What do systematic reviews say?

Postoperative systemic antibiotics (phenoxymethylpenicillin/penicillin VK, 7-day course), partial or total chemo-mechanical debridement and analgesics vs Matched placebo, partial or total chemo-mechanical debridement and analgesics

• Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults 2024 · Cochrane All outcomes

  3 days
  1 participant reported diarrhoea (placebo group); 1 participant reported fatigue and reduced energy postoperatively (antibiotic group). 61 participants (2 studies).
  2 studies · 61 participants
  Very low

Single preoperative dose of systemic antibiotics (clindamycin 600 mg), total chemo-mechanical debridement and root filling vs Matched placebo, total chemo-mechanical debridement and root filling

• Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults 2024 · Cochrane All outcomes

  7 days
  No adverse effects reported in the placebo group; 1 participant reported dizziness in the intervention group. 72 participants (1 study).
  1 study · 72 participants
  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

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

Periodontal treatment (scaling and root planing, alone or with antimicrobials) vs Alternative (less intensive) periodontal treatment, alone or with placebo

The review found no eligible studies for this question.

• Treating periodontal disease for preventing adverse birth outcomes in pregnant women 2017 · Cochrane All outcomes
  Adverse effects of therapy: Not reported for this comparison.
  0 studies
  No studies found

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