What do systematic reviews say?

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs no treatment

Cryotherapy (ice chips) may leads to lower oral mucositis (severe) compared with no treatment (low certainty).

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.36 [0.17, 0.77]
  5 studies · 472 participants
  Low

Pilocarpine lozenge (3 mg or 5 mg) vs placebo control

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes

  Single dose (up to 3 hours)
  Taweechaisupapong 2006 (crossover): participants reported a statistically significant improvement in oral dryness after both 3 mg and 5 mg pilocarpine lozenges vs placebo (P <= 0.05); no usable data presented. No…
  1 study · 33 participants
  GRADE not reported

Mucin spray (Saliva Orthana) vs Placebo spray (base without mucin)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Blixt-Johansen 1992 (parallel, elderly long-term care, poor oral mucosa): oral mucosa improved in both groups but a much greater reduction in oral pathology in the mucin spray group; no data presented.
  1 study
  GRADE not reported

GM-CSF vs placebo/no treatment

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  no estimate extracted
  8 studies
  GRADE not reported

Indigo wood root vs saline placebo

Indigo wood root led to lower oral mucositis (severe) compared with saline (placebo); GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.14 [0.02, 0.93]
  1 study · 20 participants
  GRADE not reported

Glutamine (intravenous) vs placebo

Glutamine (intravenous) led to lower oral mucositis (severe) compared with placebo; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.25 [0.1, 0.62]
  3 studies · 93 participants
  GRADE not reported

Chlorhexidine vs placebo/no treatment

Chlorhexidine showed no clear difference in oral mucositis (severe) compared with placebo/no treatment (low certainty).

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.82 [0.54, 1.23]
  4 studies · 244 participants
  Low

Carbopol (polyacrylic acid/acetate) spray vs Placebo spray

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  van der Reijden 1996 (crossover, Sjogren's syndrome): carbopol spray found partially effective; none of the sprays were completely effective; no data suitable for inclusion.
  1 study
  GRADE not reported

Honey vs no treatment

Honey led to lower oral mucositis (moderate to severe) compared with no treatment; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.48 [0.31, 0.74]
  3 studies
  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
  Frost 2002 (crossover, n=30, Sjogren's syndrome): overall mouth dryness favoured the device but only nearly significant (median 4 (IQR 2 to 4) device vs 3 (2 to 4) control; P = 0.056). Speech (P = 0.003) and swallowing…
  1 study · 30 participants
  GRADE not reported

Mucin spray (Saliva Orthana) vs Placebo spray (base without mucin)

Mucin spray (Saliva Orthana) showed no clear difference in duration of relief of dryness compared with placebo spray (base without mucin); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Duxbury 1989: no difference between mucin spray and placebo in the duration of relief of dryness (Analysis 1.4).
  1 study
  GRADE not reported

Chewing gum vs Saliva substitute spray

Chewing gum (mechanical saliva stimulant) led to lower patient preference compared with saliva substitute spray; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Bots 2005: statistically significant preference for chewing gum over Xialine spray, 39/49 (80%) preferred gum vs 10/49 (20%) spray (Chi2 17.16, df=1; P < 0.001) (Analysis 2.3). Davies 2000: more people preferred gum,…
  1 study · 65 participants
  GRADE not reported

Prednisone vs placebo

Prednisone showed no clear difference in oral mucositis (severe) compared with placebo; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.64 [0.17, 2.45]
  1 study · 66 participants
  GRADE not reported

Buffered 'Prophylin' prophylactic gel vs Placebo gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No difference between buffered gel, unbuffered gel and water for oral pH, cariogenic bacteria or Candida species.
  1 study · 14 participants
  GRADE not reported

GM-CSF vs sucralfate

GM-CSF showed no clear difference in oral mucositis (severe) compared with sucralfate; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.54 [0.24, 1.21]
  1 study · 40 participants
  GRADE not reported

Betaine (BET) toothpaste (4%) vs SLS toothpaste (1%) and combined BET+SLS toothpaste

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Rantanen 2003 (crossover): relief of oral dryness BET 44% vs BET+SLS 22% (P = 0.002) vs SLS 18% (P = 0.022) vs reference toothpaste 7% (P < 0.001); betaine-only significantly better than the other toothpastes. No…
  1 study
  GRADE not reported

Low‐level laser therapy vs Povidone

Laser (low level) led to lower oral mucositis (moderate to severe) compared with povidone; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.29 [0.16, 0.54]
  1 study · 50 participants
  GRADE not reported

Honey vs no treatment

Honey led to lower oral mucositis (any severity) compared with no treatment; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.7 [0.56, 0.88]
  3 studies
  GRADE not reported

Beta‐carotene vs no treatment

Beta carotene showed no clear difference in oral mucositis (severe) compared with no treatment; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.38 [0.14, 1.02]
  1 study · 20 participants
  GRADE not reported

Iseganan vs placebo

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  no estimate extracted
  2 studies
  GRADE not reported