Same question across reviews · CL0132
intervention :: Fluoride mouthrinse -> Adverse effects/fluorosis
ProposalThis cluster groups questions by review type, intervention category and outcome domain. It is a proposal pending human validation, so questions in it may differ in population, comparator or timing.
Reviews
16
Questions
29
current versions
GRADE rated
6
Review overlap (CCA)
NR
over all included studies of these reviews, not this question only
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Used fluoride mouth rinse vs No fluoride mouth rinse Fluorosis (percentage prevalence in permanent teeth) · Children exposed to topical fluoride when under 6 years old; fluorosis assessed in permanent teeth at 6 to 18 years · Fluorosis assessed when most permanent teeth of interest had erupted (6 to 18 years) Topical fluoride as a cause of dental fluorosis in children (2024) · Cochrane | OR 1.44 [0.62, 3.38] | 1 study | Ungraded |
Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to the patient or HCW before and/or after an AGP vs No treatment or saline or water Other adverse events: changes in microbiome in oral cavity, nasal cavity, oro- or nasopharynx · Patients without suspected or confirmed COVID-19 infection undergoing aerosol-generating procedures (AGPs), and the… Antimicrobial mouthwashes (gargling) and nasal sprays to protect healthcare workers when undertaking… (2020) · Cochrane | No data available (no included studies) | NR | No studies |
Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to the patient or HCW before and/or after an AGP vs No treatment or saline or water Other adverse events: allergy, irritation/burning of nasal, oral or oropharyngeal mucosa (e.g. erosions, ulcers, bleeding), long-term staining of mucous membranes or teeth, accidental ingestion · Patients without suspected or confirmed COVID-19 infection undergoing aerosol-generating procedures (AGPs), and the… Antimicrobial mouthwashes (gargling) and nasal sprays to protect healthcare workers when undertaking… (2020) · Cochrane | No data available (no included studies) | NR | No studies |
Chlorhexidine (mouthrinse or gel), as part of oral hygiene care vs Placebo or usual care Adverse effects · Critically ill patients (adults and children) receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | Adverse effects: information from 2 studies; one stated there were none, the other reported mild reversible irritation of the oral mucosa; very low certainty. There was a lack of evidence about adverse effects. | 2 studies | Very low |
Antimicrobial mouthwash and/or nasal spray (alone or in combination), any concentration, frequency or dosage vs No treatment, saline, or water Other adverse events (allergy, irritation/burning of nasal, oral or oropharyngeal mucosa, long-term staining of mucous membranes or teeth, accidental ingestion) · Patients with suspected or confirmed COVID-19 infection Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed… (2020) · Cochrane | No data available (no included studies) | 0 studies | No studies |
Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to healthcare workers, with or without the same intervention given to the patients with COVID-19 vs No treatment or saline or water Other adverse events: allergy, irritation/burning of nasal, oral or oropharyngeal mucosa, long-term staining of mucous membranes or teeth, accidental ingestion · Healthcare workers (HCWs) treating patients with suspected or confirmed COVID-19 infection Use of antimicrobial mouthwashes (gargling) and nasal sprays by healthcare workers to protect them when… (2020) · Cochrane | No data available (no included studies) | 0 studies | No studies |
Chlorhexidine + zinc acetate mouthwash vs Placebo mouthwash Adverse events · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced… · mean 3 months Interventions for managing halitosis (2019) · Cochrane | Adverse events: listed in the Summary of findings table but no data reported. No data were reported for adverse events. | 0 studies | No studies |
Cetylpyridinium chloride mouthwash vs Chlorhexidine + zinc mouthwash Adverse events · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced… · 2 weeks Interventions for managing halitosis (2019) · Cochrane | Adverse events reported by Borden 2002 were not related to the interventions. | 1 study · 44 participants | Ungraded |
Halita mouthwash (chlorhexidine 0.05% + cetylpyridinium chloride 0.05% + zinc lactate 0.14%) vs Placebo mouthwash Adverse events · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced… · mean 2 weeks Interventions for managing halitosis (2019) · Cochrane | Adverse events (Table 6). Risk with placebo mouthwash: None reported. Risk with halita mouthwash: tongue staining was seen in patients who gargled, rather than rinsed. 40 participants (1 RCT). Certainty: VERY LOW. | 1 study · 40 participants | Very low |
Chlorine dioxide + zinc mouthwash vs Placebo mouthwash Adverse events · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced… · 2 weeks Interventions for managing halitosis (2019) · Cochrane | Adverse events reported by Borden 2002 were not related to the interventions. | 1 study · 41 participants | Ungraded |
Halita mouthrinse vs Perio-plus mouthrinse Adverse events · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced… · mean 8 days Interventions for managing halitosis (2019) · Cochrane | Adverse events (Table 12). Risk with Perio-plus mouthrinse: 1 patient reported unpleasant feeling after the use of the product; there were no severe adverse events reported. Risk with halita mouthrinse: 1 patient… | 1 study · 36 participants | Very low |
Patient-used 250 ppm F mouthrinse (100 ppm amine F/150 ppm NaF), daily vs 0 ppm F placebo mouthrinse, daily Adverse effects · Orthodontic patients of any age with fixed braces (new DLs assessed at debond) · At debond (end of orthodontic treatment) Fluorides for preventing early tooth decay (demineralised lesions) during fixed brace treatment (2019) · Cochrane | SoF 4. Adverse effects: none of the trials reported this outcome. | 0 studies | No studies |
Cetylpyridinium chloride mouthwash vs Placebo mouthwash Adverse events · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced… · 2 weeks Interventions for managing halitosis (2019) · Cochrane | Adverse events reported by Borden 2002 were not related to the interventions. | 1 study · 47 participants | Ungraded |
Chlorine dioxide mouthrinse (with tongue scraping) vs Chlorhexidine mouthwash (with tongue scraping) Adverse events · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced… · 1 week Interventions for managing halitosis (2019) · Cochrane | Wirthlin 2011 reported altered taste sensation as the adverse event. OLT scores could not be included in the analysis as the group-wise data were not given. | 1 study · 22 participants | Ungraded |
Toothbrushing + 0.075% cetylpyridinium chloride mouthwash vs Toothbrushing Adverse events · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced… · mean 3 weeks Interventions for managing halitosis (2019) · Cochrane | Adverse events: listed in the Summary of findings table but no data reported. No data were reported for adverse events. | 0 studies | No studies |
Essential oil mouthwash vs Placebo mouthwash Adverse events · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced… · 2 weeks Interventions for managing halitosis (2019) · Cochrane | Adverse events reported by Borden 2002 were not related to the interventions. | 1 study · 45 participants | Ungraded |
HP mouthwash vs Placebo Adverse effects · Adults (>=18 years) undergoing home-based bleaching (including tetracycline- and smoking-stained teeth, any baseline… Home‐based chemically‐induced whitening (bleaching) of teeth in adults (2018) · Cochrane | Not reported | NR | No studies |
Antifibrinolytic therapy - locally-applied tranexamic acid (TXA) mouthwash/solution (SoF eligibility: TXA or EACA; all included trials used topical TXA) vs Placebo (placebo solution/mouthwash) Side effects or other adverse events requiring withdrawal · People on continuous VKA treatment undergoing minor oral surgery or dental extractions (eligibility included DOACs and… · 7 days Antifibrinolytic therapy for preventing oral bleeding in people on anticoagulants undergoing minor oral… (2018) · Cochrane | RD 0.00 [-0.04, 0.04] | 2 studies · 128 participants | Moderate |
Topical NSAID (ketoprofen lysinate mouthwash, 160 mg) vs Topical NSAID (benzidamine hydrochloride mouthwash, 22.5 mg) Adverse events · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | The study did not report this outcome. | 0 studies | No studies |
Antiseptic mouthrinse vs Placebo Side effects · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy (2017) · Cochrane | No relevant adverse events were reported in any group (Lanzos 2010) | 1 study | Ungraded |
Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in conjunction with mechanical oral hygiene procedures vs Placebo/control mouthrinse, or no mouthrinse (mechanical oral hygiene alone); controls pooled (protocol's separate comparisons versus mechanical oral hygiene alone and versus placebo/control merged) Other adverse effects (taste disturbance, oral mucosal effects, burning sensation) · Children or adults with gingivitis or periodontitis capable of performing normal mechanical oral hygiene procedures… Chlorhexidine mouthrinse as an adjunctive treatment for gingival health (2017) · Cochrane | SoF narrative row (Other adverse effects): 22 trials reported at least 1 adverse effect apart from extrinsic tooth staining and calculus formation in the chlorhexidine rinse arms. The adverse effects most commonly… | 22 studies | Ungraded |
Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in conjunction with mechanical oral hygiene procedures vs Placebo/control mouthrinse, or no mouthrinse (mechanical oral hygiene alone); controls pooled (protocol's separate comparisons versus mechanical oral hygiene alone and versus placebo/control merged) Extrinsic tooth staining (various staining indices) · Children or adults with gingivitis or periodontitis capable of performing normal mechanical oral hygiene procedures… · 6 months Chlorhexidine mouthrinse as an adjunctive treatment for gingival health (2017) · Cochrane | SMD 1.54 [1.22, 1.86] | 4 studies · 323 participants | Ungraded |
Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in conjunction with mechanical oral hygiene procedures vs Placebo/control mouthrinse, or no mouthrinse (mechanical oral hygiene alone); controls pooled (protocol's separate comparisons versus mechanical oral hygiene alone and versus placebo/control merged) Extrinsic tooth staining (various staining indices) · Children or adults with gingivitis or periodontitis capable of performing normal mechanical oral hygiene procedures… · 4 to 6 weeks Chlorhexidine mouthrinse as an adjunctive treatment for gingival health (2017) · Cochrane | SMD 1.07 [0.80, 1.34] | 8 studies · 415 participants | Moderate |
Fluoride mouthrinse (any fluoride agent, concentration, volume, frequency or technique; swished and expectorated, not swallowed) vs Placebo or no treatment Signs of acute toxicity during application of treatment (such as nausea/gagging/vomiting) · Children or adolescents aged 16 years or younger at the start of the study · At least 1 year/school year Fluoride mouthrinses for preventing dental caries in children and adolescents (2016) · Cochrane | Signs of acute toxicity during application of treatment (such as nausea/gagging/vomiting): "Not reported in any studies"; "No data on signs of acute toxicity". None of the studies reported adverse acute symptoms… | 0 studies | No studies |
Fluoride mouthrinse (any fluoride agent, concentration, volume, frequency or technique; swished and expectorated, not swallowed) vs Placebo or no treatment Tooth staining/discolouration (adverse effect) · Children or adolescents aged 16 years or younger at the start of the study · At least 1 year/school year Fluoride mouthrinses for preventing dental caries in children and adolescents (2016) · Cochrane | Study 1: "significant difference" in stain score (from the control) in the group using an amine fluoride mouthrinse; "non-significant difference" (from the control) in the group using sodium fluoride. In 2 trials where… | 3 studies | Very low |
Antiseptic mouthwash (e.g. chlorhexidine) vs Another topical agent or placebo Adverse effects of long‐term use of available topical agents · HIV‐infected adults (> 13 years of age, per CDC) with one or more painful intraoral aphthous ulcers Topical treatments for HIV‐related oral ulcers (2012) · Cochrane | No studies were included in this review. A total of 233 abstracts were retrieved; 25 were selected as potentially eligible but all were excluded (10 reported systemic rather than topical treatment; 3 non‐RCTs; 6… | 0 studies | No studies |
Amine fluoride/stannous fluoride (AmF/SnF2) mouthwash vs Chlorhexidine mouthwash Staining index · Adults with dental implants and healthy peri-implant soft tissues at baseline · 3 months Interventions for replacing missing teeth: maintaining and recovering soft tissue health around dental… (2010) · Cochrane | MD 0.06 [-0.10, 0.22] | 1 study · 33 participants | Ungraded |
Cetylpyridinium chloride + essential oils + chlorine dioxide + zinc mouthrinse (Breath Rx) vs Placebo Adverse events · Adults over 18 years with a clinical or self-assessed diagnosis of halitosis, without significant comorbidity (e.g.… · 4 weeks Mouthrinses for the treatment of halitosis (2008) · Cochrane | Borden 2002: 13 adverse events were reported in the trial, but the investigators concluded that none were likely to be related to product usage. | 1 study | Ungraded |
0.05% chlorhexidine + 0.05% cetylpyridinium chloride + 0.14% zinc lactate mouthrinse vs Placebo Adverse events (tongue and tooth staining) · Adults over 18 years with a clinical or self-assessed diagnosis of halitosis, without significant comorbidity (e.g.… · 2 weeks Mouthrinses for the treatment of halitosis (2008) · Cochrane | Winkel 2003: significantly more tongue staining (P < 0.001) and tooth staining (P < 0.002) were noted with the chlorhexidine + cetylpyridinium chloride + zinc lactate mouthrinse than with placebo. | 1 study · 40 participants | Ungraded |