What do systematic reviews say?

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

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  Adverse effects: information from 2 studies; one stated there were none, the other reported mild reversible irritation of the oral mucosa; very low certainty. There was a lack of evidence about adverse effects.
  2 studies
  Very low

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

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

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes

  Follow-up: mean 1 month
  RR 1.03 [0.80, 1.33]
  9 studies · 944 participants
  Moderate

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

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).

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes

  Follow-up: mean 1 month
  MD -1.10 [-3.20, 1.00]
  4 studies · 594 participants
  Very low

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

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).

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes

  Follow-up: mean 1 month
  MD -0.89 [-3.59, 1.82]
  5 studies · 627 participants
  Low

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

The review found no eligible studies for this question.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  The outcome of cost was not reported by any study in this comparison.
  0 studies
  No studies found

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

Chlorhexidine (mouthrinse or gel), as part of oral hygiene care showed no clear difference in duration of systemic antibiotic use compared with placebo or usual care; GRADE not reported.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  MD 0.65 [-0.58, 1.88]
  1 study · 146 participants
  GRADE not reported

Community and caregiver oral health education plus media campaign vs Pre-intervention BBTD rate

High-intensity community education was associated with a 33% reduction in BBTD prevalence, without a GRADE rating.

• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  3 years · Alaska Native and American Indian Head Start sites · High-intensity training
  Percent reduction in BBTD prevalence 33
  1 study
  GRADE not reported
• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  3 years · Alaska Native and American Indian Head Start sites · Medium-intensity training
  Percent reduction in BBTD prevalence 18
  1 study
  GRADE not reported
• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  3 years · Alaska Native and American Indian Head Start sites · Low-intensity training
  Percent reduction in BBTD prevalence 27
  1 study
  GRADE not reported

Community and caregiver oral health education plus media campaign vs Pre-intervention BBTD rate

The Alaska Native site had a 20% increase in BBTD prevalence, without a GRADE rating.

• Reducing Alaska Native paediatric oral health disparities: a systematic review of oral health interventions and a case… 2013 All outcomes

  3 years · Alaska Native Head Start site · Alaska Native site
  Percent increase in BBTD prevalence 20
  1 study
  GRADE not reported

Visual screening (oral visual inspection) by trained health workers vs No screening

• Screening programmes for the early detection and prevention of oral cancer 2013 · Cochrane All outcomes

  9 years (three cycles)
  The costs associated with the screening programme were reported after three cycles (nine years) (Subramanian 2009) (Additional Table 8). The benefit produced by a screen was 269.31 life-years saved per 100,000 for all…
  1 study
  GRADE not reported

Visual screening (oral visual inspection) by trained health workers vs No screening

The review found no eligible studies for this question.

• Screening programmes for the early detection and prevention of oral cancer 2013 · Cochrane All outcomes

  15-year follow-up
  No harms were reported.
  0 studies
  No studies found

Visual screening (oral visual inspection) by trained health workers vs No screening

Visual screening (oral visual inspection) by trained health workers led to lower stage at diagnosis (early-stage detection) compared with no screening; GRADE not reported.

• Screening programmes for the early detection and prevention of oral cancer 2013 · Cochrane All outcomes

  15-year follow-up
  RR 0.81 [0.70, 0.93]
  1 study · 523 participants
  GRADE not reported
• Screening programmes for the early detection and prevention of oral cancer 2013 · Cochrane All outcomes

  15-year follow-up · High-risk individuals (tobacco and/or alcohol users)
  RR 0.82 [0.71, 0.95]
  1 study · 486 participants
  GRADE not reported

Visual screening (oral visual inspection) by trained health workers vs No screening

The review found no eligible studies for this question.

• Screening programmes for the early detection and prevention of oral cancer 2013 · Cochrane All outcomes

  15-year follow-up
  Data on quality of life were not reported.
  0 studies
  No studies found

Visual screening (oral visual inspection) by trained health workers vs No screening

• Screening programmes for the early detection and prevention of oral cancer 2013 · Cochrane All outcomes

  15-year follow-up
  Across the four cycles (15 years), the reported sensitivity of the visual examination in detecting oral cancer was 67.4% (188/279). No information on the specificity or the positive predictive value of the programme…
  1 study
  GRADE not reported

Visual screening (oral visual inspection) by trained health workers vs No screening

• Screening programmes for the early detection and prevention of oral cancer 2013 · Cochrane All outcomes

  5-year survival
  A significantly higher five-year survival rate was reported in the screened group (55.5%) compared to the control (43.4%) (P value = 0.003).
  1 study · 523 participants
  GRADE not reported

Oral diazepam vs placebo or no intervention

It is very uncertain whether oral diazepam changes behaviour (Houpt/behavioural score) compared with placebo (including no intervention) (very low certainty).

• Sedation of children undergoing dental treatment 2018 · Cochrane All outcomes
  SMD 0.62 [-0.28, 1.53]
  1 study · 20 participants
  Very low

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Inter-examiner kappa statistics ranged from 0.44 to 0.91 across 13 studies; no meta-analysis or GRADE rating was reported.

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

  Schools, juvenile detention facility, dental clinics, and hospitals · Overall
  no estimate extracted
  13 studies
  GRADE not reported

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Positive predictive values were reported in 10 of the 13 studies that reported sensitivity and specificity; no meta-analysis or GRADE rating was reported.

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

  Schools, juvenile detention facility, dental clinics, and hospitals · Overall
  no estimate extracted
  10 studies
  GRADE not reported

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Negative predictive values were reported in 10 of the 13 studies that reported sensitivity and specificity; no meta-analysis or GRADE rating was reported.

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

  Schools, juvenile detention facility, dental clinics, and hospitals · Overall
  no estimate extracted
  10 studies
  GRADE not reported

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Intra-examiner kappa statistics ranged from 0.52 to 1.00 across 6 studies; no meta-analysis or GRADE rating was reported.

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

  Schools, juvenile detention facility, dental clinics, and hospitals · Overall
  no estimate extracted
  6 studies
  GRADE not reported

Teledentistry diagnosis using DSLR or smartphone extra-oral photographs vs Visual or clinical examination

Sensitivity ranged from 48% to 98.3% across 13 studies; no meta-analysis or GRADE rating was reported.

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

  Schools, juvenile detention facility, dental clinics, and hospitals · Overall
  Sensitivity Overall 48% to 98.3% across 13 studies; sensitivity is lesion-stage dependent: Kohara reported <40% for initial/moderate caries (75-100% for extensive) and early enamel lesions were less sensitive
  13 studies
  GRADE not reported