Silver Diamine Fluoride in Pediatric Dentistry: A Systematic Review of Its Efficacy in Arresting Caries in Primary Teeth

Background Dental caries in primary teeth is a widespread issue, ranking as one of the most prevalent conditions globally, as highlighted in the Global Burden of Disease 2010 Study. Despite preventive efforts, such as the use of fluoride toothpaste, many children, particularly those in underserved populations, continue to suffer from untreated caries. Conventional treatments for caries often involve invasive procedures, which can be challenging in pediatric patients due to behavioral or logistical barriers. Objective This systematic review aims to evaluate the effectiveness of silver diamine fluoride in preventing and arresting the progression of caries in primary teeth. The focus is to determine whether silver diamine fluoride can effectively prevent new carious lesions compared to a placebo or no treatment, and how it compares to other active caries management interventions. Methods A systematic review was conducted, adhering to PRISMA guidelines, with a focus on randomized or quasirandomized clinical trials. Eligible studies included children aged 0-12 years who received topical silver diamine fluoride treatment. The primary outcome measured was the development of new caries lesions, and secondary outcomes included adverse events. A comprehensive search of multiple academic databases and trial registries was performed. Results Silver diamine fluoride demonstrated a significant effect in halting caries progression in primary teeth, with an effectiveness rate of 89%, surpassing placebo and other treatments. The application of silver diamine fluoride was found to be especially effective in arresting caries in children with high-risk factors, such as poor oral hygiene or multiple carious lesions. However, aesthetic concerns, particularly the black staining of treated areas, were noted as a limitation, though the treatment’s efficacy often outweighed these. Conclusion Silver diamine fluoride is a cost-effective, minimally invasive solution for managing caries in primary teeth, particularly in children who face barriers to traditional dental care. Despite aesthetic concerns, its widespread use could significantly reduce the incidence of untreated dental caries in pediatric populations, especially in underserved communities. Future studies should explore long-term outcomes and improved formulations to mitigate staining issues.