What do systematic reviews say?

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs Chlorhexidine rinse

It is very uncertain whether oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed… changes oral mucositis (moderate to severe) compared with chlorhexidine rinse (very low certainty).

• Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
  RR 0.89 [0.51, 1.56]
  1 study · 133 participants
  Very low

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs High-dose leucovorin rinse

• Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
  Oral mucositis (moderate to severe). Not estimable - no participants had developed moderate or severe oral mucositis by the fourth day after chemotherapy when the data were reported (Zhang 2011, Analysis 4.2, subgroup…
  1 study · 81 participants
  GRADE not reported

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

Educational intervention with information and practical components… showed no clear difference in oral health-related attitude of nursing staff compared with (Optimised) usual care; GRADE not reported.

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
  SMD 0.30 [-0.23, 0.83]
  2 studies · 459 participants
  GRADE not reported

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

Educational intervention with information and practical components… showed no clear difference in oral health-related knowledge of nursing staff compared with (Optimised) usual care; GRADE not reported.

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
  SMD 0.94 [-0.04, 1.92]
  2 studies · 453 participants
  GRADE not reported

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

The review found no eligible studies for this question.

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
  SoF row 'Oral health': Illustrative risks -, relative effect -, participants/studies -, quality -; Comment: Outcome not reported. Not measured in any included study.
  0 studies
  No studies found

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
  One study (Bellomo 2005) assessed oral health-related behaviour of residents; 60 residents were interviewed about toothbrushing habits. Use of toothbrushes and the frequency of brushing during the study period were…
  1 study · 60 participants
  GRADE not reported

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

The review found no eligible studies for this question.

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
  SoF row 'Oral health-related quality of life': Illustrative risks -, relative effect -, participants/studies -, quality -; Comment: Outcome not reported. Not measured in any included study.
  0 studies
  No studies found

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

School-based interventions may reduce dental plaque scores (SMD -0.32, favouring intervention), but the certainty of evidence is very low.

• Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes

  Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
  SMD -0.32 [-0.46, -0.18]
  7 studies · 3339 participants
  Very low

Primary school-based interventions (one or more of: school health policy, oral health education, healthy school environment, access to oral health services, community involvement) vs usual practice

The effect of school-based interventions on gingival scores is uncertain and not statistically significant (SMD 0.12; very low certainty).

• Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income… 2022 All outcomes

  Post-intervention; follow-up varied across studies (interventions ranged from <2 years to >=2 years and longer) · Primary schools in low- and middle-income countries (Southeast Asia, Africa, the Americas, Europe, eastern Mediterranean)
  SMD 0.12 [-0.32, 0.55]
  3 studies · 1573 participants
  Very low

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Most strategies to integrate oral health into primary care were associated with improved access to oral healthcare (19 studies, narrative synthesis; ungraded).

• Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes

  Primary care, community, school, and aged-care/residential/nursing-home settings
  Access to oral healthcare was the primary outcome most studied (n=19). Most studies reported results favouring the integration strategy, including improvements in referral pathways, documentation processes, operating…
  19 studies
  GRADE not reported

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Integration strategies were generally associated with positive oral health knowledge, attitudes and perceptions among staff and patients (16 studies, narrative synthesis; ungraded).

• Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes

  Primary care, community, school, and aged-care/residential/nursing-home settings
  Knowledge/attitudes/perceptions of staff and patients was the second most studied outcome (n=16). Patient and staff perceptions on various aspects of the integration strategy were usually reported as positive.…
  16 studies
  GRADE not reported

Strategies to integrate oral health into primary care (e.g., training/education of non-dental primary care professionals, policy/financing and health-insurance changes, colocation of dental and medical services, interprofessional and community-health-worker collaboration, teledentistry, integrated oral health assessment tools, school-based activities) vs No integration / usual care (or pre-integration baseline; many included studies uncontrolled)

Most studies reported improved oral disease outcomes with integration strategies (8 of 9 studies improved, 1 no change; 9 studies, narrative synthesis; ungraded).

• Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes

  Primary care, community, school, and aged-care/residential/nursing-home settings
  Nine studies reported oral disease outcomes, seven of which measured change in dental caries estimates. Eight of the nine studies reported improved oral disease outcomes; one (Vichayanrat 2012) reported no change in…
  9 studies
  GRADE not reported

Systemic oral acyclovir vs placebo or no treatment

Systemic oral acyclovir led to lower number of individuals with oral lesions (8 days after… compared with placebo or no treatment; GRADE not reported.

• Acyclovir for treating primary herpetic gingivostomatitis 2008 · Cochrane All outcomes

  8 days after administration
  RR 0.10 [0.02, 0.38]
  1 study · 72 participants
  GRADE not reported

Systemic oral acyclovir vs placebo or no treatment

Systemic oral acyclovir led to lower number of individuals who developed new extraoral lesions after… compared with placebo or no treatment; GRADE not reported.

• Acyclovir for treating primary herpetic gingivostomatitis 2008 · Cochrane All outcomes

  After administration
  RR 0.04 [0.00, 0.65]
  1 study · 72 participants
  GRADE not reported

Oral stimulation vs non‐oral intervention

The review found no eligible studies for this question.

• Oral stimulation for promoting oral feeding in preterm infants 2023 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Oral stimulation vs non‐oral intervention

• Oral stimulation for promoting oral feeding in preterm infants 2023 · Cochrane Headline outcomes only
  no estimate extracted
  10 studies · 591 participants
  Low

Oral stimulation vs non‐oral intervention

• Oral stimulation for promoting oral feeding in preterm infants 2023 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 268 participants
  Very low

Early oral feeding vs delayed oral feeding

Early oral feeding showed no clear difference in postoperative ileus compared with delayed oral feeding (moderate certainty).

• Early versus delayed oral fluids and food for reducing complications after major abdominal gynaecologic surgery 2014 · Cochrane Headline outcomes only
  RR 0.47 [0.17, 1.29]
  3 studies · 279 participants
  Moderate

Early oral feeding vs delayed oral feeding

Early oral feeding showed no clear difference in nausea or vomiting or both compared with delayed oral feeding (moderate certainty).

• Early versus delayed oral fluids and food for reducing complications after major abdominal gynaecologic surgery 2014 · Cochrane Headline outcomes only
  RR 1.03 [0.64, 1.67]
  4 studies · 484 participants
  Moderate

Early oral feeding vs delayed oral feeding

• Early versus delayed oral fluids and food for reducing complications after major abdominal gynaecologic surgery 2014 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 338 participants
  Moderate