The Role of Silver Diamine Fluoride in Paediatric Dentistry: An Umbrella Review

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ABSTRACT

Aim

To synthesise evidence from existing systematic reviews on the clinical effectiveness of SDF for the prevention and arrest of dental caries in primary teeth.

Methods

This umbrella review was conducted in accordance with PRISMA 2020 guidelines. Systematic reviews (SRs), with or without meta-analyses, involving paediatric populations treated with SDF were retrieved from five databases (PubMed, EMBASE, Web of Science, CENTRAL, LILCAS) up to January 2025. Methodological quality was assessed using the AMSTAR 2 tool.

Results

Sixteen SRs were included. Among moderate-to-high quality reviews, biannual application of 38% SDF consistently showed superior efficacy in caries arrest (67%-99%) compared to Atraumatic Restorative Treatment (ART), glass ionomer cement (GIC), sodium fluoride varnish (NaF), and conventional restorations.

Conclusion

The biannual use of 38% SDF remains the most evidence-supported, non-invasive intervention for arresting caries in primary dentition. Further high-quality randomised trials are required to confirm long-term outcomes and support clinical guideline development.

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