ArticleCaries research2025
Cost-Effectiveness of Silver Diamine Fluoride Depends on Caries Activity: A Decision Analytic Model.
Article in Caries research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed.
- Silver Diamine Fluoride in Oral Health Policy: A Strategic Pathway to Improve Access and Equity.Journal of public health dentistry · 2026Article
- Knowledge, attitude and practice of paediatric dentists towards silver diammine fluoride in Egypt: a national survey.European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry · 2026Article
- TheBiomaterial investigations in dentistry · 2026Article
- Effect of silver diamine fluoride versus fluoride varnish in arresting early childhood caries: A clinical study.Bioinformation · 2026Article
- Implementing a disease management standard operating procedure in a contemporary private pediatric dental practice.Frontiers in dental medicine · 2026Article
- Handling uncertainty in cost-effectiveness analysis in dental medicine: a systematic review with a focus on affordability and risk-aversion.Cost effectiveness and resource allocation : C/E · 2025Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe study sought to assess the cost-effectiveness of silver diamine fluoride (SDF) relative to sodium fluoride (NaF) varnish and direct restorations placed chairside or under general anaesthesia, accounting for caries activity.
methodsAn analytical decision-tree model was developed with clinical data from multiple centres to evaluate the four treatment options among all children aged 1-6 years in Singapore (N = 231,880) over a 12-month time horizon. Base-case scenarios consisted of children with low (1 carious tooth)- and high (7 carious teeth)-caries activity. Incremental cost-effectiveness ratios (ICERs) and net monetary benefits (NMBs) were tabulated with the outcomes set to be the control of active caries and avoidance of tooth extractions. Deterministic and probabilistic sensitivity analyses were conducted.
resultsOverall, SDF was less effective than direct restorations placed chairside but was less costly. For children with low-caries activity, the ICER for SDF was SGD 9 per caries-controlled tooth and SGD 68 per extraction avoided. For children with high-caries activity, the ICERs were SGD 267 and SGD 1,909, respectively. At a willingness-to-pay threshold of SGD 30, the NMB was negative (favours restorations) for caries control in children with low-caries activity and positive (favours SDF) for all other situations. In the low-caries activity group, SDF had a 41.5% probability of being cost-effective for caries control and 49.2% probability of being cost-effective for the avoidance of extraction. The corresponding probabilities for the high-caries activity group were 99.8% and 100%. The NMB of SDF increases proportionally with caries activity, suggesting utilization of SDF should depend on caries activity. Results were most sensitive to changes in relative cost and effectiveness of SDF/direct restorations.
conclusionSDF was cost-effective in most situations except for caries control in children with low-caries activity. Direct restorations were more effective and should be considered in low-caries activity children.
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