What do systematic reviews say?

20 questions · 20 findings · 1 reviews · Oral Health

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No studies found 0 · 0%GRADE not reported 18 · 90%Very low 0 · 0%Low 1 · 5%Moderate 1 · 5%High 0 · 0%

Povidone iodine rinse vs usual or supportive care

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Povidone iodine versus usual care (Seguin 2006, 67 participants): a reduction in VAP was found; single study, not replicated, interpret with caution.
1 study · 67 participants
GRADE not reported

Saline rinse plus swab vs Saline-soaked swab

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Saline rinse plus swab led to lower incidence of VAP compared with saline-soaked swab alone (usual care); GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 0.41 [0.23, 0.72]
2 studies · 153 participants
GRADE not reported

Chlorhexidine vs Nanosil (nanosilver)

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Chlorhexidine versus Nanosil (Khaky 2018): some evidence of a benefit for Nanosil; single study, not replicated, interpret with caution.
1 study
GRADE not reported

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

Incidence of VAP · Critically ill patients (adults and children) receiving mechanical ventilation in ICU

Chlorhexidine (mouthrinse or gel), as part of oral hygiene care probably leads to lower incidence of VAP compared with placebo or usual care (moderate certainty).

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Follow-up: mean 1 month
RR 0.67 [0.47, 0.97]
13 studies · 1206 participants
Moderate

Hydrogen peroxide vs Normal saline

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Hydrogen peroxide versus normal saline (Nobahar 2016): a reduction in VAP was found; single study, not replicated, interpret with caution.
1 study
GRADE not reported

Chlorhexidine vs Potassium permanganate

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Chlorhexidine showed no clear difference in incidence of VAP compared with potassium permanganate; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 0.87 [0.50, 1.52]
2 studies
GRADE not reported

Essential oil mouthwash vs Sodium bicarbonate rinse

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Listerine versus sodium bicarbonate (Berry 2013): no evidence of a difference in VAP incidence; single study, high risk of bias.
1 study
GRADE not reported

Saline rinse vs Saline-soaked swab

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Saline rinse led to lower incidence of VAP compared with saline-soaked swab; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 0.47 [0.37, 0.62]
4 studies · 488 participants
GRADE not reported

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

Incidence of VAP · Critically ill adults receiving mechanical ventilation in ICU

Toothbrushing (with or without antiseptics), as part of oral hygiene… may leads to lower incidence of VAP compared with no toothbrushing (with or without antiseptics) (low certainty).

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Follow-up: mean 1 month
RR 0.61 [0.41, 0.91]
5 studies · 910 participants
Low

Essential oil mouthwash vs Sterile water rinse

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Listerine versus sterile water (Berry 2013): no evidence of a difference in VAP incidence; single study, high risk of bias.
1 study
GRADE not reported

Sodium bicarbonate rinse (plus toothbrushing) vs Water rinse (plus toothbrushing)

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Sodium bicarbonate rinse (plus toothbrushing) showed no clear difference in incidence of VAP compared with water rinse (plus toothbrushing); GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 1.57 [0.62, 3.99]
2 studies · 347 participants
GRADE not reported

Triclosan rinse vs Saline rinse

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Triclosan rinse showed no clear difference in incidence of VAP compared with saline rinse; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 0.89 [0.71, 1.12]
1 study · 324 participants
GRADE not reported

Powered toothbrushing (as part of comprehensive oral care) vs Manual toothbrushing

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Powered toothbrushing (as part of comprehensive oral care) showed no clear difference in incidence of VAP compared with manual toothbrushing (standard oral care); GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 0.84 [0.37, 1.91]
1 study · 78 participants
GRADE not reported

Biotene OralBalance vs control

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Biotene OralBalance versus control (Stefanescu 2013, 41 participants): no difference in incidence of VAP; single study, high risk of bias.
1 study · 41 participants
GRADE not reported

Chlorhexidine vs Miswak

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Chlorhexidine versus miswak (Irani 2019): no evidence of a difference in incidence of VAP; single study. Also no difference in number treated with systemic antibiotics.
1 study
GRADE not reported

Potassium permanganate vs placebo

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Potassium permanganate versus placebo (Meidani 2018): no evidence of a difference in VAP incidence; single study.
1 study
GRADE not reported

Povidone iodine rinse vs Saline rinse or placebo

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Povidone iodine rinse led to lower incidence of VAP compared with saline rinse or placebo; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 0.69 [0.50, 0.95]
3 studies · 356 participants
GRADE not reported

Saline rinse vs usual or supportive care

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Saline rinse led to lower incidence of VAP compared with usual care (no rinse); GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 0.60 [0.39, 0.91]
2 studies · 324 participants
GRADE not reported

Chlorhexidine vs Hydrogen peroxide

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Chlorhexidine versus hydrogen peroxide (Dahiya 2012): no evidence of a difference in incidence of VAP; single study.
1 study
GRADE not reported

Chlorhexidine vs Ozonated water

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Chlorhexidine versus ozonated water (Hanifi 2017): some evidence of a benefit for ozonated water; single study, not replicated, interpret with caution.
1 study
GRADE not reported