What do systematic reviews say?

Gum chewing (sugar-free) vs Pooled controls: no gum, placebo/control gum, probiotic, or fluoride varnish

In a sensitivity analysis assuming a 0.95 baseline-to-endpoint correlation for the sugar-free gum arm, the effect remained significant (SMD -0.55, 95% CI -0.80 to -0.30; 13 trials, I2 73%); certainty not formally graded.

• A systematic review and meta-analysis of the role of sugar-free chewing gum on Streptococcus mutans. 2021 All outcomes

  Final/end-of-study time point (follow-up 2 weeks to 18 months) · Schools, kindergartens, universities and community settings; adults and children; multiple countries · Sensitivity analysis: baseline-to-endpoint correlation 0.95 for SFG arm
  SMD -0.55 [-0.80, -0.30]
  13 studies · 1335 participants
  GRADE not reported
• A systematic review and meta-analysis of the role of sugar-free chewing gum on Streptococcus mutans. 2021 All outcomes

  Final/end-of-study time point (follow-up 2 weeks to 18 months) · Schools, kindergartens, universities and community settings; adults and children; multiple countries · Overall (vs all controls)
  SMD -0.42 [-0.60, -0.25]
  13 studies · 1335 participants
  GRADE not reported

Er,Cr:YSGG laser (erbium,chromium:yttrium-scandium-gallium-garnet) vs Placebo (placebo laser or placebo agent) or no treatment

Er,Cr:YSGG laser (erbium,chromium:yttrium-scandium-gallium-garnet) showed no clear difference in changes in intensity of pain (VAS 0 to 10) tested through tactile… compared with placebo (placebo laser or placebo agent) or no treatment; GRADE not reported.

• Laser therapy for dentinal hypersensitivity 2021 · Cochrane All outcomes

  Medium term (24 hours to 2 months)
  MD 0.38 [-0.13, 0.89]
  1 study
  GRADE not reported

In-office laser therapy (all types combined) vs Placebo (placebo laser or placebo agent) or no treatment

The review found no eligible studies for this question.

• Laser therapy for dentinal hypersensitivity 2021 · Cochrane All outcomes
  Outcome not measured in any of the included studies
  0 studies
  No studies found

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes adverse effects compared with placebo (very low certainty).

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes

  1st to 7th day
  RR 1.46 [0.81, 2.64]
  8 studies · 1277 participants
  Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes trismus (dichotomous, 7th day) compared with placebo (very low certainty).

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes

  7th day
  RR 0.77 [0.42, 1.41]
  3 studies · 199 participants
  Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs Placebo

The review found no eligible studies for this question.

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
  No studies: none of the 23 included trials evaluated tooth extraction in immunocompromised patients; subgroup analysis based on immune status was not possible as no such studies were identified.
  0 studies
  No studies found

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes fever (6th-7th day) compared with placebo (very low certainty).

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes

  6th to 7th day
  RR 0.66 [0.24, 1.79]
  4 studies · 475 participants
  Very low

Xylitol-only sugar-free chewing gum vs Pooled controls: no gum, placebo/control gum, probiotic, or fluoride varnish

Xylitol-only sugar-free gum significantly reduced Streptococcus mutans load versus pooled controls (SMD -0.46, 95% CI -0.64 to -0.28; 12 trials, I2 43%); certainty not formally graded.

• A systematic review and meta-analysis of the role of sugar-free chewing gum on Streptococcus mutans. 2021 All outcomes

  Final/end-of-study time point (follow-up 2 weeks to 18 months) · Schools, kindergartens, universities and community settings; adults and children; multiple countries · Overall (vs all controls)
  SMD -0.46 [-0.64, -0.28]
  12 studies · 1295 participants
  GRADE not reported

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs Placebo

The review found no eligible studies for this question.

• Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
  No studies in general dental practice for removal of decayed teeth. PUB3 added one routine intra-alveolar extraction trial and one complex oral surgery trial (2 of 23 non-third-molar), but the single intra-alveolar…
  0 studies
  No studies found

Clobetasol propionate plus miconazole (adjunctive antifungal) vs Clobetasol propionate plus placebo

• Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
  Lodi 2007: 5 cases of candidosis among 15 participants without antifungal vs 0 with adjunctive miconazole (low-certainty)
  1 study · 35 participants
  Low

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary Lactobacilli counts were unchanged in two studies but significantly increased in one study one month after BoNT (ungraded; no effect estimate reported).

• Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes

  Before vs after BoNT injection (2018 study: significant Lactobacilli increase at 1 month; Wu 2011 and 2017 study no change) · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
  No statistically significant changes in Lactobacilli CFU counts were reported by Wu et al. or by Tiigimae-Saar 2017. However, the 2018 study found that Lactobacilli CFU counts were significantly increased one month…
  3 studies
  GRADE not reported

Oral prednisone plus curcuminoids (adjunctive) vs Oral prednisone plus placebo

• Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
  Chainani-Wu 2007: no difference between adjunctive curcuminoids and placebo (recruitment stopped after interim analysis)
  1 study · 28 participants
  GRADE not reported

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 probably leads to lower incidence of VAP 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 0.67 [0.47, 0.97]
  13 studies · 1206 participants
  Moderate

Potassium permanganate vs placebo

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  Potassium permanganate versus placebo (Meidani 2018, 100 participants): no evidence of a difference in mortality; single study.
  1 study · 100 participants
  GRADE not reported

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

No included study reported salivary osmolality; this pre-planned outcome remains unassessed (no studies).

• Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes

  Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
  no estimate extracted
  0 studies
  No studies found

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 caregivers' preferences was not reported by any study in this comparison.
  0 studies
  No studies found

Topical corticosteroids vs placebo

Topical corticosteroid showed no clear difference in clinical score compared with placebo (low certainty).

• Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes

  end of treatment
  MD -0.38 [-0.89, 0.14]
  1 study · 32 participants
  Low

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

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

BoNT injections were not associated with significant changes in salivary S. mutans counts across three studies (ungraded; no effect estimate reported).

• Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes

  Before vs after BoNT injection · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
  The RCT by Wu et al. reported no statistically significant changes in S. mutans CFU counts (p-values only). The studies of Tiigimae-Saar did not find statistically significant differences in S. mutans CFU counts either.
  3 studies
  GRADE not reported

Povidone iodine rinse vs Saline rinse or placebo

Povidone iodine rinse showed no clear difference in mortality compared with saline rinse or placebo; GRADE not reported.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  RR 1.00 [0.66, 1.50]
  2 studies · 217 participants
  GRADE not reported