Data sources: Data, from reports written in English, Spanish, or Portuguese, were identified using searches in Medline, LILACS (Latin American and Caribbean Health Sciences Literature), Embase, the Cochrane Library, and the Brazilian Dental Library databases.
Study selection: Human randomised controlled trials (RCT), or cohort or case-control studies, where patients not teeth were the unit of assessment, were included. Studies were excluded if they were early reports of longer studies, in vitro or animal studies, narrative reviews or editorials, or were published in languages other than English, Spanish or Portuguese. Studies were assessed independently by two investigators with disputes being resolved by a third. Quality was assessed using the Jadad scale. Data extraction and synthesis Data were extracted independently by two investigators. The prevented fraction (PF) and number-needed-to-treat (NNT) were calculated.
Results: Two studies met the inclusion criteria. They indicated that the silver diamine fluoride (SDF) lowest PF for caries arrest and caries prevention were 96.1% and 70.3%, respectively; NNT were 0.8 (95% confidence interval, 0.5-1.0) and 0.9 (95% confidence interval, 0.4-1.1), respectively. Adverse events were monitored, with no significant differences being found between control and experimental groups.
Conclusions: These promising results suggest that SDF is more effective than fluoride varnish, and may be a valuable caries-preventive intervention.