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).