Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,348 questions · 1,514 findings · 111 reviews · Oral Health

No studies found 287 · 19%GRADE not reported 823 · 54.4%Very low 243 · 16.1%Low 104 · 6.9%Moderate 49 · 3.2%High 8 · 0.5%

Clobetasol propionate plus miconazole (adjunctive antifungal) vs Clobetasol propionate plus placebo

Candidosis (adverse effect) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment
1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary Lactobacilli counts · Patients with drooling (sialorrhea) due to neurological disease

Salivary Lactobacilli counts were unchanged in two studies but significantly increased in one study one month after BoNT (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection (2018 study: significant Lactobacilli increase at 1 month; Wu 2011 and 2017 study no change) · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    No statistically significant changes in Lactobacilli CFU counts were reported by Wu et al. or by Tiigimae-Saar 2017. However, the 2018 study found that Lactobacilli CFU counts were significantly increased one month…
    3 studies
    GRADE not reported

Oral prednisone plus curcuminoids (adjunctive) vs Oral prednisone plus placebo

Reduction in pain · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment
1 finding from 1 review

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

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary osmolality (hydration level) · Patients with drooling (sialorrhea) due to neurological disease

No included study reported salivary osmolality; this pre-planned outcome remains unassessed (no studies).

1 finding from 1 review

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

Caregivers' preferences for oral hygiene care · Critically ill patients (adults and children) receiving mechanical ventilation in ICU

The review found no eligible studies for this question.

1 finding from 1 review

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

Adverse effects · Critically ill patients (adults and children) receiving mechanical ventilation in ICU
1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary S. mutans level · Patients with drooling (sialorrhea) due to neurological disease

BoNT injections were not associated with significant changes in salivary S. mutans counts across three studies (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    The RCT by Wu et al. reported no statistically significant changes in S. mutans CFU counts (p-values only). The studies of Tiigimae-Saar did not find statistically significant differences in S. mutans CFU counts either.
    3 studies
    GRADE not reported

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

All‐cause mortality · Critically ill patients (adults and children) receiving mechanical ventilation in ICU

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

1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary pH · Patients with drooling (sialorrhea) due to neurological disease

BoNT injections were not associated with significant changes in oral/salivary pH across three studies (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    Wu et al. did not observe significant differences in participants' oral pH before and after BoNT-A injections between the active and control groups. There were also no statistically significant differences regarding…
    3 studies
    GRADE not reported

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

Plaque index (PI) / oral hygiene · Critically ill patients (adults and children) receiving mechanical ventilation in ICU
1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Development of >=1 new carious lesion (caries incidence) · Patients with drooling (sialorrhea) due to neurological disease

In one RCT, BoNT-B 2500 U was not associated with a statistically significant increase in new caries versus placebo (RR 2.4, 95% CI 0.48 to 11.80; not significant).

2 findings from 1 review

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

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

It is very uncertain whether chlorhexidine (mouthrinse or gel), as part of oral hygiene care changes duration of mechanical ventilation compared with placebo or usual care (very low certainty).

1 finding from 1 review

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

Duration of ICU stay · Critically ill patients (adults and children) receiving mechanical ventilation in ICU

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

1 finding from 1 review