Abstract
ObjectiveSilver 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 sourcesStudies published in PubMed/MEDLINE, Scopus, or Web of Science through July 2021 with no date or language restrictions.Study selectionAny 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 synthesisPotentially 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.Results19 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).ConclusionsEvidence 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.
Highlights
Silver diamine fluoride (SDF) is a novel therapy for the non-surgical treatment and prevention of dental caries, primarily delivered as a 38% concentration solution consisting of 24-27% silver, 7.5-11% ammonia, and 5-6% fluoride [1]
Results across all treatments indicate no differences in Oral health-related quality of life (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)
Summary
Silver diamine fluoride (SDF) is a novel therapy for the non-surgical treatment and prevention of dental caries, primarily delivered as a 38% concentration solution consisting of 24-27% silver, 7.5-11% ammonia, and 5-6% fluoride [1]. The comparative simplicity and efficiency of applying SDF make it an attractive alternative to traditional nonrestorative treatments [4, 5], commonly used in community settings to mitigate the substantial burden of disease in underserved populations [6]. When applied to dental decay, the oxidizing effects of silver diamine fluoride results in irreversible black stains and superficial staining of the oral mucosa, potentially leading to aesthetic problems and negative impacts on oral health-related quality of life [7, 8]. It is possible that prototypical quality of life may increase due to a reduction of the burden of disease, yet simultaneously harm subjective perceptions of self [11]
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