What do systematic reviews say?

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

Flossing plus toothbrushing vs Toothbrushing alone

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  Adverse effects were assessed and reported in seven studies. Three reported no adverse events on the oral hard or soft tissues. Four reported sporadic adverse events with mild severity, with no evidence of a difference…
  7 studies
  GRADE not reported

Oral irrigation plus toothbrushing vs Toothbrushing alone

• Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
  Three studies reported that there were no adverse events, one reported one incidence of aphthous ulcer in irrigator group, one reported oral lacerations but found no difference between the interventions, and one did…
  5 studies
  GRADE not reported

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
  Harms and adverse outcomes: Not reported (neither study reported on adverse effects).
  0 studies
  No studies found

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

Flossing plus toothbrushing (self-performed; manual or automated floss) vs Toothbrushing alone

• Flossing for the management of periodontal diseases and dental caries in adults 2011 · Cochrane All outcomes
  Not estimable (5 studies). Adverse effects were assessed in five studies, but they used different outcome measures, so meta-analysis was not appropriate. The main harm identified was soft-tissue trauma to the gingival…
  5 studies
  GRADE not reported

Fluoride mouthrinse (0.05-0.32% sodium fluoride or amine fluoride) added to daily fluoride toothpaste vs Control: fluoride toothpaste alone, placebo mouthrinse + toothpaste, or non-fluoride (chlorhexidine) mouthrinse + toothpaste

No adverse effects were reported in any of the seven included studies (ungraded).

• Fluoride mouthrinses for prevention of initial caries in orthodontic patients - a systematic review and meta-analysis. 2025 All outcomes

  During treatment · Clinical orthodontic (fixed multi-bracket appliance) treatment
  No side- or adverse effects were reported in any of the included reports.
  7 studies · 704 participants
  GRADE not reported

Fluoride mouthrinse, gel or varnish combined with fluoride toothpaste (any combined regimen) vs Fluoride toothpaste alone

• Combinations of topical fluoride (toothpastes, mouthrinses, gels, varnishes) versus single topical fluoride for… 2004 · Cochrane All outcomes
  Adverse-effect data scarcely reported: a stain score in one trial and 'any side effects' in one trial without complete or useable data (stated 'no side effects observed in both groups'). No useful information on tooth…
  Studies not reported
  GRADE not reported