What do systematic reviews say?

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)

• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes
  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 studies
  GRADE not reported

Professional oral care vs Usual oral care

• Oral care measures for preventing nursing home‐acquired pneumonia 2022 · Cochrane All outcomes
  Measured in only 1 study (834 participants), which reported no serious events and 64 non-serious events, the most common of which were oral cavity disturbances (not defined) and dental staining.
  1 study · 834 participants
  GRADE not reported

Extra-oral pulp extirpation at day 0 vs Intra-oral pulp extirpation at day 7

• Interventions for treating traumatised permanent front teeth: avulsed (knocked out) and replanted 2019 · Cochrane All outcomes
  Giannetti 2006 did not report this outcome; following email correspondence, authors reported no adverse effects were seen (uncertain whether formally assessed).
  1 study
  GRADE not reported

Aciclovir (oral or intravenous) for treatment vs placebo

• Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer 2009 · Cochrane All outcomes
  Adverse effects were assessed in both studies. For intravenous aciclovir the most commonly reported adverse effect was a reaction at the injection site (8 (16%) aciclovir versus 3 (7%) placebo; all patients, n = 97);…
  2 studies
  GRADE not reported

Biotene OralBalance vs control

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  Adverse effects (Stefanescu 2013): no significant difference between groups with respect to adverse events in buccal mucosa.
  1 study
  GRADE not reported

Topical treatments (benzydamine hydrochloride oral rinse) vs placebo

• Interventions for treating burning mouth syndrome 2016 · Cochrane All outcomes

  short-term (up to 3 months) · benzydamine hydrochloride
  SoF9. Adverse effects: single study narratively reported that no adverse effects occurred from benzydamine hydrochloride oral rinse; 20 participants (1 RCT); very low.
  1 study · 20 participants
  Very low

Hyperbaric oxygen therapy plus standard care (surgery, antibiotics, oral rinse) vs Standard care alone (surgery, antibiotics, oral rinse)

The review found no eligible studies for this question.

• Interventions for treating bisphosphonate‐related osteonecrosis of the jaw (BRONJ) 2016 · Cochrane All outcomes
  no estimate extracted
  0 studies
  No studies found

NSAIDs (ketorolac oral rinse; systemic celecoxib) vs placebo or no treatment

• Interventions for treating oral leukoplakia to prevent oral cancer 2016 · Cochrane All outcomes

  over 3 months
  SoF 3, Safety of the intervention over 3 months: systemic celecoxib (1 study) - 32 intervention participants reported 56 adverse effects, 20 placebo participants reported 20; 4 grade 3 events; 2 discontinued. Ketorolac…
  2 studies
  GRADE not reported

Chlorhexidine (mouthrinse or gel), as part of oral hygiene care vs placebo or usual care

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  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 studies
  Very low

Toothbrushing (with or without antiseptics), as part of oral hygiene care vs No toothbrushing (with or without antiseptics)

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  Adverse effects: information from two studies, which stated that there were none; very low certainty. There is a lack of evidence about adverse effects.
  2 studies
  Very low

Systemic oral acyclovir vs placebo or no treatment

• Acyclovir for treating primary herpetic gingivostomatitis 2008 · Cochrane All outcomes
  Amir 1997b: two children in each group (2 vs 2) had mild gastrointestinal symptoms that resolved spontaneously after 24 to 48 hours without a change in study treatment. Ducoulombier 1988: no significant adverse effects…
  2 studies
  GRADE not reported

Intraoral distalising appliance vs Headgear (extraoral appliance)

The review found no eligible studies for this question.

• Orthodontic treatment for distalising upper first molars in children and adolescents 2013 · Cochrane All outcomes
  Adverse effects were not reported by these studies.
  0 studies
  No studies found

Intraoral distalising appliance vs Another (different) intraoral distalising appliance

The review found no eligible studies for this question.

• Orthodontic treatment for distalising upper first molars in children and adolescents 2013 · Cochrane All outcomes
  Adverse effects were not reported by these studies.
  0 studies
  No studies found

Prophylactic aciclovir (oral or intravenous) vs placebo

• Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer 2009 · Cochrane All outcomes
  Adverse effects were reported in nine trials. Diagnosis was by evaluation of clinical signs and symptoms (e.g. rash, neurological impairment) and by laboratory tests including renal and hepatic function. None of the…
  9 studies
  GRADE not reported

Slow-release fluoride device (fluoride glass beads) vs Fluoride mouthrinse

• Fluorides for preventing early tooth decay (demineralised lesions) during fixed brace treatment 2019 · Cochrane All outcomes

  At debond; follow-up 19 months
  Additional SoF Table 3. Adverse effects: current design of the fluoride glass bead inadequate; high attrition partly due to bead breakages ('an improved method of attachment is needed'). 37 participants (1 RCT, Luther…
  1 study · 37 participants
  Very low

Rofecoxib (oral, 50 mg on first day then 25 to 50 mg per day for 4 days) vs Tinidazole (1 g per day for 3 days)

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  4 days
  No adverse effects reported in translation.
  1 study · 60 participants
  GRADE not reported

Prednisone (oral, commencing 25 mg with phased dose reduction over 2 months) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  2 months
  Femiano 2003: one significant adverse event (gastritis) for the prednisone group versus none for placebo. Femiano 2010: more drug-related adverse effects for those treated with prednisone than placebo.
  2 studies
  GRADE not reported

Prednisone (oral, commencing 25 mg with phased dose reduction over 2 months) vs Montelukast (leukotriene receptor antagonist)

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  2 months
  The study reported more drug-related adverse effects for those treated with prednisone than montelukast.
  1 study · 40 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
  None of the included studies assessed adverse effects of the intervention.
  0 studies
  No studies found

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