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Meta-Analysis
. 2024 Nov 7;11(11):CD012718.
doi: 10.1002/14651858.CD012718.pub2.

Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults

Helen V Worthington  1 , Sharon R Lewis  1 , Anne-Marie Glenny  1 , Shulamite S Huang  2 , Nicola Pt Innes  3 , Lucy O'Malley  1 , Philip Riley  1 , Tanya Walsh  1 , May Chun Mei Wong  4 , Janet E Clarkson  5 , Analia Veitz-Keenan  6
Affiliations
Meta-Analysis

Topical silver diamine fluoride (SDF) for preventing and managing dental caries in children and adults

Helen V Worthington et al. Cochrane Database Syst Rev. .

Abstract

Background: Dental caries is the world's most prevalent disease. Untreated caries can cause pain and negatively impact psychosocial health, functioning, and nutrition. It is important to identify cost-effective, easy-to-use agents, which can prevent or arrest caries. This review evaluates silver diamine fluoride (SDF).

Objectives: To assess the effects of silver diamine fluoride for preventing and managing caries in primary and permanent teeth (coronal and root caries) compared to any other intervention including placebo or no treatment.

Search methods: We searched CENTRAL, MEDLINE, Embase, Cochrane Oral Health's Trial Register and two clinical trials registers in June 2023.

Selection criteria: We included randomised controlled trials (RCTs), with parallel-group or split-mouth design, in children and adults (with or without carious lesions) that compared SDF with placebo or no treatment; different frequencies, concentrations or duration of SDF; or any other intervention.

Data collection and analysis: We used standard methodological procedures expected by Cochrane, and GRADE to assess the certainty of the evidence. We collected data for primary caries prevention (change in caries increment), arrest of carious lesions, secondary prevention of caries (lesions do not progress from initial classification), adverse effects, dental pain or sensitivity, and aesthetics at the end of study follow-up.

Main results: We included 29 RCTs (13,036 participants; 12,020 children, 1016 older adults). We summarise outcome data for the five most clinically relevant comparisons. All studies included high risks of bias, and some findings were imprecise (e.g. because of small sample sizes). SDF versus placebo or no treatment (14 studies; 2695 children, 905 older adults) Compared to placebo or no treatment, SDF may help prevent new caries in the primary dentition (1 study, 373 participants), or on the coronal surfaces of permanent dentition (1 study, 373 participants) but the evidence is very uncertain. SDF likely prevents new root caries (mean difference (MD) -0.79 surfaces, 95% confidence interval (CI) -1.40 to -0.17; 3 studies, 439 participants; moderate-certainty evidence). SDF may help arrest caries in the primary dentition (MD 0.86 surfaces, 95% CI 0.39 to 1.33; 2 studies, 841 participants; low-certainty evidence) and the permanent dentition (coronal: 1 study, 373 participants; root: 1 study, 158 participants) but the evidence is very uncertain. The evidence is very uncertain for secondary prevention of caries (primary dentition: 1 study, 128 participants; permanent dentition (coronal): 1 study, 663 participants), for adverse effects (5 studies, 1299 participants), and aesthetics (1 study, 43 participants). Different approaches to SDF application (5 studies, 1808 children) Studies compared different frequencies or intervals of application, different concentrations of SDF, and different durations of treatment. Some studies included multiple comparisons of different approaches. Because of the different approaches, we could not combine findings from these studies. Due to very low-certainty evidence, we were unsure whether any approach to SDF application was better than another for caries arrest (4 studies, including 8 comparisons of different approaches, 1360 participants); secondary prevention of caries (1 study, 203 participants), or led to differences in adverse effects (3 studies, 1121 children) or aesthetics (1 study, 119 children). SDF versus fluoride varnish (8 studies, 2868 children, 223 older adults) Compared to flouride varnish, SDF may result in little or no difference to the prevention of new caries in the primary dentition (MD 0.00, 95% CI -0.26 to 0.26; 1 study, 434 participants; low-certainty evidence). The evidence is very uncertain for this outcome measure in the permanent dentition (coronal: 1 study, 237 participants; root: 1 study, 100 participants; very low-certainty evidence). Due to very low-certainty evidence, we were unsure whether or not there were any differences between flouride varnish (applied weekly for three applications) and SDF for caries arrest and secondary prevention of caries in the primary dentition (1 study, 309 participants). Similarly, we were unsure of adverse effects (3 studies, 980 children), dental pain or sensitivity (1 study, 62 children), or aesthetics (1 study, 263 children). SDF versus sealants and resin infiltration (2 studies, 343 children) Very low-certainty evidence in this comparison meant we were unsure if either treatment was better than the other for primary prevention of caries in permanent dentition (coronal: 1 study, 242 participants), or adverse effects (2 studies, 336 participants). SDF versus atraumatic restorative treatment (ART) with glass ionomer cement (GIC) or GI material (4 studies, 610 children) Very low-certainty evidence in this comparison meant we were unsure if either treatment was better than the other at arresting caries in the primary dentition (1 study, 143 participants). We were also unsure whether there were any differences between treatments in adverse effects (3 studies, 482 participants), dental pain or sensitivity (1 study, 234 participants), or aesthetics (2 studies, 248 participants).

Authors' conclusions: In the primary dentition, evidence remains uncertain whether SDF prevents new caries or progression of existing caries compared to placebo or no treatment, but it may offer benefit over placebo or no treatment in caries arrest. Compared to placebo or no treatment, SDF probably also helps prevent new root caries. However, the evidence is uncertain for other caries outcome measures in this dentition and in all caries outcomes for coronal surfaces of permanent dentition. Compared to flouride varnish, SDF may offer little or no benefit in preventing new caries in the primary dentition, but the evidence is very uncertain for other caries outcome measures in the primary dentition and for preventing new caries in the permanent dentition. We were unable to establish whether one SDF treatment approach was better than another, or how SDF compared to other treatments, because of very low-certainty evidence. The impact of SDF staining of teeth was poorly reported and the evidence for adverse effects is very uncertain. Additional well-conducted studies are needed. These should measure the impact of staining and be analysed to take account of clustering issues within participants.

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Conflict of interest statement

  1. HW reports being Emeritus Co‐ordinating Editor for Cochrane Oral Health; she has had no role in the editorial process for this review.

  2. SL is a former Deputy Co‐ordinating Editor of the Cochrane Bone, Joint and Muscle Trauma group; she has had no role in the editorial process for this review.

  3. AMG reports being Joint Co‐ordinating Editor for Cochrane Oral Health; she has had no role in the editorial process for this review.

  4. SH reports conducting an economic evaluation that included one of the included studies in this review. SH was not involved in the data extraction, or assessment of risk of bias and certainty of the evidence involving this study.

  5. NI reports being a Professor of Paediatric Dentistry and Honorary Consultant in Paediatric Dentistry. NI has declared that they have no conflict of interest.

  6. LO'M reports being a former Methods Editor with Cochrane Oral Health; she has had no role in the editorial process for this review

  7. PR reports being Deputy Co‐ordinating Editor for Cochrane Oral Health; he has had no role in the editorial process for this review.

  8. TW reports being a principal investigator for an unrestricted research grant from Colgate‐Palmolive; paid to The University of Manchester, where TW is wholly employed. Colgate‐Palmolive does not manufacture silver diamine fluoride. TW reports being a former Statistical Editor for Cochrane Oral Health; she has had no role in the editorial process for this review.

  9. MW reports being an author on some studies that were eligible for inclusion in the work. These studies did not involve funding from a commercial sponsor and, in this review, MW was not involved in the data extraction, or assessment of risk of bias and the certainty of the evidence involving these studies. MW reports being a former Editor for Cochrane Oral Health; she has had no role in the editorial process for this review.

  10. JC reports having an editorial role for Cochrane Oral Health (Joint Co‐ordinating Editor); she has had no role in the editorial process for this review.

  11. AVK reports being a Dentistry Clinical Professor. AVK has declared she has no conflicts of interest.

Update of

  • doi: 10.1002/14651858.CD012718

References

References to studies included in this review

Abdellatif 2021 {published data only}
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    1. NCT04654624. Child discomfort and parental acceptability of silver diamine fluoride and alternative restorative treatment [Child discomfort and parental acceptability of silver diamine fluoride and alternative restorative treatment: a randomized controlled clinical trial]. classic.clinicaltrials.gov/ct2/show/record/NCT04654624 (first received 4 December 2020).
Azouru 2022 {published data only}
    1. Azouru MO, Ashiwaju MO, Edomwonyi A, Oyapero A, Obisesan B, Omotuyole A. Randomized controlled trial on the effectiveness of silver diamine fluoride in arresting caries in children in Lagos, Southwest Nigeria. Brazilian Journal of Oral Sciences 2022;21:e226341.
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Braga 2009 {published data only}
    1. Braga MM, Mendes FM, De Benedetto MS, Imparato JC. Effect of silver diammine fluoride on incipient caries lesions in erupting permanent first molars: a pilot study. Journal of Dentistry for Children 2009;76(1):28-33. - PubMed
Cleary 2022 {published data only}
    1. Cleary J, Al-Hadidi R, Scully A, Yahn W, Zaid Z, Boynton JR, et al. A 12-month randomized clinical trial of 38% SDF vs. restorative treatment. JDR Clinical and Translational Research 2022;7(2):135-44. [DOI: 10.1177/23800844211072741] [PMID: ] - DOI - PubMed
Daga 2020 {published data only}
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Ericson 2023 {published data only}
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Fahmi 2019 {published data only}
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Gao 2019 {published data only}
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Jiang 2022 {published data only}
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    1. Jiang CM, Wong MC, Chu CH, Dai L, Lo EC. Changes in parental satisfaction and oral health-related quality of life of preschool children after receiving atraumatic treatment with or without prior silver diamine fluoride application. Journal of Evidence-based Dental Practice 2022;22(3):101751. [PMID: ] - PubMed
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Li 2017 {published and unpublished data}
    1. Li R, Lo EC, Liu BY, Wong MC, Chu CH. Randomized clinical trial on arresting dental root caries through silver diammine fluoride applications in community-dwelling elders. Journal of Dentistry 2016;51:15-20. - PubMed
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Liu 2012 {published data only}
    1. Liu BY, Lo EC, Chu CH, Lin HC. Randomized trial on fluorides and sealants for fissure caries prevention. Journal of Dental Research 91;8:753-8. - PubMed
    1. NCT01446107. Effectiveness of fissure sealant and topical fluoride application in preventing dental caries [A randomized controlled trial on the effectiveness of fissure sealant and topical fluoride application in preventing dental caries]. clinicaltrials.gov/ct2/show/record/NCT01446107 (first received 5 October 2011).
Llodra 2005 {published and unpublished data}
    1. Llodra JC, Rodriguez A, Ferrer B, Menardia V, Ramos T, Morato M. Efficacy of silver diamine fluoride for caries reduction in primary teeth and first permanent molars of schoolchildren: 36-month clinical trial. Journal of Dental Research 2005;84(8):721-4. [DOI: 10.1177/154405910508400807] [PMID: ] - DOI - PubMed
Mabangkhru 2020 {published data only}
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Mattos‐Silveira 2015 {published and unpublished data}
    1. Mattos Silveira J. Diamino fluoreto de prata - uma nova proposta para o tratmento näo operatório de lesöes proximals em molares deciduos: estudo clinico randomizado [Thesis]. Sāo Paulo (Brazil): Universidade de Sāo Paulo , 2016.
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Mendiratta 2021 {published data only}
    1. Mendiratta M, Manjunath BC, Kumar A, Yadav V, Shyam R, Wig M. Effectiveness of silver diamine fluoride and glass ionomer cement combined with fluoride varnish in arresting dental caries among intellectually disabled individuals: a randomized controlled trial. Special Care in Dentistry 2021;41(5):544-52. [DOI: 10.1111/scd.12607] [PMID: ] - DOI - PubMed
Milgrom 2018 {published data only}
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Rehim 2021 {published data only}
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Ruff 2022 {published data only}
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Seberol 2013 {published and unpublished data}
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Sirivichayakul 2023 {published data only}
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Tan 2010 {published data only}
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Torres‐Arellano 2012 {published and unpublished data}
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Vollú 2019 {published data only}
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Yee 2009 {published data only}
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Zhang 2013 {published data only}
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Zheng 2023 {published data only}
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References to studies excluded from this review

Bijella 1991 {published data only}
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Chu 2002 {published data only}
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Garrastazu 2019 {published data only}
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Hamdi 2022 {published data only}
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Hernandez 2013 {published data only}
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Lo 1998 {published data only}
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Lo 2001 {published data only}
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Mani Prakash 2022 {published data only}
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    1. Mohammed SM, Awad SM, Wahba AH. Comparison of clinical outcomes of silver-modified atraumatic restorative technique vs atraumatic restorative technique in primary teeth: a randomized controlled trial. Journal of Comtemporary Dental Practice 2022;23(11):1140-5. [PMID: ] - PubMed
Monse 2012 {published data only}
    1. Monse B, Heinrich-Weltzien R, Mulder J, Holmgren C, Palenstein Helderman WH. Caries preventive efficacy of silver diammine fluoride (SDF) and ART sealants in a school-based daily fluoride toothbrushing program in the Philippines. BMC Oral Health 2012;12:52. [DOI: 10.1186/1472-6831-12-52] - DOI - PMC - PubMed
Salem 2022 {published data only}
    1. NCT05265104. Laser versus silver diamine fluoride in Hall technique in primary teeth (SDF) [Clinical and radiographic evaluation of the efficacy of laser versus silver diamine flouride (SDF) in Hall technique in primary teeth]. classic.clinicaltrials.gov/ct2/show/NCT05265104 (first received 3 March 2022).
    1. Salem GA, Sharaf RF, El Mansy M. Efficacy of diode laser application versus silver diamine fluoride (SDF) as a modification of Hall technique in primary teeth. Saudi Dental Journal 2022;34:8723. - PMC - PubMed
Satyarup 2022 {published data only}
    1. Satyarup D, Mohanty S, Nagarajappa R, Mahapatra I, Dalai RP. Comparison of the effectiveness of 38% silver diamine fluoride and atraumatic restorative treatment for treating dental caries in a school setting: a randomized clinical trial. Dental and Medical Problems 2022;59(2):217–23. [DOI: 10.17219/dmp/143547] - DOI - PubMed
Shah 2013 {published data only}
    1. Shah S, Bhaskar V, Venkataraghavan K, Choudhary P, Ganesh M, et al. Efficacy of silver diamine fluoride as antibacterial as well as anitplaque agent compared to fluoride varnish and acidulated phosphate fluoride gel: an in vivo study. Indian Journal of Dental Research 2013;24(5):575-81. - PubMed
Sing‐In 2019 {published data only}
    1. Sing-In P, Kitsahawong K, Pungchanchaikul P, Pitphat W, Kittiprawong R, Dasanayake A. Impact of different fluoride treatments on OHRQoL of children. Journal of Dental Research 2019;98(Spec Iss A):no pagination.
Thakur 2022 {published data only}
    1. Thakur S, Sojan M, Singhal P, Chauhan D. A comparative study to evaluate the effectiveness of silver diamine fluoride at different time durations of application in treating carious primary teeth: a randomized trial. International Journal of Clinical Pediatric Dentistry 2022;15(S-2):S147–50. - PMC - PubMed
Turton 2021 {published data only}
    1. ISRCTN87596444. Arrest of caries using different silver fluoride solutions in the Healthy Kids Cambodia project. www.isrctn.com/ISRCTN87596444 (first received 31 January 2019).
    1. Turton B, Horn R, Durward C. Caries arrest and lesion appearance using two different silver fluoride therapies on primary teeth with and without potassium iodide: 12-month results. Clinical and Experimental Dental Research 2021;7(4):609–19. [WEBSITE: https:// doi.org/10.1002/cre2.367] - PMC - PubMed
    1. Turton B, Horn R, Durward C. Caries arrest and lesion appearance using two different silver fluoride therapies with and without potassium iodide: 6-month results. Journal of Dental Research 2020;99 (Spec Iss A):1. - PMC - PubMed
Vasconcelos 2011 {published data only}
    1. Vasconcelos FM. Atraumatic treatment to arrrest caries in the primary dentition and its impact on the permanent dentition: clinical trial [Tratamento atraumático para paralisar cárie na dentição decídua e seu im- pacto na dentição permanente: ensaio clínico]. Pernambuco, Faculty of Dentistry Camaragibe, University of Pernambuco (FOP/ UPE) 2011;PhD:1-104.
Verma 2022 {published data only}
    1. Verma S, Sogi S, Chatterjee S, Sharma P, Dhindsa A, Kapoor R. Antibacterial, antiplaque and anticaries effect of silver diamine fluoride and fluoride varnish in children. Journal of Pharmaceutical Negative Results 2022;13:1589.

References to studies awaiting assessment

Chan 2020 {published data only}
    1. Chan WL, Jiang M, Chu CH, Lo E. Application of SDF versus ART in treating primary tooth caries. Journal of Dental Research 2020;99(Spec Iss A):no pagination.
    1. Chan WL, Jiang M, Chu CH, Lo E. Application of SDF versus ART restoration in treating dentine caries lesions in primary teeth. Journal of Dental Research 2022;101(Spec Iss B):no pagination.
    1. Chan WL, Jiang M, Chu CH, Lo EC. Application of SDF versus ART restoration in treating dentine caries lesions in primary teeth. Journal of Dental Research 2020;99(Spec Iss B):no pagination.
CTRI/2021/04/032480 {unpublished data only}
    1. CTRI/2021/04/032480. Comparing the effectiveness of non silver fluoride varnish and silver diamine fluoride varnish in halting dental decay progression among Anganwadi children of Mangalore [Comparison of the effectiveness of non silver fluoride varnish and silver diamine fluoride varnish in arresting dental caries among Anganwadi children of Mangalore: a randomized control trial]. ctri.nic.in/Clinicaltrials/advsearch2.php (first received 1 April 2021).
ISRCTN14037606 {published data only}
    1. ISRCTN14037606. Effectiveness of silver fluoride agents to arrest caries in children [Detection of the cariostatic efficacy of silver diamine fluoride and nano-silver fluoride using reveal fluorescence dental loupes in children]. www.isrctn.com/ISRCTN14037606?q=ISRCTN14037606&filters=&sort=&am... (first received 26 June 2022).
ISRCTN17005348 {published data only}
    1. ISRCTN17005348. New non-invasive treatments for the control and treatment of early childhood caries [Treatment of early childhood caries with three different topical fluoride treatments: a randomised clinical trial]. www.isrctn.com/ISRCTN17005348?q=ISRCTN17005348&filters=&sort=&am... (first received 16 June 2021).
Jaradat 2018 {published data only}
    1. Jaradat M, Owais A, Guzman-Armstrong S, Kolker J, Sousa Melo S, Marshall T, et al. Silver diamine fluoride effectiveness in arresting early approximal carious lesions. Journal of Dental Research 2018;97(Spec Iss A):no pagination.
    1. NCT02591147. Silver diamine fluoride pilot study (SDF) [Effectiveness of silver diamine fluoride in arresting early approximal carious lesion progression: a pilot study]. clinicaltrials.gov/ct2/show/record/NCT02591147 (first received 29 October 2015).
Jirattanasopha 2021 {published data only}
    1. Jirattanasopha V, Mabangkhru S, Phonghanyudh A, Duangthip D, Chu CH. Arresting enamel caires with silver diamine fluoride in young children. Journal of Dental Research 2021;100(Spec Iss A):no pagination.
Lo 2015 {published data only}
    1. Lo E, Li R, Chu CH, Lin H. Arresting root caries through SDF in fluoridated and non-fluoridated areas. Journal of Dental Research 2015;94(Spec Iss A):no pagination.
    1. Lo E, Li R, Chu CH, Lin HC. Effectiveness of SDF in arresting root caries in different fluoridated areas. Journal of Dental Research 2016;95(Spec Iss B):no pagination.
    1. Lo E, Li R, Chu CH, Lin HC. Preventing root caries with SDF in fluoridated and non-fluoridated areas. Journal of Dental Research 2017;96(Spec Iss A):no pagination.
NCT01508611 {published data only}
    1. NCT01508611. Cost-efficacy of silver diammine fluoride in erupting molars [Cost-efficacy of silver diammine fluoride to control caries lesions in erupting permanent first molars - randomized clinical trial]. classic.clinicaltrials.gov/ct2/show/NCT01508611 (first posted 12 January 2012).
NCT03649659 {published data only}
    1. NCT03649659. Effectiveness of silver diamine fluoride (SDF) in arresting cavitated caries lesions [Phase III RCT of the effectiveness of silver diamine fluoride in arresting cavitated caries lesions]. classic.clinicaltrials.gov/ct2/show/NCT03649659 (first received 28 August 2018).
NCT04514094 {published data only}
    1. NCT04514094. Silver diamine fluoride effectiveness versus atraumatic restorative treatment in arresting ECC [Effectiveness of silver diamine fluoride in arresting early childhood caries: randomized controlled clinical trial]. clinicaltrials.gov/show/NCT04514094 (first received 14 August 2020).
NCT05314660 {published data only}
    1. NCT05314660. Arresting active dentine lesions and quality of life among a group of preschool children. clinicaltrials.gov/show/NCT05314660 (first received 6 April 2022).
NCT05761041 {published data only}
    1. NCT05761041. Silver diamine fluoride versus sodium fluoride varnish with parental behavior nodification in arresting early childhood caries [Effectiveness of silver diamine fluoride versus sodium fluoride varnish with parental behavior modification for arresting early childhood caries: a randomized clinical trial]. clinicaltrials.gov/study/NCT05761041 (first received 9 March 2023).
Nelson 2020 {published data only}
    1. NCT03916926. Older adult effectiveness of 2 treatments [Reducing oral health disparities of older adults: comparative effectiveness of 2 treatments]. classic.clinicaltrials.gov/ct2/show/record/NCT03916926 (first received 16 April 2019).
    1. Nelson S, Albert JM, Milgrom P. Comparative effectiveness of two nonsurgical treatments to reduce oral health disparities from untreated tooth decay in older adults: protocol for a cluster randomized trial. JMIR Research Protocols 2020;9(9):e17840. [PMID: ] - PMC - PubMed
Salamoon 2021 {published data only}
    1. Salamoon MA, Waly NG, Elmasry ES, Abdelgawad F. Effect of discoloration of silver diamine fluoride versus sodium fluoride varnish in treatment of carious primary teeth: a randomized clinical trial. Indian Journal of Public Health Research and Development 2021;12(4):183.
Yan 2022 {published data only}
    1. NCT04655430. Effect of application time of 38% silver diamine fluoride solution on arresting dental caries in preschool children [Effect of application time of 38% silver diamine fluoride solution on arresting dental caries in preschool children: a randomized double blinded controlled trial]. classic.clinicaltrials.gov/ct2/show/record/NCT04655430 (first received 7 December 2020).
    1. Yan IG, Zheng FM, Gao SS, Duangthip D, Lo EC, Chu CH. Effect of application time of 38% silver diamine fluoride solution on arresting early childhood caries in preschool children: a randomised double-blinded controlled trial protocol. Trials 2022;23(1):215. [PMID: ] - PMC - PubMed
Zhang 2020 {published data only}
    1. NCT03654820. Effectiveness on SDF solution and PVP-I combined NaF varnish in preventing root caries in elders [Effectiveness of using silver diammine fluoride solution and combination of povidone iodine and sodium fluoride varnish in preventing dental root caries in elders: a randomized, double-blind, non-inferiority trial]. classic.clinicaltrials.gov/ct2/show/record/NCT03654820 (first received 31 August 2018).
    1. Zhang J, Leung K, Chu CH, Jiang M, Lo E. Povidone iodine and NaF vanish versus sliver fluoride in preventing root caries. Journal of Dental Research 2020;98(Spec Iss A):no pagination.
    1. Zhang J, Lo E, Leung K, Chu CH. Clinical trial combining PVP-I and NaF in preventing root caries. Journal of Dental Research 2019;98(Spec Iss A):no pagination.
    1. Zhang J, Lo EC, Leung KC, Chu CH. SDF versus PVP-I and NaF in arresting root caries. Journal of Dental Research 2020;99(Spec Iss B):no pagination.

References to ongoing studies

CTRI/2020/02/023420 {published data only}
    1. CTRI/2020/02/023420. Effect of fluoride paint in arresting decay among children of age 24-72 months in Mangaluru Taluk [Effectiveness of silver diamine fluoride in early childhood caries among 24-72 months old children in Mangaluru Taluk - a randomized control trial]. ctri.nic.in (first received 18 February 2020).
CTRI/2020/07/026614 {published data only}
    1. CTRI/2020/07/026614. Comparison of two types treatment of decayed teeth in primary school children with limited access to dental care [A six month clinical evaluation of silver diamine fluoride and atraumatic restorative treatment for treating dental caries]. ctri.nic.in (first received 16 July 2020).
CTRI/2020/11/029210 {published data only}
    1. CTRI/2020/11/029210. Assessing benefits of treatment of dental caries using 38% silver diamine fluoride and placebo among primary school children in Hyderabad City: a randomized controlled trial [Effectiveness of 38% silver diamine flouride in arresting caries with a placebo among primary school children in Hyderabad City: a randomized controlled trial]. ctri.nic.in (first received 18 November 2020).
CTRI/2021/05/033876 {published data only}
    1. CTRI/2021/05/033876. Comparitive effectiveness of SDF and GC IX for caries prevention in children [Evaluation of 38% SDF (silver diamine fluoride) versus high viscosity glass ionomer cement for management of initial dentinal caries in primary molars: a clinical trial]. ctri/nic.in (first received 31 May 2021).
CTRI/2022/04/042177 {published data only}
    1. CTRI/2022/04/042177. Topical fluorides to arrest dental caries among Anganwadi children in Jaipur - a randomized controlled trial [Efficacy of silver diamine fluoride versus fluoride varnish to arrest dental caries among Anganwadi children in Jaipur – a randomized controlled trial ]. www.ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=41765 (first received 26 April 2022).
Duangthip 2022 {published data only}
    1. Duangthip D, He S, Gao SS, Chu CH, Lo EC. Effectiveness of silver diamine fluoride for preventing occlusal caries in the primary teeth of preschool children: protocol for a randomized controlled trial. JMIR Research Protocols 2022;11(5):e35145. [DOI: 10.2196/35145] [PMID: ] - DOI - PMC - PubMed
    1. NCT05084001. Silver diamine fluoride in preventing occlusal caries in primary teeth [Effectiveness of silver diamine fluoride in preventing occlusal caries in primary teeth of preschool children: a 30-month randomized clinical trial]. classic.clinicaltrials.gov/ct2/show/record/NCT05084001 (first received 19 October 2021).
Gao 2020 {published data only}
    1. Gao SS, Chen KJ, Duangthip D, Wong MC, Lo EC, Chu CH. Preventing early childhood caries with silver diamine fluoride: study protocol for a randomised clinical trial. Trials 2020;21:140. [PMID: ] - PMC - PubMed
    1. NCT04075474. Preventing early childhood caries with silver diamine fluoride [Preventing early childhood caries with silver diamine fluoride - a randomised clinical trial]. classic.clinicaltrials.gov/ct2/show/record/NCT04075474 (first received 30 August 2019).
Janakiram 2021 {published data only}
    1. CTRI/2020/03/024265. Application of silver diamine fluoride as preventive agent for dental caries in children [Effectiveness of various frequencies of application of 38% silver diamine fluoride (SDF) on cavitated carious lesion of primary teeth of pre-school children]. ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=41917&EncHid=&u... (first received 25 March 2020).
    1. Janakiram C, Ramanarayanan V, Devan I. Effectiveness of silver diammine fluoride applications for dental caries cessation in tribal preschool children in India: study protocol for a randomized controlled trial. Methods and Protocols 2021;4(2):30. [DOI: 10.3390/mps4020030] [PMCID: PMC8162555] [PMID: ] - DOI - PMC - PubMed
NCT03770286 {published data only}
    1. NCT03770286. Treatment of interproximal cavities on primary molar teeth with silver diamine fluoride [Treatment of interproximal carious lesions on primary molar teeth with SDF and Super Floss application versus SDF without Super Floss versus fluoride varnish alone: a pilot phase 3 randomized controlled trial]. classic.clinicaltrials.gov/ct2/show/record/NCT03770286?term=NCT03770286&... (first received 10 December 2018).
NCT04054635 {published data only}
    1. NCT04054635. A clinical trial of silver diamine fluoride to arrest early childhood caries in young children [A randomized clinical trial of silver diamine fluoride to arrest early childhood caries in young children]. classic.clinicaltrials.gov/ct2/show/record/NCT04054635 (first received 13 August 2019).
NCT04213573 {published data only}
    1. NCT04213573. Efficacy of silver diamine fluoride and its parental perception [Parental perception of silver diamine fluoride staining and its efficacy on caries arrestment in comparison to sodium fluoride with casein phosphopeptide-amorphous calcium phosphate]. https://classic.clinicaltrials.gov/ct2/show/record/NCT04213573 (first received 30 December 2019).
NCT04432415 {published data only}
    1. NCT04432415. Comparison of silver diamine fluoride and sodium fluoride varnish to prevent and arrest root caries in older adults [Comparison of the efficacy of silver diamine fluoride solution and sodium fluoride varnish for the prevention and arrest of root caries in a group of older adults]. clinicaltrials.gov/show/NCT04432415 (first received 16 June 2020).
NCT04737057 {published data only}
    1. NCT04737057. Clinical efficiency and child's behavior of hall versus SDF techniques in the management of carious primary molar. clinicaltrials.gov/show/NCT04737057 (first received 3 February 2021).
NCT05008718 {published data only}
    1. NCT05008718. Silver diamine fluoride: a randomized controlled trial on its effectiveness as a caries arresting agent. clinicaltrials.gov/show/NCT05008718 (first received 17 August 2021).
NCT05188846 {published data only}
    1. NCT05188846. Caries arresting in primary molar teeth using SDF vs ART [Caries arresting treatment using silver diamine fluoride (SDF) versus SDF modified atraumatic restorative technique (SMART) for management of carious vital primary teeth: a randomized clinical trial]. clinicaltrials.gov/show/NCT05188846 (first received 12 January 2022).
NCT05255913 {published data only}
    1. NCT05255913. Effectiveness of nano-silver fluoride and silver diamine fluoride for arresting early childhood caries [Effectiveness of nano-silver fluoride and silver diamine fluoride for arresting early childhood caries (a randomized clinical trial)]. clinicaltrials.gov/show/NCT05255913 (first received 25 February 2022).
Ruff 2018 {published data only}
    1. NCT03448107. Comparative effectiveness of treatments to prevent dental caries [Comparative effectiveness of treatments to prevent dental caries given to rural children in school-based settings: protocol for a cluster randomized controlled trial]. classic.clinicaltrials.gov/ct2/show/record/NCT03448107 (first received 27 February 2018). - PMC - PubMed
    1. Ruff RR, Niederman R. Comparative effectiveness of treatments to prevent dental caries given to rural children in school-based settings: protocol for a cluster randomised controlled trial. BMJ Open 2018;8(4):e022646. [PMID: ] - PMC - PubMed
Varughese 2022 {published data only}
    1. Varughese A, Janakiram C, Varma B, Mathew A, Venugopalan SR, Ramanarayanan V, et al. Effectiveness of 38% silver diamine fluoride application along with atraumatic restorative treatment for arresting caries in permanent teeth when compared to atraumatic restorative treatment in adults-study protocol for a randomized controlled trial. Methods and Protocols 2022;5(6):87. [PMID: ] - PMC - PubMed

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