The Effect of Silver Diamine Fluoride in Preventing Caries in the Primary Dentition

A Systematic Review and Meta-Analysis

Branca Heloisa Oliveira, Anjana Rajendra, Analia Veitz-Keenan, Richard Niederman

Research output: Contribution to journalArticle

Abstract

Objectives: To investigate whether silver diamine fluoride (SDF) is effective in preventing new caries lesions in primary teeth when compared to placebo or active treatments. Methods: Systematic review (CRD42016036963) of controlled clinical trials. Searches were performed in 9 electronic databases, 5 registers of ongoing trials, and reference lists of identified review articles. Two researchers carried out data extraction and quality appraisal independently. The primary outcome was the difference in caries increment (decayed, missing, and filled surfaces or teeth – dmfs or dmft) between SDF and control groups. These differences were pooled as weighted mean differences (WMD) and prevented fractions (PF). Results: Searches yielded 2,366 unique records; 6 reports of 4 trials that randomized 1,118 and analyzed 915 participants were included. Two trials compared SDF to no treatment, 1 compared SDF to placebo and sodium fluoride varnish (FV), and 1 compared SDF to high-viscosity glass ionomer cement (GIC). All studies had at least 1 domain with unclear or high risk of bias. After 24 months of follow-up, in comparison to placebo, no treatment, and FV, SDF applications significantly reduced the development of new dentin caries lesions (placebo or no treatment: WMD = –1.15, PF = 77.5%; FV: WMD = –0.43, PF = 54.0%). GIC was more effective than SDF after 12 months of follow-up but the difference between them was not statistically significant (WMD, dmft: 0.34, PF: –6.09%). Conclusion: When applied to caries lesions in primary teeth, SDF compared to no treatment, placebo or FV appears to effectively prevent dental caries in the entire dentition. However, trials specifically designed to assess this outcome are needed.

Original languageEnglish (US)
Pages (from-to)24-32
Number of pages9
JournalCaries Research
DOIs
StateAccepted/In press - Jun 6 2018

Fingerprint

Deciduous Tooth
Meta-Analysis
Topical Fluorides
Placebos
Glass Ionomer Cements
Therapeutics
Sodium Fluoride
Dentition
silver diamine fluoride
Controlled Clinical Trials
Dental Caries
Dentin
Viscosity
Tooth
Research Personnel
Databases
Control Groups

Keywords

  • Cariostatic agents
  • Dental caries
  • Preventive dentistry
  • Silver diamine fluoride
  • Systematic review

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

The Effect of Silver Diamine Fluoride in Preventing Caries in the Primary Dentition : A Systematic Review and Meta-Analysis. / Oliveira, Branca Heloisa; Rajendra, Anjana; Veitz-Keenan, Analia; Niederman, Richard.

In: Caries Research, 06.06.2018, p. 24-32.

Research output: Contribution to journalArticle

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abstract = "Objectives: To investigate whether silver diamine fluoride (SDF) is effective in preventing new caries lesions in primary teeth when compared to placebo or active treatments. Methods: Systematic review (CRD42016036963) of controlled clinical trials. Searches were performed in 9 electronic databases, 5 registers of ongoing trials, and reference lists of identified review articles. Two researchers carried out data extraction and quality appraisal independently. The primary outcome was the difference in caries increment (decayed, missing, and filled surfaces or teeth – dmfs or dmft) between SDF and control groups. These differences were pooled as weighted mean differences (WMD) and prevented fractions (PF). Results: Searches yielded 2,366 unique records; 6 reports of 4 trials that randomized 1,118 and analyzed 915 participants were included. Two trials compared SDF to no treatment, 1 compared SDF to placebo and sodium fluoride varnish (FV), and 1 compared SDF to high-viscosity glass ionomer cement (GIC). All studies had at least 1 domain with unclear or high risk of bias. After 24 months of follow-up, in comparison to placebo, no treatment, and FV, SDF applications significantly reduced the development of new dentin caries lesions (placebo or no treatment: WMD = –1.15, PF = 77.5{\%}; FV: WMD = –0.43, PF = 54.0{\%}). GIC was more effective than SDF after 12 months of follow-up but the difference between them was not statistically significant (WMD, dmft: 0.34, PF: –6.09{\%}). Conclusion: When applied to caries lesions in primary teeth, SDF compared to no treatment, placebo or FV appears to effectively prevent dental caries in the entire dentition. However, trials specifically designed to assess this outcome are needed.",
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