Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,297 questions · 3,638 findings · 215 reviews · All outcomes

No studies found 98 · 2.7%GRADE not reported 2,946 · 81%Very low 263 · 7.2%Low 158 · 4.3%Moderate 137 · 3.8%High 36 · 1%

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

Percussion pain at 72 hours · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in percussion pain at 72 hours compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

1 finding from 1 review

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

Percussion pain at 7 days · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in percussion pain at 7 days compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

1 finding from 1 review

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

Adverse effects · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)
1 finding from 1 review

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

Pain at 7 days · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

It is very uncertain whether postoperative systemic antibiotics… changes pain at 7 days compared with matched placebo, partial or total chemo-mechanical debridement and… (very low certainty).

1 finding from 1 review

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

Number of paracetamol (acetaminophen) with codeine tablets required · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in number of paracetamol (acetaminophen) with codeine tablets required compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

1 finding from 1 review

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

Endodontic flare-up · Adults with a symptomatic necrotic tooth or localised acute apical abscess (no signs of spreading infection or systemic involvement)

Postoperative systemic antibiotics… showed no clear difference in endodontic flare-up compared with matched placebo, partial or total chemo-mechanical debridement and…; GRADE not reported.

1 finding from 1 review

A permanent restorative material or technique (e.g. amalgam; glass ionomer (type I-IV); composite resin (macrofilled, microfilled, hybrid, nanofilled); resin-modified glass ionomer (compomer, giomer); cement/cermet; stainless steel or nickel-chrome crown; pre-fabricated resin/porcelain veneer facing; microabrasion) vs A different permanent restorative material or technique

Outcome not reported · Children and adolescents under 18 years with amelogenesis imperfecta requiring restorative care of anterior teeth, irrespective of…

The review found no eligible studies for this question.

1 finding from 1 review

A permanent restorative material or technique (e.g. amalgam; glass ionomer (type I-IV); composite resin (macrofilled, microfilled, hybrid, nanofilled); resin-modified glass ionomer (compomer, giomer); cement/cermet; stainless steel or nickel-chrome crown; pre-fabricated resin/porcelain veneer facing; microabrasion) vs A different permanent restorative material or technique

Outcome not reported · Children and adolescents under 18 years with amelogenesis imperfecta requiring restorative care of posterior teeth, irrespective of…

The review found no eligible studies for this question.

1 finding from 1 review

Electronic cigarette use vs Non-smokers

Peri-implant clinical and radiographic parameters (plaque index, probing depth, bone loss, pro-inflammatory profile) · Adult e-cigarette (ENDS) users with dental implants (incl. male implant-supported prosthesis patients)

Among dental implant patients, e-cigarette users show worse peri-implant parameters (more plaque, worse clinical and radiographic outcomes) than non-smokers (narrative synthesis; ungraded).

1 finding from 1 review
  • An Umbrella Review of E-Cigarettes' Impact on Oral Microbiota and Biofilm Buildup. 2025 All outcomes
    Dental implant / peri-implant care · Implant/peri-implant populations: Vamos (implant patients), Youssef (male implant patients only), Yang (broad SR incl. peri-implant)
    Narrative synthesis: e-cigarette users with dental implants showed a higher peri-implant plaque index and worse clinico-radiographic and immunological peri-implant parameters than non-smokers (worse than non-smokers…
    3 studies
    GRADE not reported

Electronic cigarette use vs Non-smokers (non-users)

Periodontitis / periodontal disease and periodontal parameters · Adult e-cigarette (ENDS) users (general oral health; predominantly natural dentition)

E-cigarette users appear more likely to develop periodontal disease and worse periodontal parameters than non-smokers (narrative synthesis; ungraded).

1 finding from 1 review

Visual or visual-tactile classification systems (any system: ICDAS, ERK, Nyvad, Downer, Lussi, UniViSS, or unspecified) vs Reference standard (histology, excavation, radiographs/microCT, or tooth separation)

Diagnostic accuracy (sensitivity/specificity) for enamel caries, not meta-analyzed · Asymptomatic children, adolescents, or adults presenting for clinical examination (in vivo studies), or extracted teeth of children or…
1 finding from 1 review

Rubber dam vs No rubber dam

Reduction in level of contamination in aerosols (CFU) during restorative procedures at 2 metres from mouth (CCT) · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether rubber dam changes reduction in level of contamination in aerosols (CFU) during… compared with no rubber dam (very low certainty).

2 findings from 1 review

Rubber dam vs No rubber dam

Reduction in level of contamination in aerosols (CFU) during restorative procedures at 1 metre from mouth (CCT) · People undergoing aerosol-generating procedures (AGPs) in a dental setting

Rubber dam led to lower reduction in level of contamination in aerosols (CFU) during… compared with no rubber dam; GRADE not reported.

2 findings from 1 review

Green tea mouthwash vs Placebo mouthwash

Volatile sulphur compounds (VSC), halimeter · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced or physiological…

Green tea mouthwash showed no clear difference in volatile sulphur compounds (VSC), halimeter compared with placebo mouthwash; GRADE not reported.

1 finding from 1 review

Toothbrushing + Turkish gall oral rinse vs Toothbrushing alone

Volatile sulphur compounds (VSC), halimeter · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced or physiological…

Toothbrushing + Turkish gall oral rinse showed no clear difference in volatile sulphur compounds (VSC), halimeter compared with toothbrushing; GRADE not reported.

1 finding from 1 review

Lemongrass oil mouthwash vs Placebo mouthwash

Volatile sulphur compounds (VSC), halimeter · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced or physiological…

Lemongrass oil mouthwash led to lower volatile sulphur compounds (VSC), halimeter compared with placebo mouthwash; GRADE not reported.

1 finding from 1 review

Abrasive candy; abrasive candy + 2% propolis; abrasive candy + 0.5% zinc gluconate vs Abrasive candy + 1% propolis + 0.25% zinc

Volatile sulphur compounds (VSC), halimeter · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced or physiological…
1 finding from 1 review
  • Interventions for managing halitosis 2019 · Cochrane All outcomes
    Barak 2012 (5-arm RCT) compared abrasive candy, abrasive candy with propolis and abrasive candy with zinc gluconate versus abrasive candy with propolis and zinc; VSC measured by halimeter. We could not use the results…
    1 study
    GRADE not reported

Hinokitiol gel vs Placebo gel

VSC: methyl mercaptan · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced or physiological…

Hinokitiol gel showed no clear difference in VSC: methyl mercaptan compared with placebo gel; GRADE not reported.

1 finding from 1 review

Triclosan dentifrice vs Negative control dentifrice

Volatile sulphur compounds (VSC), halimeter · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced or physiological…
1 finding from 1 review
  • Interventions for managing halitosis 2019 · Cochrane All outcomes
    Nogueira-Filho 2002 (5-arm trial) compared three commercial 0.3% triclosan dentifrices and an experimental formulation versus a negative control dentifrice; VSC by halimeter. We could not use the results in the…
    1 study
    GRADE not reported

Toothbrushing + 0.075% cetylpyridinium chloride mouthwash vs Toothbrushing alone

Volatile sulphur compounds (VSC), halimeter · Adolescents and adults aged over 16 years with clinical or self-assessed halitosis of oral origin; excluding induced or physiological…

Toothbrushing + 0.075% cetylpyridinium chloride mouthwash led to lower volatile sulphur compounds (VSC), halimeter compared with toothbrushing; GRADE not reported.

1 finding from 1 review