What do systematic reviews say?

Chlorhexidine vs Potassium permanganate

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

• 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

• 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

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

Toothbrushing (with or without antiseptics), as part of oral hygiene… showed no clear difference in mortality compared with no toothbrushing (with or without antiseptics) (low certainty).

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

  Follow-up: mean 1 month
  RR 0.84 [0.67, 1.05]
  5 studies · 910 participants
  Low

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

Saline rinse vs Saline-soaked swab

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

• 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)

The review found no eligible studies for this question.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  This outcome was not reported by any of the studies in this comparison.
  0 studies
  No studies found

Povidone iodine coolant vs Distilled water coolant

It is very uncertain whether povidone iodine coolant changes reduction in level of contamination in aerosols (CFU): povidone… compared with distilled water coolant (very low certainty).

• Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases 2020 · Cochrane All outcomes
  MD -656.45 [-672.74, -640.16]
  1 study · 40 participants
  Very low

Intervention not reported

• Does Er,Cr:YSGG reduce the microleakage of restorations when used for cavity preparation? A systematic review and… 2020 All outcomes

  Geraldo-Martins 2013 (excluded from meta-analysis; higher microleakage with Er,Cr:YSGG)
  Qualitative NR [NR, NR]
  1 study
  GRADE not reported

Povidone iodine rinse vs Saline rinse or placebo

Povidone iodine rinse showed no clear difference in mortality compared with saline rinse or placebo; GRADE not reported.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  RR 1.00 [0.66, 1.50]
  2 studies · 217 participants
  GRADE not reported

Triclosan rinse vs Saline rinse

Triclosan rinse led to lower duration of mechanical ventilation compared with saline rinse; GRADE not reported.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  MD -5.24 [-5.64, -4.84]
  1 study · 324 participants
  GRADE not reported

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

Chlorhexidine (mouthrinse or gel), as part of oral hygiene care showed no clear difference in mortality compared with placebo or usual care (moderate certainty).

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

  Follow-up: mean 1 month
  RR 1.03 [0.80, 1.33]
  9 studies · 944 participants
  Moderate

Ozonisation vs No ozonisation / standard operatory

The review found no eligible studies for this question.

• Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases 2020 · Cochrane All outcomes
  no estimate extracted
  0 studies
  No studies found

Resin-based fissure sealant plus fluoride varnish vs Fluoride varnish

The review found no eligible studies for this question.

• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes
  The study (Splieth 2001) did not measure the number of visits to the dentist for repair of sealant or fluoride varnish application.
  0 studies
  No studies found

High-volume evacuation (HVE) vs Conventional dental suction (low-volume evacuator / saliva ejector)

It is very uncertain whether high-volume evacuation (HVE) changes reduction in level of contamination in aerosols (CFU) during… compared with conventional dental suction (low-volume evacuator / saliva ejector) (very low certainty).

• Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases 2020 · Cochrane All outcomes
  MD -2.30 [-5.32, 0.72]
  1 study · 6 participants
  Very low

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

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).

• 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

Chlorhexidine vs Potassium permanganate

Chlorhexidine showed no clear difference in mortality compared with potassium permanganate; GRADE not reported.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  RR 1.11 [0.89, 1.38]
  2 studies
  GRADE not reported

Saline rinse vs usual or supportive care

Saline rinse showed no clear difference in duration of ICU stay compared with usual care (no rinse); GRADE not reported.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  MD -1.17 [-3.95, 1.60]
  2 studies · 324 participants
  GRADE not reported

Ultraviolet (UV) light air decontamination vs No UV light / standard operatory

The review found no eligible studies for this question.

• Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases 2020 · Cochrane All outcomes
  no estimate extracted
  0 studies
  No studies found

Essential oil mouthwash vs Sterile water rinse

• 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

Resin-based fissure sealant plus fluoride varnish vs Fluoride varnish

The review found no eligible studies for this question.

• Pit and fissure sealants versus fluoride varnishes for preventing dental decay in the permanent teeth of children and… 2020 · Cochrane All outcomes
  The study (Splieth 2001) did not report progression of dentinal carious lesions into enamel or dentine.
  0 studies
  No studies found