SILVER DIAMINE FLUORIDE PREVENTS CARIES IN PRIMARY TEETH SUPERIOR TO NO TREATMENT, PLACEBO, OR FLUORIDE VARNISH

Subjects or Study Selection This systematic review and meta-analysis included clinical studies that investigated the caries-preventive effect of silver diamine fluoride (SDF) treatment for the primary teeth of children age birth through 12 years. A literature search included 9 databases, 5 registers of ongoing trials, and reference lists of identified review articles. Two investigators carried out data extraction and assessed the risk of bias independently. Key Study Factor The key intervention was SDF treatment. Comparisons were no intervention, placebo, any topical cariostatic agents, resin or glass ionomer sealants, or restorative materials. Main Outcome Measure The main outcome was the development of new dentin caries lesions at the surface, tooth, or patient level. Outcome was measured by the difference in mean caries increment between SDF and control groups and pooled as weighted mean difference (WMD). Main Results The review included 4 studies that randomized 1118 and analyzed 915 participants. Meta-analysis excluded 1 study with insufficient information to appraise it for risk of bias. Two studies compared SDF to no treatment, 1 study compared SDF to placebo and sodium fluoride varnish (FV), and 1 study compared SDF to glass ionomer cement. At 24 months, SDF treatment significantly reduced the development of new dentin caries lesions (placebo or no treatment: WMD 5 21.15, FV: WMD 5 20.43). Glass ionomer cement was more effective than SDF after 12 months, but the difference was not statistically significant (WMD, dmft: 0.34). Conclusions SDF treatment prevents dental caries in the entire dentition when compared to no treatment, placebo, or FV. However, rigorously designed studies to provide unbiased highquality evidence on the benefits of SDF applications for caries prevention are needed.