Silver diamine fluoride versus conventional restorative treatment for dental caries in primary teeth of children: a meta-analysis.
Ping Chang, Yuan-Yuan Liang, Xiao-Long Li et al.
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In 30 seconds
This meta-analysis compared 30% to 38% silver diamine fluoride (SDF) with conventional restorative approaches for caries control in children with carious primary teeth. Eight randomized trials included 12,445 teeth or surfaces from 8,507 children; seven trials contributed to the primary caries-arrest analysis. There was no statistically significant difference between treatments in caries arrest (RR = 1.25, 95% CI 0.88 to 1.78). Considerable heterogeneity (I2 = 96.1%) and wide confidence intervals limit confidence in the pooled estimate, so the findings do not establish equivalence.
Key findings
- Seven trials found no statistically significant difference in caries arrest between SDF and conventional restorative treatment (RR = 1.25, 95% CI 0.88 to 1.78).
- Between-study heterogeneity was considerable (I2 = 96.1%), and exploratory subgroup analyses did not resolve it.
- A treatment-time analysis based on only two studies favored SDF.
Why it matters
The pooled evidence does not show a clear caries-arrest advantage for either approach, but uncertainty and substantial variation between studies prevent concluding that they are equivalent. The findings help frame SDF as a possible minimally invasive option while underscoring that treatment choice involves factors beyond the pooled efficacy estimate, including staining, cooperation, caregiver preferences, and retreatment needs.
What to keep in mind
Considerable heterogeneity and wide confidence intervals limit confidence in the pooled estimate; subgroup analyses did not explain the heterogeneity. The treatment-time comparison included only two studies.