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Evidence found and GRADE certainty

23 questions · 23 findings · 5 reviews · Oral medicine and oral cancer

No studies found 2 · 8.7%GRADE not reported 16 · 69.6%Very low 3 · 13%Low 2 · 8.7%Moderate 0 · 0%High 0 · 0%

Chlorhexidine vs Cryotherapy (ice chips) 60 minutes

Oral mucositis (any severity) · Patients with cancer receiving radiotherapy, chemotherapy or targeted therapies

Chlorhexidine showed no clear difference in oral mucositis (any severity) compared with cryotherapy (ice chips); GRADE not reported.

1 finding from 1 review

Chlorhexidine vs Cryotherapy (ice chips) 60 minutes

Oral mucositis (moderate to severe) · Patients with cancer receiving radiotherapy, chemotherapy or targeted therapies

Chlorhexidine showed no clear difference in oral mucositis (moderate to severe) compared with cryotherapy (ice chips); GRADE not reported.

1 finding from 1 review

Chlorhexidine vs Cryotherapy (ice chips) 60 minutes

Oral mucositis (severe) · Patients with cancer receiving radiotherapy, chemotherapy or targeted therapies

Chlorhexidine showed no clear difference in oral mucositis (severe) compared with cryotherapy (ice chips); GRADE not reported.

1 finding from 1 review

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

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

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

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

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

0.05% chlorhexidine + 0.05% cetylpyridinium chloride + 0.14% zinc lactate mouthrinse vs placebo

Organoleptic assessment of halitosis (mean change from baseline) · Adults over 18 years with a clinical or self-assessed diagnosis of halitosis, without significant comorbidity (e.g. diabetes) or…
1 finding from 1 review
  • Mouthrinses for the treatment of halitosis 2008 · Cochrane All outcomes
    2 weeks
    Winkel 2003 (2-week trial): mean change (SD) in organoleptic score (scale 0 to 5). 0.05% chlorhexidine + 0.05% cetylpyridinium chloride + 0.14% zinc lactate: -1.13 (1.1), baseline 2.8 (0.5) to 1.5 (1.0) at day 14, P <…
    1 study · 40 participants
    GRADE not reported

0.05% chlorhexidine + 0.05% cetylpyridinium chloride + 0.14% zinc lactate mouthrinse vs placebo

Volatile sulphur compounds (VSC), gas chromatography · Adults over 18 years with a clinical or self-assessed diagnosis of halitosis, without significant comorbidity (e.g. diabetes) or…
1 finding from 1 review
  • Mouthrinses for the treatment of halitosis 2008 · Cochrane All outcomes
    2 weeks
    Winkel 2003: mean change (SD) in peak VSC (ppb). Mouthrinse: -120 (92), baseline 292 (141) to 172 (104) at day 14, P < 0.005; Placebo: 8 (145), baseline 352 (161) to 360 (254). The mouthrinse caused a significantly…
    1 study · 40 participants
    GRADE not reported

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. diabetes) or…
1 finding from 1 review
  • Mouthrinses for the treatment of halitosis 2008 · Cochrane All outcomes
    2 weeks
    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
    GRADE not reported

0.05% chlorhexidine + 0.05% cetylpyridinium chloride + 0.14% zinc lactate mouthrinse vs Placebo mouthwash

Volatile sulphur compounds (VSC), halimeter · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced or physiological…

Halita mouthwash (chlorhexidine 0.05% + cetylpyridinium chloride… led to lower volatile sulphur compounds (VSC), halimeter compared with placebo mouthwash; GRADE not reported.

1 finding from 1 review

0.05% chlorhexidine + 0.05% cetylpyridinium chloride + 0.14% zinc lactate mouthrinse 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…
1 finding from 1 review
  • Interventions for managing halitosis 2019 · Cochrane All outcomes
    mean 2 weeks
    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