What do systematic reviews say?

Colchicine (0.5 mg three times per day) vs placebo

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

  6 months
  There was a greater percentage of treatment interruptions in the colchicine group due to gastrointestinal adverse effects (Fisher's exact test P=0.009). The review noted potential evidence of harm at a dose of 1.5 mg…
  1 study · 43 participants
  GRADE not reported

Camel thorn (plant distillate) vs placebo

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

  up to 14 days
  No evidence of drug side effects was observed.
  1 study · 93 participants
  GRADE not reported

LongoVital (herbal plus vitamin component) vs LongoVital (herbal component alone)

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

  4 months
  Reported adverse events were minor and evenly distributed between the groups (Kolseth 2005).
  1 study · 40 participants
  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

LongoVital (herbal component alone) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes
  Reported adverse events were minor and evenly distributed between the groups (Kolseth 2005). 'Very few and mostly harmless side-effects' were observed (Bratel 2005).
  2 studies
  GRADE not reported

Carboxymethylcellulose (CMC) spray vs Placebo (spray base without CMC / water)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Donatsky 1982 (crossover, n=15, Sjogren's syndrome): CMC spray had a similar effect on oral dryness to the spray base, but was more effective than water. Paired crossover data not presented; effect size not estimable.
  1 study · 15 participants
  GRADE not reported

Saliva stimulant lozenge (sorbitol, Sorbee) vs Saliva substitute spray

Saliva stimulant lozenge (sorbitol, Sorbee) led to lower patient preference compared with saliva substitute spray (MouthKote); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Stewart 1998: no statistically significant difference in patient preference between lozenge and spray (Analysis 2.3).
  1 study · 80 participants
  GRADE not reported

Consumption of xylitol chewing gum by women (mothers) vs Profylin lozenge (xylitol/sorbitol + CMC)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Patients ranked gum and lozenge equal for preference.
  1 study · 18 participants
  GRADE not reported

Consumption of xylitol chewing gum by women (mothers) vs Profylin lozenge (xylitol/sorbitol + CMC)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No change in stimulated whole saliva.
  1 study · 18 participants
  GRADE not reported

Carboxymethylcellulose (CMC) spray vs Salinum linseed oil spray

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Mean plaque and gingival indices were reduced during the Salinum (linseed) period; incomplete comparative data.
  1 study · 20 participants
  GRADE not reported

Carboxymethylcellulose (CMC) mouthwash vs Glycerin mouthwash

Carboxymethylcellulose (CMC) mouthwash led to higher improvement in dry mouth ('excellent benefit', dichotomous) compared with glycerin mouthwash; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  RR 3.95 [1.17, 13.36]
  1 study · 148 participants
  GRADE not reported

Saliva stimulant lozenge (sorbitol, Sorbee) vs Saliva substitute spray

Saliva stimulant lozenge (sorbitol, Sorbee) showed no clear difference in salivary flow (unstimulated whole saliva) compared with saliva substitute spray (MouthKote); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  MD -0.01 [-0.03, 0.02]
  1 study · 80 participants
  GRADE not reported

Various saliva stimulants (chewable tablet, lozenges, chewing gum, CMC mouthrinse/sprays; 8-arm) vs Saliva substitutes / other products

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No product had a long-term effect on stimulated whole saliva production.
  1 study · 106 participants
  GRADE not reported

CMC/sorbitol pre-moistened swabs vs Lemon glycerin swabs

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  CMC/sorbitol also improved dentition and gingival scores; no supporting data presented.
  1 study · 20 participants
  GRADE not reported

CMC spray / aloe vera gel / canola oil spray vs Mucin spray (and between each other)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No significant difference in patient preference between the treatments (Chi2 3.67, df=3; P = 0.30).
  1 study · 123 participants
  GRADE not reported

Reservoir biteguard device releasing a saliva substitute (with KY jelly + Saliva Orthana) vs Biteguard without reservoir (with KY jelly + Saliva Orthana)

Reservoir biteguard device releasing a saliva substitute (with KY… showed no clear difference in xerostomia (Xerostomia Inventory) compared with biteguard without reservoir (with KY jelly + Saliva Orthana); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  SMD -0.06 [-0.48, 0.37]
  1 study · 86 participants
  GRADE not reported

Mucoadhesive disk (carbomer/triglycerides + antimicrobial agents) vs Placebo disk

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Kerr 2010 (crossover, high risk of bias): no difference in oral dryness between active and placebo disks; increase in subjective oral moistness with both, persisting up to 2 weeks after last use (likely carryover);…
  1 study
  GRADE not reported

Chewing gum vs Saliva substitute spray

Chewing gum (mechanical saliva stimulant) showed no clear difference in xerostomia (mouth dryness, VAS/scale) compared with saliva substitute spray; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  SMD -0.11 [-0.33, 0.11]
  2 studies
  GRADE not reported

Buffered 'Prophylin' prophylactic gel vs Placebo gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Persson 2007 (crossover, n=14, institutionalised elderly): no dry mouth symptom data after treatment were presented.
  1 study · 14 participants
  GRADE not reported

Intraoral device releasing Biotene Oral Balance gel vs usual care without an aid

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  More participants preferred the intraoral device (66%) compared with usual care; data not suitable for meta-analysis.
  1 study · 30 participants
  GRADE not reported