What do systematic reviews say?

Toothbrushing + 0.075% cetylpyridinium chloride mouthwash vs Toothbrushing alone

Toothbrushing + 0.075% cetylpyridinium chloride mouthwash may leads to lower dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with toothbrushing (low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 3 weeks
  MD -0.48 [-0.72, -0.24]
  1 study · 70 participants
  Low

0.6% eucalyptus chewing gum vs Placebo chewing gum

It is very uncertain whether 0.6% eucalyptus chewing gum changes dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with placebo chewing gum (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 4 weeks
  MD -0.1 [-0.31, 0.11]
  1 study · 65 participants
  Very low

Salvadora persica (miswak) mouthrinse vs Chlorhexidine mouthwash

It is very uncertain whether miswak (Salvadora persica) mouthwash changes dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with chlorhexidine mouthwash (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 1 week
  MD 0.01 [-0.95, 0.97]
  1 study · 21 participants
  Very low

1450 to 1500 ppm F toothpaste vs 1000 to 1250 ppm F toothpaste

1450 to 1500 ppm F toothpaste probably leads to lower caries increment, surface index D(M)FS compared with 1000 to 1250 ppm F toothpaste (moderate certainty).

• Fluoride toothpastes of different concentrations for preventing dental caries 2019 · Cochrane All outcomes

  Closest to 36 months
  SMD -0.08 [-0.14, -0.01]
  10 studies
  Moderate

1700 to 2200 ppm F toothpaste vs 250 ppm F toothpaste

1700 to 2200 ppm F toothpaste showed no clear difference in caries increment, tooth index D(M)FT compared with 250 ppm F toothpaste (low certainty).

• Fluoride toothpastes of different concentrations for preventing dental caries 2019 · Cochrane All outcomes

  Closest to 36 months
  SMD -0.23 [-0.5, 0.05]
  Studies not reported
  Low

2400 to 2800 ppm F toothpaste vs 440 to 550 ppm F toothpaste

2400 to 2800 ppm F toothpaste showed no clear difference in caries increment, tooth index D(M)FT compared with 440 to 550 ppm F toothpaste (low certainty).

• Fluoride toothpastes of different concentrations for preventing dental caries 2019 · Cochrane All outcomes

  Closest to 36 months
  SMD -0.2 [-0.46, 0.05]
  Studies not reported
  Low

440 to 550 ppm F toothpaste vs Non-fluoride (0 ppm F) placebo toothpaste

440 to 550 ppm F toothpaste showed no clear difference in caries increment, surface index D(M)FS compared with non-fluoride (0 ppm F) placebo toothpaste (low certainty).

• Fluoride toothpastes of different concentrations for preventing dental caries 2019 · Cochrane All outcomes

  Closest to 36 months
  SMD -0.12 [-0.31, 0.07]
  2 studies
  Low

1500 ppm F toothpaste vs Non-fluoride (0 ppm F) placebo toothpaste

• Fluoride toothpastes of different concentrations for preventing dental caries 2019 · Cochrane All outcomes

  12 months
  No studies reported poolable d(m)ft increment; Cahen 1982 reported a df-rate of 18.25% (n=708) in the 0 ppm group vs 13.64% (n=632, 1500 ppm SMFP) and 9.37% (n=668, amine fluoride) groups.
  1 study
  GRADE not reported

0.2% zinc sulphate toothpaste vs Placebo toothpaste (without zinc)

0.2% zinc sulphate toothpaste led to lower volatile sulphur compounds (VSC) compared with placebo toothpaste (without zinc); GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  4 weeks
  MD -11.3 [-20.45, -2.15]
  1 study · 188 participants
  GRADE not reported

Salvadora persica (miswak) mouthrinse vs Chlorhexidine mouthwash

It is very uncertain whether miswak (Salvadora persica) mouthwash changes patient self-assessment VAS (scale 0 to 10) compared with chlorhexidine mouthwash (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 1 week
  MD -0.18 [-1.59, 1.23]
  1 study · 21 participants
  Very low

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… showed no clear difference in gingival bleeding (long term) compared with usual care (no specific treatment) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  MD -0.20 [-0.86, 0.46]
  1 study · 304 participants
  Low

1450 to 1500 ppm F toothpaste vs 250 ppm F toothpaste

1450 to 1500 ppm F toothpaste may leads to lower caries increment, tooth index D(M)FT compared with 250 ppm F toothpaste (low certainty).

• Fluoride toothpastes of different concentrations for preventing dental caries 2019 · Cochrane All outcomes

  Closest to 36 months
  SMD -0.28 [-0.47, -0.09]
  Studies not reported
  Low

Learning disability (CLD) vs No learning disability (CNLD)

Narrative reports from 6 studies suggested greater unmet dental treatment need in children with learning disabilities (5 of 6 studies), but no quantitative data were available (certainty not graded).

• Dental caries experience, care index and restorative index in children with learning disabilities and children without… 2019 All outcomes

  Community and clinical settings (specialist paediatric dental clinics to school classrooms); 25 studies across 18 countries
  Six studies gave narrative reports of unmet dental need (Table 10); 5 of 6 reported greater unmet treatment need in CLD than CNLD, with no supporting numerical data.
  6 studies
  GRADE not reported

Oral-health promotion programs (OHPPs): community-based oral-health education/training, supervised toothbrushing with fluoride toothpaste and topical fluoride, dental screening, and dietary advice vs No oral-health promotion program, or a differing (usual-care) action under similar conditions

Oral-health promotion programs were associated with markedly lower odds of DMFT/S in children (OR 0.19, 95% CI 0.10 to 0.39; ungraded, very high heterogeneity I2=98.5%).

• Clinical Effectiveness and Cost-Effectiveness of Oral-Health Promotion in Dental Caries Prevention among Children:… 2019 All outcomes

  Community settings: home visits, telephone contacts, healthcare centers, and primary schools
  OR 0.19 [0.10, 0.39]
  8 studies
  GRADE not reported

0.6% eucalyptus chewing gum vs 0.4% eucalyptus chewing gum

0.6% eucalyptus chewing gum showed no clear difference in volatile sulphur compounds (VSC) compared with 0.4% eucalyptus chewing gum; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  4 weeks
  MD 0.0 [-0.21, 0.21]
  1 study · 64 participants
  GRADE not reported

Mineral trioxide aggregate (MTA) pulpotomy dressing vs Abscess remedy (AR)

A single RCT found higher pulpotomy success with MTA than abscess remedy (100% vs 80%; statistically significant, P<0.05; not pooled; ungraded).

• Materials for pulpotomy in immature permanent teeth: a systematic review and meta-analysis. 2019 All outcomes

  3 to 24 months · Pediatric dental clinic (India)
  Single RCT (Eppa 2018, 3-arm; 20 MTA and 20 AR teeth): MTA 100% (20/20) vs abscess remedy 80% (16/20) clinical and radiographic success; the 4 abscess-remedy failures occurred at 3 months; difference statistically…
  1 study · 40 participants
  GRADE not reported

Toothbrushing + 0.075% cetylpyridinium chloride mouthwash vs Toothbrushing alone

The review found no eligible studies for this question.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 3 weeks
  Patient-reported OLT score: listed in the Summary of findings table but no data reported. No data were reported for patient-reported OLT score.
  0 studies
  No studies found

Pycnogenol chewing gum vs Placebo chewing gum

Pycnogenol chewing gum led to lower VSC: hydrogen sulphide compared with placebo chewing gum; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  4 weeks
  MD -114.9 [-206.59, -23.21]
  1 study · 21 participants
  GRADE not reported

Zinc chloride + sodium fluoride dentifrice vs Sodium fluoride (control) toothpaste

• Interventions for managing halitosis 2019 · Cochrane All outcomes
  Payne 2011 reported 19 non-oral and 12 oral adverse effects. The oral effects were tingling sensation in lips, dry mouth or sore gums.
  1 study
  GRADE not reported

Fluoride toothpaste vs Placebo (non-fluoride) toothpaste or fluoride toothpaste of a different concentration

• Fluoride toothpastes of different concentrations for preventing dental caries 2019 · Cochrane All outcomes

  Closest to 36 months
  16 studies assessed possible side effects, principally oral (soft tissue) pathologies and tooth staining. 6 studies reported no untoward events; 6 reported greater staining in the stannous fluoride group; 1 reported no…
  16 studies
  GRADE not reported