What do systematic reviews say?

Intervention not reported

• Teledentistry accuracy for caries diagnosis: a systematic review of in-vivo studies using extra-oral photography… 2024 All outcomes

  Overall narrative conclusion across included studies
  Study conclusion (narrative) 17 of 19 studies concluded photographic diagnostic accuracy comparable to visual caries assessment
  19 studies
  GRADE not reported

Intervention not reported

• Strategies to integrate oral health into primary care: a systematic review. 2023 All outcomes
  1 study reported an unfavourable outcome
  1 study
  GRADE not reported

Chlorhexidine mouthwash vs placebo

Chlorhexidine mouthwash reduced Mutans streptococci versus placebo, but certainty is very low.

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  ≤ 3 months
  Colony count of MS was significantly reduced compared to placebos according to three studies [34; 48; 52]; colony count of MS was slightly reduced compared to placebo in a short time in one study [40].
  4 studies
  Very low

Chlorhexidine mouthwash vs Blank control

Chlorhexidine mouthwash reduced Mutans streptococci versus blank control, but certainty is very low.

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  ≤ 3 months
  Colony count of MS was significantly reduced compared to blank control according to one study [53]; one study reported a significant reduction compared to baseline [51].
  2 studies
  Very low

Surgery vs Radiotherapy alone

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
  Adverse events: grade 2+ treatment-related events similar (31/34 radiotherapy vs 33/34 surgery; RR 0.94, 0.83 to 1.06); more hearing loss/neutropenia/constipation/tinnitus with radiotherapy, more oral bleeding/trismus…
  1 study · 68 participants
  Very low

Herbal mouthwash vs placebo

Herbal mouthwash reduced some plaque-related indices versus placebo, with low-certainty evidence.

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  ≤ 3 months
  PI was significantly reduced compared to placebo [56]; VPI was significantly reduced compared to placebo [41]; PI was insignificantly reduced compared to placebo [19].
  3 studies
  Low

Fluoride mouthwash vs Blank control

Short-term fluoride mouthwash reduced Mutans streptococci, but certainty is very low.

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  ≤ 3 months
  Colony count of MS was significantly reduced compared to baseline according to two studies [33; 34].
  2 studies
  Very low
• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  ≥ 12 months
  Colony count of MS was similar to blank control according to two studies [37; 59].
  2 studies
  Very low

Chlorhexidine mouthwash vs Placebo mouthwash

Chlorhexidine mouthwash may reduce pocket probing depth versus placebo in the short term (low certainty).

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  <=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
  PD was significantly reduced except mid-lingual site compared to placebo [32]. The changes of PD were significantly higher compared to placebo [56].
  2 studies
  Low

Chlorhexidine mouthwash vs Blank control

Chlorhexidine mouthwash may reduce the Plaque Index versus blank control in the short term (WMD -0.70, 95% CI -1.12 to -0.27), but the evidence is very uncertain (very low certainty).

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  <=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
  WMD -0.70 [-1.12, -0.27]
  4 studies · 188 participants
  Very low

Cetylpyridinium chloride mouthwash vs Blank control

CPC mouthwash may reduce plaque-related indexes versus blank control in the short term, but the evidence is very uncertain (very low certainty).

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  <=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
  BBPI was significantly reduced compared to blank control [47]. PI was significantly reduced compared to blank control [50]. The amount of dental plaque was significantly reduced compared to baseline [38].
  3 studies
  Very low

Herbal mouthwash vs placebo

Herbal mouthwash reduced Mutans streptococci versus placebo, but certainty is very low.

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  ≤ 3 months
  Colony count of MS was significantly reduced compared to placebo [52]; colony count was slightly reduced compared to placebo in a short time in one study [40].
  2 studies
  Very low

Fluoride mouthwash vs Blank control

Short-term fluoride mouthwash has uncertain effects on gingival inflammation-related indexes versus blank control (very low certainty).

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  <=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
  MGI' and BI' was significantly reduced compared to baseline [34]. BOP and GI was slightly lower compared to blank control [46].
  2 studies
  Very low

Fluoride mouthwash vs Blank control

Long-term fluoride mouthwash showed mixed plaque-index effects, with very low-certainty evidence.

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  ≥ 12 months
  PI was similar to blank control [37]; API was slightly reduced compared to blank control and significant at 6 and 9 months [59].
  2 studies
  Very low
• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  ≤ 3 months
  TI was significantly reduced compared to baseline [34]; PI was significantly reduced compared to baseline but similar to blank control [46].
  2 studies
  Very low

Surgery vs Radiotherapy alone

Surgery showed no clear difference in total mortality compared with radiotherapy alone (low certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes

  3 years
  HR 0.83 [0.09, 7.46]
  1 study · 68 participants
  Low

Fluoride mouthwash vs Blank control

Long-term (>=12 months) fluoride mouthwash may make little or no difference to Lactobacilli colony counts versus blank control (very low certainty).

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  >=12 months (long-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
  Colony count of LB was similar to blank control according to two studies [37, 59].
  2 studies
  Very low

Surgery vs Radiotherapy alone

The review found no eligible studies for this question.

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
  Locoregional recurrence: not reported.
  0 studies
  No studies found

Chlorhexidine mouthwash vs Blank control

Chlorhexidine mouthwash may reduce the Gingival Index versus blank control in the short term (WMD -0.54, 95% CI -0.96 to -0.13), but with very high heterogeneity the evidence is very uncertain (very low certainty).

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  <=3 months (short-term) · Orthodontic patients undergoing orthodontic treatment (randomized controlled trials; multiple countries)
  WMD -0.54 [-0.96, -0.13]
  6 studies · 274 participants
  Very low

Herbal mouthwash vs placebo

Herbal mouthwash reduced gingival inflammation-related indices versus placebo, but certainty is very low.

• The efficacy of mouthwashes on oral microorganisms and gingivitis in patients undergoing orthodontic treatment:… 2023 All outcomes

  ≤ 3 months
  GBI was significantly reduced compared to placebo [41]; GBI was significantly reduced compared to placebo [56]; BI was significantly reduced compared to placebo [40].
  3 studies
  Very low

Combined OCP vs placebo or no treatment

• Combined oral contraceptive pill for primary dysmenorrhoea 2023 · Cochrane Headline outcomes only
  no estimate extracted
  6 studies · 588 participants
  High

Combined low‐dose OCP vs another combined low‐dose OCP

It is very uncertain whether combined low‐dose OCP changes absence from work or school compared with another combined low‐dose OCP (very low certainty).

• Combined oral contraceptive pill for primary dysmenorrhoea 2023 · Cochrane Headline outcomes only
  RR 1.12 [0.64, 1.99]
  1 study · 445 participants
  Very low