Gap finder

Search review questions

Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.

Limit to evidence status or GRADE (optional)

29 questions in 16 reviews · intervention: Fluoride mouthrinse · outcome domain: Adverse effects/fluorosis

current versions
No studies 11 · 37.9%Ungraded 12 · 41.4%Very low 4 · 13.8%Low 0 · 0%Moderate 2 · 6.9%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Intervention categories, outcome domains and clusters are a proposed key pending human validation. Clear all filters

QuestionEffectEvidenceStatus / 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 studyUngraded
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)NRNo 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)NRNo 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 studiesVery 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 studiesNo 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 studiesNo 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 studiesNo 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 participantsUngraded
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 participantsVery 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 participantsUngraded
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 participantsVery 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 studiesNo 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 participantsUngraded
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 participantsUngraded
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 studiesNo 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 participantsUngraded
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 reportedNRNo 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 participantsModerate
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 studiesNo 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 studyUngraded
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 studiesUngraded
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 participantsUngraded
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 participantsModerate
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 studiesNo 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 studiesVery 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 studiesNo 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 participantsUngraded
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 studyUngraded
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 participantsUngraded