CoChat
Sign Up
Cited by 20Dental Health and Care UtilizationDental materials and restorationsEndodontics and Root Canal Treatments

Effectiveness of silver diamine fluoride (SDF) in arresting coronal dental caries in children and adolescents: a systematic review

Open access
Satish Vishwanathaiah, Prabhadevi C Maganur, Ather Ahmed Syed, Ateet Kakti, Atlal Hassan Hussain Jaafari, Dhalia Hassan Albar, Apathsakayan Renugalakshmi, Ganesh Jeevanandan +3 more·2024·Journal of Clinical Pediatric Dentistry
DOI 10.22514/jocpd.2024.101
Open this paper in CoChat — free accountOpen PDF

Abstract

Dental caries remains a significant public health issue for children globally, leading to adverse effects on health and development. Silver diamine fluoride (SDF) is a potential preventive agent that can prevent caries progression in children. This systematic review examined the effectiveness of silver diamine fluoride in arresting caries compared to other fluorides. An electronic search of MEDLINE, PubMed, EMBASE, Cochrane, Web of Science, Scopus databases was carried out examining articles in English from 2001 to 2023. Studies included in the analysis examined the application of SDF in children and adolescents with coronal caries lesions on primary teeth or permanent first molars. Fifteen studies, involving a total of 7895 children, were incorporated. The application regimen varied across studies. Most studies in this review consistently suggested that SDF is effective in arresting caries. An annual application of SDF effectively reduced Streptococcus mutans count. Adverse effects were primarily tooth staining and less commonly, oral mucosal irritation. A majority of studies showed a high risk of bias due to methodological insufficiencies. Overall, the evidence suggests that SDF is effective in arresting dental caries in children. It offers a viable, cost-effective, and minimally invasive treatment option, particularly suitable for use in low-resource settings. However, the aesthetic concern of tooth staining with SDF use remains a challenge. Further well-designed clinical trials may provide a fuller picture of SDF which can shape public health policy and shift towards a minimally invasive treatment approach.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.22514/jocpd.2024.101

Cites

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Evidence from school- and community-based programs suggests that SDF can be incorporated into broader prevention strategies as a pragmatic disease-control measure that can arrest active lesions, reduce treatment escalation, and create a bridge to further restorative or specialist care when required.

    “Evidence from school‐ and community‐based programs suggests that SDF can be incorporated into broader prevention strategies, not as a replacement for comprehensive dental care, but as a pragmatic disease‐control measure that can arrest active lesions, reduce treatment escalation, and create a bridge to further restorative or specialist care when required [2, 4, 23].”

    From Silver Diamine Fluoride in Oral Health Policy: A Strategic Pathway to Improve Access and Equity (2026) · cites this paper as [23]

    Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Still being checked.

Research works printed but not linked: 69

  1. Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nature Reviews Disease Primers. 2017; 3: 17038.
  2. McGrath C, Broder H, Wilson-Genderson M. Assessing the impact of oral health on the life quality of children: implications for research and practice. Community Dentistry and Oral Epidemiology. 2004; 32: 81-85.
  3. Feitosa S, Colares V, Pinkham J. The psychosocial effects of severe caries in 4-year-old children in Recife, Pernambuco, Brazil. Cad Saude Publication. 2005; 21: 1550-1556.
  4. Singh N, Dubey N, Rathore M, Pandey P. Impact of early childhood caries on quality of life: child and parent perspectives. Journal of Oral Biology and Craniofacial Research. 2020; 10: 83-86.
  5. Filstrup SL, Briskie D, da Fonseca M, Lawrence L, Wandera A, Inglehart MR. Early childhood caries and quality of life: child and parent perspectives. Pediatric Dentistry. 2003; 25: 431-440.
  6. Martins-Júnior PA, Vieira-Andrade RG, Corrêa-Faria P, Oliveira-Ferreira F, Marques LS, Ramos-Jorge ML. Impact of early childhood caries on the oral health-related quality of life of preschool children and their parents. Caries Research. 2013; 47: 211-218.
  7. Teng AYT, Liang CY, Liu YCG. Socio-economic status may associate different risk(s) with early childhood caries (ECC) that can cause the development of psychomotor deficiency in preschool children aged 3- 6 years old: the results of preliminary analysis from a cohort study. International Journal of Environmental Research and Public Health. 2021; 18: 9011.
  8. Zaror C, Matamala-Santander A, Ferrer M, Rivera-Mendoza F, Espinoza- Espinoza G, Martínez-Zapata MJ. Impact of early childhood caries on oral health-related quality of life: a systematic review and meta-analysis. International Journal of Dental Hygiene. 2022; 20: 120-135.
  9. Uribe SE, Innes N, Maldupa I. The global prevalence of early childhood caries: a systematic review with meta-analysis using the who diagnostic criteria. International Journal of Paediatric Dentistry. 2021; 31: 817-830.
  10. Kazeminia M, Abdi A, Shohaimi S, Jalali R, Vaisi-Raygani A, Salari N, et al. Dental caries in primary and permanent teeth in children's worldwide, 1995 to 2019: a systematic review and meta-analysis. Head & Face Medicine. 2020; 16: 22.
  11. Phantumvanit P, Makino Y, Ogawa H, Rugg-Gunn A, Moynihan P, Petersen PE, et al. Who global consultation on public health intervention against early childhood caries. Community Dentistry and Oral Epidemiology. 2018; 46: 280-287.
  12. Tinanoff N, Baez RJ, Diaz Guillory C, Donly KJ, Feldens CA, McGrath C, et al. Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: global perspective. International Journal of Paediatric Dentistry. 2019; 29: 238-248.
  13. Pierce A, Singh S, Lee J, Grant C, Cruz de Jesus V, Schroth RJ. The burden of early childhood caries in Canadian children and associated risk factors. Frontiers in Public Health. 2019; 7: 328.
  14. Colak H, Dülgergil CT, Dalli M, Hamidi MM. Early childhood caries update: a review of causes, diagnoses, and treatments. Journal of Natural Science, Biology and Medicine. 2013; 4: 29-38.
  15. Poureslami HR, Van Amerongen WE. Early childhood caries (ECC): an infectious transmissible oral disease. The Indian Journal of Pediatrics. 2009; 76: 191-194.
  16. Schwendicke F. Contemporary concepts in carious tissue removal: a review. Journal of Esthetic and Restorative Dentistry. 2017; 29: 403-408.
  17. Johansen E, Olsen TO. Topical fluorides in the prevention and arrest of dental caries. In Johansen E, Olsen TO (eds.) Continuing evaluation of the use of fluorides (pp. 61-110). 1st edn. CRC Press: Boca Raton. 2019.
  18. Baik A, Alamoudi N, El-Housseiny A, Altuwirqi A. Fluoride varnishes for preventing occlusal dental caries: a review. Journal of Dentistry. 2021; 9: 64.
  19. Zhao IS, Gao SS, Hiraishi N, Burrow MF, Duangthip D, Mei ML, et al. Mechanisms of silver diamine fluoride on arresting caries: a literature review. International Dental Journal. 2018; 68: 67-76.
  20. Thibodeau EA, Handelman SL, Marquis RE. Inhibition and killing of oral bacteria by silver ions generated with low intensity direct current. Journal of Dental Research. 1978; 57: 922-926.
  21. dos Santos VE, Filho AV, Ribeiro Targino AG, Pelagio Flores MA, Galembeck A, Caldas AF, et al. A new "Silver-Bullet" to treat caries in children-nano silver fluoride: a randomised clinical trial. Journal of Dentistry. 2014; 42: 945-951.
  22. Suzuki T, Nishida M, Sobue S, Moriwaki Y. Effects of diammine silver fluoride on tooth enamel. The Journal of Osaka University Dental School. 1974; 14: 61-72.
  23. Wu MY, Suryanarayanan K, van Ooij WJ, Oerther DB. Using microbial genomics to evaluate the effectiveness of silver to prevent biofilm formation. Water Science and Technology. 2007; 55: 413-419.
  24. Horst JA, Ellenikiotis H, Milgrom PL. UCSF protocol for caries arrest using silver diamine fluoride: rationale, indications and consent. Journal of the California Dental Association. 2016; 44: 16-28.
  25. Nishino M, Yoshida S, Sobue S, Kato J, Nishida M. Effect of topically applied ammoniacal silver fluoride on dental caries in children. The Journal of Osaka University Dental School. 1969; 9: 149-155.
  26. Wilson J, Swanbeck S, Banning G, Alhwayek T, Sullivan V, Howard KM, et al. Assessment of sodium diamine fluoride (SDF) with light curing technique: a pilot study of antimicrobial effects. Methods and Protocols. 2022; 5: 31.
  27. Li R, Lo ECM, Liu BY, Wong MCM, 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.
  28. Whiting P, Savović J, Higgins JPT, Caldwell DM, Reeves BC, Shea B, et al. ROBIS: a new tool to assess risk of bias in systematic reviews was developed. Journal of Clinical Epidemiology. 2016; 69: 225-234.
  29. Mei ML, Li Q, Chu C, Lo E, Samaranayake LP. Antibacterial effects of silver diamine fluoride on multi-species cariogenic biofilm on caries. Annals of Clinical Microbiology and Antimicrobials. 2013; 12: 4.
  30. Milgrom P, Horst JA, Ludwig S, Rothen M, Chaffee BW, Lyalina S, et al. Topical silver diamine fluoride for dental caries arrest in preschool children: a randomized controlled trial and microbiological analysis of caries associated microbes and resistance gene expression. Journal of Dentistry. 2018; 68: 72-78.
  31. Fung MHT, Duangthip D, Wong MCM, Lo ECM, Chu CH. Randomized clinical trial of 12% and 38% silver diamine fluoride treatment. Journal of Dental Research. 2018; 97: 171-178.
  32. Brignardello-Petersen R. 37% silver diamine fluoride is more effective than 12% silver diamine fluoride in arresting caries in the primary dentition. The Journal of the American Dental Association. 2017; 148: e205.
  33. Duangthip D, Chu CH, Lo ECM. A randomized clinical trial on arresting dentine caries in preschool children by topical fluorides-18 month results. Journal of Dentistry. 2016; 44: 57-63.
  34. Devji T. Silver diamine fluoride is probably more effective than atraumatic restorative treatment, fluoride varnish, or no treatment for controlling caries progression in children. The Journal of the American Dental Association. 2018; 149: e65.
  35. Tolba ZO, Hamza HS, Moheb DM, Hassanein HE, El Sayed HM. Effectiveness of two concentrations 12% versus 38% of silver diamine fluoride in arresting cavitated dentin caries among children: a systematic review. Egyptian Pediatric Association Gazette. 2019; 67: 1-7.
  36. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. British Medical Journal. 2021; 372: n71.
  37. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al. Cochrane handbook for systematic reviews of interventions. 2nd edn. John Wiley & Sons: Chichester. 2019.
  38. Chu CH, Lo ECM, Lin HC. Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children. Journal of Dental Research. 2002; 81: 767-770.
  39. Zhi QH, Lo ECM, Lin HC. Randomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children. Journal of Dentistry. 2012; 40: 962-967.
  40. Liu BY, Lo ECM, Chu CH, Lin HC. Randomized trial on fluorides and sealants for fissure caries prevention. Journal of Dental Research. 2012; 91: 753-758.
  41. Lo EC, Chu CH, Lin HC. A Community-based caries control program for pre-school children using topical fluorides: 18-month results. Journal of Dental Research. 2001; 80: 2071-2074.
  42. Gao SS, Chen KJ, Duangthip D, Wong MCM, Lo ECM, Chu CH. Arresting early childhood caries using silver and fluoride products-a randomised trial. Journal of Dentistry. 2020; 103: 103522.
  43. Tirupathi S, Svsg N, Rajasekhar S, Nuvvula S. Comparative cariostatic efficacy of a novel nano-silver fluoride varnish with 38% silver diamine fluoride varnish a double-blind randomized clinical trial. Journal of Clinical and Experimental Dentistry. 2019; 11: e105-e112.
  44. Shah S, Bhaskar V, Venkataraghavan K, Choudhary P, Ganesh M, Trivedi K. Efficacy of silver diamine fluoride as an antibacterial as well as antiplaque agent compared to fluoride varnish and acidulated phosphate fluoride gel: an in vivo study. Indian Journal of Dental Research. 2013; 24: 575-581.
  45. Shah S, Bhaskar V, Chawla S, Venkataraghavan K, Choudhary P, Ganesh M, et al. Efficacy of silver diamine fluoride as a topical fluoride agent compared to fluoride varnish and acidulated phosphate fluoride gel: an in vivo study. Journal of Pediatric Dentistry. 2014; 2: 5-12.
  46. Abdellatif EB, El Kashlan MK, El Tantawi M. Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow up of a randomized field trial. BMC Oral Health. 2023; 23: 875.
  47. Yassin R, Amer H, Tantawi ME. Effectiveness of silver diamine fluoride versus sodium fluoride varnish combined with mother's motivational interviewing for arresting early childhood caries: a randomized clinical trial. BMC Oral Health. 2023; 23: 710.
  48. Yee R, Holmgren C, Mulder J, Lama D, Walker D, van Palenstein Helderman W. Efficacy of silver diamine fluoride for arresting caries treatment. Journal of Dental Research. 2009; 88: 644-647.
  49. 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: 721-724.
  50. Monse B, Heinrich-Weltzien R, Mulder J, Holmgren C, van 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.
  51. Mabangkhru S, Duangthip D, Chu CH, Phonghanyudh A, Jirarattana- sopha V. A randomized clinical trial to arrest dentin caries in young children using silver diamine fluoride. Journal of Dentistry. 2020; 99: 103375.
  52. Yang ZR, Sun F, Zhan SY. Risk on bias assessment: (2) revised Cochrane risk of bias tool for individually randomized, parallel group trials (RoB2.0). Chinese Journal of Epidemiology. 2017; 38: 1285-1291. (In Chinese)
  53. Sterne JA, Hernán MA, Reeves BC, Savović J, Berkman ND, Viswanathan M, et al. ROBINS-I: a tool for assessing risk of bias in non- randomised studies of interventions. The BMJ. 2016; 355: i4919.
  54. Mouradian WE, Wehr E, Crall JJ. Disparities in children's oral health and access to dental care. JAMA. 2000; 284: 2625-2631.
  55. Kamble AN, Chimata VK, Katge FA, Nanavati KK, Shetty SK. Comparative evaluation of effect of potassium iodide and glutathione on tooth discoloration after application of 38% silver diamine fluoride in primary molars: an in vitro study. International Journal of Clinical Pediatric Dentistry. 2021; 14: 752-756.
  56. Detsomboonrat P, Thongmak P, Lertpayab P, Aiemsri W, Sooampon S. Optimal concentration of potassium iodide to reduce the black staining of silver diamine fluoride. Journal of Dental Sciences. 2022; 17: 300-307.
  57. Chibinski AC, Wambier LM, Feltrin J, Loguercio AD, Wambier DS, Reis A. Silver diamine fluoride has efficacy in controlling caries progression in primary teeth: a systematic review and meta-analysis. Caries Research. 2017; 51: 527-541.
  58. Niederman R, Huang SS, Trescher A, Listl S. Getting the incentives right: improving oral health equity with universal school-based caries prevention. American Journal of Public Health. 2017; 107: S50-S55.
  59. Ganesh A, Muthu MS, Mohan A, Kirubakaran R. Prevalence of early childhood caries in India-a systematic review. The Indian Journal of Pediatrics. 2019; 86: 276-286.
  60. Zhang X, Yang S, Liao Z, Xu L, Li C, Zeng H, et al. Prevalence and care index of early childhood caries in mainland China: evidence from epidemiological surveys during 1987-2013. Scientific Reports. 2016; 6: 18897.
  61. Mei ML, Lo ECM, Chu CH. Arresting dentine caries with silver diamine fluoride: what's behind it? Journal of Dental Research. 2018; 97: 751- 758.
  62. Asghar M, Omar RA, Yahya R, Yap AU, Shaikh MS. Approaches to minimize tooth staining associated with silver diamine fluoride: a systematic review. Journal of Esthetic and Restorative Dentistry. 2023; 35: 322-332.
  63. Crystal YO, Niederman R. Evidence-based dentistry update on silver diamine fluoride. Dental Clinics of North America. 2019; 63: 45-68.
  64. Contreras V, Toro MJ, Elías-Boneta AR, Encarnación-Burgos A. Effectiveness of silver diamine fluoride in caries prevention and arrest: a systematic literature review. General Dentistry. 2017; 65: 22-29.
  65. Hendre AD, Taylor GW, Chávez EM, Hyde S. A systematic review of silver diamine fluoride: effectiveness and application in older adults. Gerodontology. 2017; 34: 411-419.
  66. Trieu A, Mohamed A, Lynch E. Silver diamine fluoride versus sodium fluoride for arresting dentine caries in children: a systematic review and meta-analysis. Scientific Reports.2019; 9: 2115.
  67. Seifo N, Al-yaseen W, Innes N. The efficacy of silver diamine fluoride in arresting caries in children. Evidence-Based Dentistry. 2018; 19: 42-43.
  68. Bhojraj N, Shanbhog R, Singhania S. Is silver diamine fluoride really a magic alternative in pediatric caries management? World Journal of Dentistry. 2021; 12: 350-354.
  69. Wajahat M, Abbas B, Tariq K, Imran E, Aslam S, Khurshid Z. Parental perception of silver diamine fluoride for the management of dental caries. Journal of Taibah University Medical Sciences. 2022; 17: 408-414.

Cited by

Sorted by citations

Related

Authors
Vishwanathaiah, S., Maganur, P. C., Syed, A. A., Kakti, A., Jaafari, A. H. H., Albar, D. H., Renugalakshmi, A., Jeevanandan, G., Khurshid, Z., Baeshen, H. A., & Patil, S.
Affiliations
  • Jazan University (SA)
  • Riyadh Elm University (SA)
  • Saveetha University (IN)
  • King Faisal University (SA)
  • King Abdulaziz University (SA)
  • Roseman University of Health Sciences (US)
ORCID
Venue
Journal of Clinical Pediatric Dentistry
Publisher
MRE Press
Published
2024
Volume
48
Issue
5
Pages
27
ISSN
  • 0145-5508 (ISSN-L)
  • 1053-4628
DOI
10.22514/jocpd.2024.101
OpenAlex
W4402287718
Cited by
20
References
0
Citations by year
2026: 11 · 2025: 9
FWCI
1.64
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Pediatric Dentistry (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
  • Health Sciences › Dentistry › Orthodontics › Dental materials and restorations
  • Health Sciences › Dentistry › Oral Surgery › Endodontics and Root Canal Treatments
Keywords
silver diamine fluoride, caries arrest, children, adolescents, primary teeth, first permanent molars, fluoride, Streptococcus mutans, tooth discoloration, oral mucosal irritation, minimally invasive dentistry, dental caries prevention
MeSH terms
Adolescent, Quaternary Ammonium Compounds, Cariostatic Agents, Child, Dental Caries, Fluorides, Topical, Humans, Silver Compounds

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review