Findings

What do systematic reviews say?

24 questions · 24 findings · 4 reviews · Oral Health

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No studies found 7 · 29.2%GRADE not reported 6 · 25%Very low 9 · 37.5%Low 2 · 8.3%Moderate 0 · 0%High 0 · 0%

Chlorhexidine mouthwash vs placebo

Cariogenic bacteria (Mutans streptococci) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Chlorhexidine mouthwash reduced Mutans streptococci versus placebo, but certainty is very low.

1 finding from 1 review

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
≤ 3 months
Colony count of MS was significantly reduced compared to placebos according to three studies [34; 48; 52]; colony count of MS was slightly reduced compared to placebo in a short time in one study [40].
4 studies
Very low

Chlorhexidine mouthwash vs Blank control

Cariogenic bacteria (Mutans streptococci) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Chlorhexidine mouthwash reduced Mutans streptococci versus blank control, but certainty is very low.

1 finding from 1 review

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
≤ 3 months
Colony count of MS was significantly reduced compared to blank control according to one study [53]; one study reported a significant reduction compared to baseline [51].
2 studies
Very low

Chlorhexidine mouthwash vs placebo

Plaque index (PI) / oral hygiene · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

Chlorhexidine mouthwash reduced Plaque Index versus placebo, but certainty is very low.

1 finding from 1 review

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
≤ 3 months
Plaque Index was significantly reduced compared to placebos according to two studies [20; 32].
2 studies
Very low

Chlorhexidine mouthwash vs Salt and soda mouthwash

Mucositis eradicated · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis

Chlorhexidine mouthwash showed no clear difference in mucositis eradicated compared with salt and soda mouthwash; GRADE not reported.

1 finding from 1 review

Interventions for treating oral mucositis for patients with cancer receiving treatment 2010 · Cochrane All outcomes
RR 1.10 [0.90, 1.35]
1 study · 138 participants
GRADE not reported

Chlorhexidine mouthwash vs Salt and soda mouthwash

Time to heal mucositis (days) · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis

Chlorhexidine mouthwash showed no clear difference in time to heal mucositis (days) compared with salt and soda mouthwash; GRADE not reported.

1 finding from 1 review

Interventions for treating oral mucositis for patients with cancer receiving treatment 2010 · Cochrane All outcomes
MD -0.40 [-1.49, 0.69]
1 study · 100 participants
GRADE not reported

Chlorhexidine mouthwash vs Salt and soda mouthwash

Average pain scores (0-100 VAS) · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis

Chlorhexidine mouthwash showed no clear difference in average pain scores (0-100 VAS) compared with salt and soda mouthwash; GRADE not reported.

1 finding from 1 review

Interventions for treating oral mucositis for patients with cancer receiving treatment 2010 · Cochrane All outcomes
MD -3.50 [-13.35, 6.35]
1 study · 63 participants
GRADE not reported

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 or physiological…

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for managing halitosis 2019 · Cochrane All outcomes
mean 3 months
Adverse events: listed in the Summary of findings table but no data reported. No data were reported for adverse events.
0 studies
No studies found

Chlorhexidine + zinc acetate mouthwash vs Placebo mouthwash

Patient-reported OLT score · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced or physiological…

The review found no eligible studies for this question.

1 finding from 1 review

Interventions for managing halitosis 2019 · Cochrane All outcomes
mean 3 months
Patient-reported OLT score: listed in the Summary of findings table but no data reported. No data were reported for patient-reported OLT score.
0 studies
No studies found

Chlorhexidine + zinc acetate mouthwash vs Placebo mouthwash

Dentist-reported organoleptic test (OLT) score (scale 0 to 5) · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced or physiological…

It is very uncertain whether chlorhexidine + zinc acetate mouthwash changes dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with placebo mouthwash (very low certainty).

1 finding from 1 review

Interventions for managing halitosis 2019 · Cochrane All outcomes
mean 3 months
MD -0.2 [-0.58, 0.18]
1 study · 44 participants
Very low

Antiseptic mouthwash (e.g. chlorhexidine) vs Another topical agent or placebo

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · HIV‐infected adults (> 13 years of age, per CDC) with one or more painful intraoral aphthous ulcers

The review found no eligible studies for this question.

1 finding from 1 review

Topical treatments for HIV‐related oral ulcers 2012 · Cochrane All outcomes
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 found

Antiseptic mouthwash (e.g. chlorhexidine) vs Another topical agent or placebo

Duration to heal oral ulcerations after initiation of treatment · HIV‐infected adults (> 13 years of age, per CDC) with one or more painful intraoral aphthous ulcers

The review found no eligible studies for this question.

1 finding from 1 review

Topical treatments for HIV‐related oral ulcers 2012 · Cochrane All outcomes
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 found

Antiseptic mouthwash (e.g. chlorhexidine) vs Another topical agent or placebo

Healing of ulceration · HIV‐infected adults (> 13 years of age, per CDC) with one or more painful intraoral aphthous ulcers

The review found no eligible studies for this question.

1 finding from 1 review

Topical treatments for HIV‐related oral ulcers 2012 · Cochrane All outcomes
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 found

Antiseptic mouthwash (e.g. chlorhexidine) vs Another topical agent or placebo

Incidence and recurrence after healing of ulcers · HIV‐infected adults (> 13 years of age, per CDC) with one or more painful intraoral aphthous ulcers

The review found no eligible studies for this question.

1 finding from 1 review

Topical treatments for HIV‐related oral ulcers 2012 · Cochrane All outcomes
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 found

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

The review found no eligible studies for this question.

1 finding from 1 review

Topical treatments for HIV‐related oral ulcers 2012 · Cochrane All outcomes
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 found

Chlorhexidine mouthwash vs Placebo mouthwash

Probing pocket depth (PPD/PD) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Chlorhexidine mouthwash may reduce pocket probing depth versus placebo in the short term (low certainty).

1 finding from 1 review

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
<=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
PD was significantly reduced except mid-lingual site compared to placebo [32]. The changes of PD were significantly higher compared to placebo [56].
2 studies
Low

Chlorhexidine mouthwash vs Blank control

Plaque · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Chlorhexidine mouthwash may reduce the Plaque Index versus blank control in the short term (WMD -0.70, 95% CI -1.12 to -0.27), but the evidence is very uncertain (very low certainty).

1 finding from 1 review

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
<=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
WMD -0.70 [-1.12, -0.27]
4 studies · 188 participants
Very low

Chlorhexidine mouthwash vs Blank control

Gingival index (GI) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Chlorhexidine mouthwash may reduce the Gingival Index versus blank control in the short term (WMD -0.54, 95% CI -0.96 to -0.13), but with very high heterogeneity the evidence is very uncertain (very low certainty).

1 finding from 1 review

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
<=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
WMD -0.54 [-0.96, -0.13]
6 studies · 274 participants
Very low

Chlorhexidine mouthwash vs Placebo mouthwash

Gingival index (GI) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Chlorhexidine mouthwash probably reduces the Gingival Index versus placebo in the short term (WMD -0.45, 95% CI -0.70 to -0.20; low certainty).

1 finding from 1 review

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
<=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
WMD -0.45 [-0.70, -0.20]
3 studies · 98 participants
Low

Chlorhexidine mouthwash vs Blank control

Total bacteria (colony count) · Orthodontic patients (any age) undergoing orthodontic treatment (mostly fixed appliances)

Chlorhexidine mouthwash may reduce total bacteria colony counts versus blank control in the short term, but the evidence is very uncertain (very low certainty).

1 finding from 1 review

The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes
<=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
Colony count of total bacteria were significantly reduced compared to placebos according to two studies [34, 43].
2 studies
Very low

Mouthwash (amine/stannous fluoride; or chlorhexidine + cetylpyridinium + zinc) vs Chlorhexidine mouthwash or tap water

OLT and VSC scores · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced or physiological…

1 finding from 1 review

Interventions for managing halitosis 2019 · Cochrane All outcomes
7 days
Wigger-Alberti 2010 mouthwash data (ASF; CHX + CPC + Zn; CHX; tap water) were calculated from a graph (Additional Table 1) but not included, as the report did not give details of sample size per group.
1 study
GRADE not reported