Silver diamine fluoride and oral health-related quality of life: A review and network metaanalysis

Ryan Richard Ruff, Rachel Whittemore, Martyna Grochecki, Jillian Bateson, Tamarinda J.Barry Godín

Research output: Contribution to journalArticlepeer-review


Objective Silver diamine fluoride (SDF) is an effective non-surgical treatment for dental caries which may also impact oral health-related quality of life (OHRQoL). The objective of this study was to conduct a network meta-analysis of SDF versus other standard of care therapies on OHRQoL. Data sources Studies published in PubMed/MEDLINE, Scopus, or Web of Science through July 2021 with no date or language restrictions. Study selection Any randomized controlled trial, cohort, or case-control study that included silver diamine fluoride as either a single or combinative treatment for dental caries and a quantitatively measured outcome for oral health-related quality of life was included. Data extraction and synthesis Potentially eligible studies were screened by two independent reviewers trained in conducting systematic reviews. Studies meeting inclusion criteria underwent a full-text review with data being extracted using a standardized form, including publication details, study methodology, outcomes, assessors, and sample information. Studies underwent a risk of bias assessment. Quantitative synthesis was performed using fixed effects meta-analysis and individual comparisons were assessed via network meta-analysis. Main outcome(s) and measure(s) Oral health-related quality of life. Results 19 articles were returned following search strategies. Following screening, ten studies were evaluated for full-text eligibility and five were retained for meta-analyses. Results across all treatments indicate no differences in OHRQoL when compared to SDF (SMD = -0.06, 95% CI = -0.20, 0.08). Direct and indirect estimates from network meta-analysis indicated that OHRQoL in children was not significantly different when treated with SDF versus atraumatic restorations (d = 0.02, 95% CI = -0.32, 0.36) or placebo (d = 0.03, 95% CI = -0.16, 0.22). Conclusions Evidence from the literature consistently shows no discernible impact on OHRQoL across various non-surgical treatments for dental caries. Overall oral health-related quality of life may increase regardless of treatment protocol due to treatment of the underlying disease. Concerns over the staining of dental decay and oral mucosa resulting from treatment with silver diamine fluoride do not seem to affect OHRQoL.

Original languageEnglish (US)
Article numbere0261627
JournalPloS one
Issue number2
StatePublished - Feb 2022


  • Cariostatic Agents/therapeutic use
  • Databases, Factual
  • Dental Caries/prevention & control
  • Fluorides, Topical/therapeutic use
  • Humans
  • Oral Health
  • Quality of Life
  • Quaternary Ammonium Compounds/therapeutic use
  • Silver Compounds/therapeutic use

ASJC Scopus subject areas

  • General


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