What do systematic reviews say?

Chlorhexidine vs Hydrogen peroxide

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  Chlorhexidine versus hydrogen peroxide (Dahiya 2012): no evidence of a difference in incidence of VAP; single study.
  1 study
  GRADE not reported

Clinical examination with risk-based recall vs Clinical examination with 24-month recall

Clinical examination with risk-based recall showed no clear difference in dental caries: prevalence of root caries compared with clinical examination with 24-month recall; GRADE not reported.

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  RR 1.21 [0.72, 2.03]
  1 study · 247 participants
  GRADE not reported

Clinical examination with 24-month recall vs Clinical examination with 6-month recall

Clinical examination with 24-month recall showed no clear difference in dental caries: prevalence of root caries compared with clinical examination with 6-month recall; GRADE not reported.

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  RR 1.17 [0.65, 2.11]
  1 study · 238 participants
  GRADE not reported

Clinical examination with 24-month recall vs Clinical examination with 12-month recall

It is very uncertain whether clinical examination with 24-month recall changes dental caries: DMFS increment (permanent teeth) compared with clinical examination with 12-month recall (very low certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  2 years · 16-20 year olds (permanent teeth)
  MD 0.86 [-0.03, 1.75]
  1 study · 127 participants
  Very low

Clinical examination with risk-based recall vs Clinical examination with 24-month recall

Clinical examination with risk-based recall showed no clear difference in dental caries: prevalence of moderate to extensive caries (ICDAS 3-6) compared with clinical examination with 24-month recall (moderate certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  RR 1.06 [0.95, 1.19]
  1 study · 279 participants
  Moderate

Saline rinse vs usual or supportive care

Saline rinse showed no clear difference in mortality compared with usual care (no rinse); GRADE not reported.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  RR 1.10 [0.87, 1.39]
  2 studies · 324 participants
  GRADE not reported

Clinical examination with risk-based recall vs Clinical examination with 24-month recall

Clinical examination with risk-based recall showed no clear difference in dental caries: number of tooth surfaces with any caries (ICDAS 1-6) compared with clinical examination with 24-month recall (moderate certainty).

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  MD 1.40 [-0.69, 3.49]
  1 study · 279 participants
  Moderate

Sodium bicarbonate rinse (plus toothbrushing) vs Water rinse (plus toothbrushing)

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  Adverse effects (Berry 2011, CHX versus sodium bicarbonate versus water): no adverse events were reported associated with the interventions.
  1 study
  GRADE not reported

Chlorhexidine vs Ozonated water

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  Chlorhexidine versus ozonated water (Hanifi 2017): some evidence of a benefit for ozonated water; single study, not replicated, interpret with caution.
  1 study
  GRADE not reported

Clinical examination with risk-based recall vs Clinical examination with 24-month recall

Clinical examination with risk-based recall led to higher cost (patient perspective): total cost per patient (GBP) compared with clinical examination with 24-month recall; GRADE not reported.

• Recall intervals for oral health in primary care patients 2020 · Cochrane All outcomes

  4 years
  MD 34.00 [9.78, 58.22]
  1 study · 375 participants
  GRADE not reported

Povidone iodine rinse vs Saline rinse or placebo

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  Adverse effects (Seguin 2014): no evidence of a difference in acute respiratory distress syndrome (RR 11.00, 95% CI 0.62 to 195.61), agitation and/or hypertension (RR 0.48, 95% CI 0.12 to 1.86), epistaxis (RR 0.14, 95%…
  1 study
  GRADE not reported

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Electric toothbrush (self, carer or carer-assisted brushing) showed no clear difference in plaque (medium term) compared with manual toothbrush (self, carer or carer-assisted brushing) (low certainty).

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

  Medium term (6 weeks to 12 months)
  SMD 0.29 [-0.07, 0.65]
  2 studies · 120 participants
  Low
• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  Assorted plaque indices scale 0-5, 1-4 weeks; 247 participants (4 RCTs); Very Low. Uncertain effect on plaque short term: 2 studies (69 participants) favoured the electric toothbrush; 2 studies (178 participants)…
  4 studies · 247 participants
  Very low

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

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

  Long term (>12 months)
  Comparison 2.8 (reported; not GRADE-rated). One NRS (Bratel 1991, 23 participants), self-efficacy at 16 months: 10/12 people with ID using the electric toothbrush reported a preference for it, finding it easier to use…
  1 study · 23 participants
  GRADE not reported

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

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

  Short term (<6 weeks)
  Electric vs manual toothbrush. Assorted gingival indices scale 0-4, 2-4 weeks; 252 participants (4 RCTs); Low. Four studies showed no significant differences for gingival inflammation short term; data could not be…
  4 studies · 252 participants
  Low

Toothpaste with a plaque-disclosing agent vs Conventional toothpaste

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

  Short term (<6 weeks)
  Toothpaste with a plaque-disclosing agent vs conventional toothpaste, children with Down syndrome. Ainamo & Bay Gingival Bleeding Index, mean 10 days; percent mean difference 18 (intervention) vs 8 (control), P<0.001…
  1 study · 40 participants
  Very low

Toothpaste with a plaque-disclosing agent vs Conventional toothpaste

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

  Short term (<6 weeks)
  Simplified Green & Vermillion Oral Hygiene Index (plaque), mean 10 days; percent mean difference 65 (intervention) vs 15 (control), P<0.0001 favouring the disclosing-agent toothpaste; 40 participants (SoF states 80,…
  1 study · 40 participants
  Very low

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Electric toothbrush (self, carer or carer-assisted brushing) showed no clear difference in gingival inflammation (medium term) compared with manual toothbrush (self, carer or carer-assisted brushing) (moderate certainty).

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

  Medium term (6 weeks to 12 months)
  MD 0.02 [-0.06, 0.09]
  2 studies · 120 participants
  Moderate

Special manual toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

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

  Medium term (6 weeks to 12 months)
  Comparison 1.6 (graded in the Effects of interventions text; not tabulated in the SoF). Bildt 2010, Superbrush vs conventional, 4 months, 18 participants (1 RCT): carer handling of toothbrush MD 0.50 (95% CI -0.35 to…
  1 study · 18 participants
  Very low

NSAIDs vs placebo

• Oral non‐steroidal anti‐inflammatory drug therapy for lung disease in cystic fibrosis 2019 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 226 participants
  Moderate

NSAIDs vs placebo

• Oral non‐steroidal anti‐inflammatory drug therapy for lung disease in cystic fibrosis 2019 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 147 participants
  Moderate