A systematic review of silver diamine fluoride: Effectiveness and application in older adults

Gerodontology. 2017 Dec;34(4):411-419. doi: 10.1111/ger.12294. Epub 2017 Aug 15.


Objective: This systematic review examines the effectiveness of silver diamine fluoride (SDF) in the management of caries in older adults.

Background: Silver diamine fluoride has been extensively researched and proven effective for caries prevention and arrest in children. Limited studies support its effectiveness in adult and older adult populations.

Materials and methods: Multiple databases were searched according to specified inclusion-exclusion criteria. Quality assessment used modified Centre for Evidence-Based Medicine worksheets.

Results: Three randomised controlled trials were identified that addressed the effectiveness of SDF on root caries in older adults, but none addressed coronal caries. Root caries prevented fraction and arrest rate for SDF were significantly higher than placebo. The prevented fraction for caries prevention for SDF compared to placebo was 71% in a 3-year study and 25% in a 2-year study. The prevented fraction for caries arrest for SDF was 725% greater in a 24-month study and 100% greater than placebo in a 30-month study. No severe adverse effects were observed.

Conclusion: This systematic review evaluates the use of SDF for both root caries prevention and arrest in older adults. Existing reports of SDF trials support effectiveness in root caries prevention and arrest, remineralization of deep occlusal lesions and treatment of hypersensitive dentin.

Keywords: arrest; caries; older adults; prevent; safety; silver diamine fluoride; systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Age Factors
  • Aged
  • Cariostatic Agents / therapeutic use*
  • Fluorides, Topical
  • Humans
  • Quaternary Ammonium Compounds / therapeutic use*
  • Root Caries / prevention & control*
  • Silver Compounds


  • Cariostatic Agents
  • Fluorides, Topical
  • Quaternary Ammonium Compounds
  • Silver Compounds
  • silver diamine fluoride