What do systematic reviews say?

Chlorhexidine 0.12% mouthrinse vs Pre-treatment (baseline, same group)

0.12% chlorhexidine rinse reduced plaque relative to baseline; not GRADE-rated.

• The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes

  Pre- vs post-treatment · In vivo clinical trial (human oral cavity) · Chlorhexidine concentration: 0.12%
  MD 1.79 [1.39, 2.19]
  2 studies · 126 participants
  GRADE not reported

Rubber/elastomeric cleaning stick plus toothbrushing vs Toothbrushing alone

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  One study measured probing pocket depth but no data were reported (Graziani 2017 mentioned PPD as outcome but no data).
  1 study
  GRADE not reported

Wooden cleaning stick plus toothbrushing vs Toothbrushing alone

The review found no eligible studies for this question.

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  No included study assessed caries as an outcome.
  0 studies
  No studies found

Salvadora persica (miswak) mouthrinse vs Pre-treatment (baseline, same group)

Salvadora persica rinse reduced plaque relative to its own baseline; not GRADE-rated.

• The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes

  Pre- vs post-treatment · In vivo clinical trial (human oral cavity)
  MD 0.46 [0.29, 0.63]
  12 studies · 310 participants
  GRADE not reported

Placebo rinse vs Pre-treatment (baseline, same group)

Placebo rinse did not significantly change Streptococcus mutans counts relative to baseline; not GRADE-rated.

• The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes

  Pre- vs post-treatment · In vivo clinical trial (human oral cavity)
  MD 0.34 [-0.07, 0.76]
  5 studies · 71 participants
  GRADE not reported

Interdental brushing plus toothbrushing vs Toothbrushing alone

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  One study measured probing pocket depth but no data were reported (Graziani 2017).
  1 study
  GRADE not reported

Interdental brushing plus toothbrushing vs Flossing plus toothbrushing

The review found no eligible studies for this question.

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  No included study assessed caries as an outcome.
  0 studies
  No studies found
• Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes
  Not estimable. No included study assessed caries as an outcome. (See comment)
  0 studies
  No studies found

Wooden cleaning stick plus toothbrushing vs Flossing plus toothbrushing

The review found no eligible studies for this question.

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  Gingivitis measured by gingival index: Not measured.
  0 studies
  No studies found
• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  3 months
  MD 0.01 [-0.12, 0.14]
  1 study · 24 participants
  Very low

Interdental brushing plus toothbrushing vs Toothbrushing alone

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  Harms and adverse outcomes (SoF): Neither study reported any information about adverse events. Jared 2005 assessed adverse events (participants issued a symptom diary) but did not report the findings; Graziani 2017 did…
  1 study
  GRADE not reported
• Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes
  Not estimable. Only 1 study reported adverse outcomes in terms of problems with the use of the assigned interdental cleaning aids. (See comment) In this comparison the single study (Jared 2005) asked participants to…
  1 study
  GRADE not reported

Wooden cleaning stick plus toothbrushing vs Flossing plus toothbrushing

The review found no eligible studies for this question.

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  Harms and adverse outcomes: Not reported (neither study reported on adverse effects).
  0 studies
  No studies found

Rubber/elastomeric cleaning stick plus toothbrushing vs Toothbrushing alone

It is very uncertain whether rubber/elastomeric cleaning stick plus toothbrushing changes plaque compared with toothbrushing alone (very low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  MD -0.22 [-0.41, -0.03]
  1 study · 30 participants
  Very low

Rubber/elastomeric cleaning stick plus toothbrushing vs Interdental brushing plus toothbrushing

The review found no eligible studies for this question.

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  No included study assessed caries as an outcome.
  0 studies
  No studies found

Chlorhexidine 0.2% vs Pre-treatment (baseline, same group)

0.2% chlorhexidine rinse reduced plaque relative to baseline; not GRADE-rated.

• The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes

  Pre- vs post-treatment · In vivo clinical trial (human oral cavity) · Chlorhexidine concentration: 0.2%
  MD 0.45 [0.19, 0.70]
  10 studies · 282 participants
  GRADE not reported

Wooden cleaning stick plus toothbrushing vs Toothbrushing alone

The review found no eligible studies for this question.

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  Harms and adverse outcomes: Not reported (neither study reported on adverse effects).
  0 studies
  No studies found

Rubber/elastomeric cleaning stick plus toothbrushing vs Interdental brushing plus toothbrushing

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  Harms and adverse outcomes (SoF): Not reported. Yost 2006 performed examinations of the oral soft tissue at the final visit but did not report the findings; Graziani 2017 and Smith 1988 did not measure adverse effects.
  1 study
  GRADE not reported

Oral irrigation plus toothbrushing vs Flossing plus toothbrushing

It is very uncertain whether oral irrigation plus toothbrushing changes plaque compared with flossing plus toothbrushing (very low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  1 month
  SMD 0.31 [-0.08, 0.70]
  2 studies · 133 participants
  Very low

Rubber/elastomeric cleaning stick plus toothbrushing vs Interdental brushing plus toothbrushing

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  Two studies measured periodontitis but data not presented or usable (Smith 1988 PPD unusable; Graziani 2017 measured PPD but no data).
  2 studies
  GRADE not reported

Oral irrigation plus toothbrushing vs Toothbrushing alone

The review found no eligible studies for this question.

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  No included study assessed caries as an outcome.
  0 studies
  No studies found

Rubber/elastomeric cleaning stick plus toothbrushing vs Toothbrushing alone

The review found no eligible studies for this question.

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  No included study assessed caries as an outcome.
  0 studies
  No studies found

Interdental brushing plus toothbrushing vs Flossing plus toothbrushing

Interdental brushing plus toothbrushing showed no clear difference in periodontitis (probing pocket depth) compared with flossing plus toothbrushing (low certainty).

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes

  4 to 6 weeks
  MD -0.06 [-0.27, 0.16]
  3 studies · 107 participants
  Low