Non-Cochrane · intervention · PM41743338
Comparative Efficacy of Silver Diamine Fluoride and Sodium Fluoride in Managing Early Childhood Caries: An Updated Systematic Review and Meta-Analysis.
Farahi Atiyeh, Abdollah Kookhi Nazieh, Abbasi Benika, et al. · International journal of dentistry · 2026 · PubMed · doi:10.1155/ijod/9959261
Findings
Population Children aged 0 to 6 years with early childhood caries
7 findings
| 38% silver diamine fluoride (SDF), topical | 5% sodium fluoride (NaF), topical (mostly varnish) | Odds of developing decayed, missing and filled surfaces (DMFS) 6 to 18 months (mostly 12 months) · Follow-up more than 12 months | OR 0.91 [0.48, 1.76] GRADE not reported 3 studies |
| 38% silver diamine fluoride (SDF), topical | 5% sodium fluoride (NaF), topical | Odds of caries lesion arrest | OR 1.41 [1.03, 1.94] Moderate Downgraded: inconsistency 9 studies · 3266 participants |
| 38% silver diamine fluoride (SDF), topical | 5% sodium fluoride (NaF), topical (mostly varnish) | Odds of developing decayed, missing and filled surfaces (DMFS) 6 to 18 months (mostly 12 months) · Follow-up less than 12 months | OR 1.18 [0.59, 2.38] GRADE not reported 2 studies |
| 38% silver diamine fluoride (SDF), topical | 5% sodium fluoride (NaF), topical (mostly varnish) | Odds of developing decayed, missing and filled surfaces (DMFS) 6 to 18 months (mostly 12 months) | OR 1.07 [0.70, 1.64] Low Downgraded: risk of bias, imprecision 9 studies · 3266 participants |
| 38% silver diamine fluoride (SDF), topical | 5% sodium fluoride (NaF), topical (mostly varnish) | Odds of caries lesion arrest 6 to 18 months (mostly 12 months) · Follow-up less than 12 months | OR 1.25 [0.88, 1.77] GRADE not reported 4 studies |
| 38% silver diamine fluoride (SDF), topical | 5% sodium fluoride (NaF), topical (mostly varnish) | Odds of developing decayed, missing and filled surfaces (DMFS) 6 to 18 months (mostly 12 months) · Sensitivity analysis: REML random-effects model | OR 1.07 [0.70, 1.64] GRADE not reported 9 studies · 3266 participants |
| 38% silver diamine fluoride (SDF), topical | 5% sodium fluoride (NaF), topical (mostly varnish) | Odds of caries lesion arrest 6 to 18 months (mostly 12 months) · Follow-up more than 12 months | OR 1.71 [0.96, 3.05] GRADE not reported 3 studies |
Included primary studies 9
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Abdellatif 2023 Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow… PMID:37978488 | 2023 | 2 other reviews | Odds of caries lesion arrest | not extracted yet |
| Mabangkhru 2020 A randomized clinical trial to arrest dentin caries in young children using silver diamine fluoride DOI:10.1016/j.jdent.2020.103375 | 2020 | 2 other reviews | Odds of caries lesion arrest | not extracted yet |
| Abdel Rehim 2021 Pain, New Caries and Failure of Carious Primary Teeth after Application of Silver Diamine Fluoride Versus Sodium Fluoride Varnish: A… DOI:10.37506/ijphrd.v12i3.16124 | 2021 | this review only | Odds of developing decayed, missing and filled surfaces (DMFS) | not extracted yet |
| Golpak 2020 [Continuing nursing through telephone consultation]. PMID:3852020 | 1985 | this review only | Odds of developing decayed, missing and filled surfaces (DMFS); Odds of caries lesion arrest | not extracted yet |
| Phonghanyudh 2022 Is Silver Diamine Fluoride Effective in Arresting Enamel Caries? A Randomized Clinical Trial DOI:10.3390/ijerph19158992 | 2022 | this review only | Odds of developing decayed, missing and filled surfaces (DMFS); Odds of caries lesion arrest | not extracted yet |
| Sirivichayakul 2023 The effectiveness of topical fluoride agents on preventing development of approximal caries in primary teeth: a randomized clinical trial DOI:10.1186/s12903-023-03045-4 | 2023 | this review only | not stated | not extracted yet |
| Thwin 2017 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Yassin 2023 Effectiveness of silver diamine fluoride versus sodium fluoride varnish combined with mother’s motivational interviewing for arresting… DOI:10.1186/s12903-023-03456-3 | 2023 | this review only | Odds of caries lesion arrest | not extracted yet |
| Zheng 2025 Randomized Clinical Trial on Caries Prevention of Silver Diamine Fluoride DOI:10.1177/00220345251363837 | 2025 | this review only | not stated | 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). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children aged 0 to 6 years with early childhood caries | Children aged 1 to 6 years with early childhood caries (n=3266: 2213 SDF, 1053 NaF) |
| Intervention | Topical silver diamine fluoride (SDF) | 38% SDF (n=9 RCTs) |
| Comparison | Topical sodium fluoride (NaF) | 5% NaF, mostly varnish (n=9 RCTs) |
| Outcomes | Caries arrest; decayed, missing and filled surfaces (DMFS) | Caries arrest (n=5 trials in forest plot); DMFS (n=3 trials in forest plot) |
| Study designs | Randomized controlled trials, English language | RCTs (n=9) |
| Timing | Follow-up duration (preplanned subgroups by months) | Follow-up 3 to 18 months, mostly 12 months |
AMSTAR 2 items
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 | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | Partial Yes | no |
| 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: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: N/A | NRSI: N/A · RCT: No | no |
| 12Impact of risk of bias on the pooled results | Yes | Yes | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |