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Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.
1,325 questions in 34 reviews · Oral medicine and oral cancer
current versionsNo studies 164 · 12.4%Ungraded 841 · 63.5%Very low 209 · 15.8%Low 72 · 5.4%Moderate 38 · 2.9%High 1 · 0.1%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Allopurinol mouthwash vs Placebo Time to heal mucositis (days) · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis Interventions for treating oral mucositis for patients with cancer receiving treatment (2010) · Cochrane | MD -4.50 [-5.77, -3.23] | 1 study · 44 participants | Ungraded |
Hydromorphone vs Morphine Average pain scores (0-100 VAS) · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis Interventions for treating oral mucositis for patients with cancer receiving treatment (2010) · Cochrane | MD 0.60 [-9.24, 10.44] | 1 study · 56 participants | Ungraded |
Vitamin E (topical) vs Vitamin E (swallowed) Mucositis eradicated · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis Interventions for treating oral mucositis for patients with cancer receiving treatment (2010) · Cochrane | RR 53.74 [3.41, 846.84] | 1 study · 63 participants | Ungraded |
Altered fractionation radiotherapy (hyperfractionated and/or accelerated) vs Conventional (standard) fractionation radiotherapy Mortality · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and… · 5 years, Studies at low risk of bias (sensitivity analysis) Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy (2010) · Cochrane | HR 0.93 [0.80, 1.07] | 5 studies · 1511 participants | Moderate |
Pre-operative radiotherapy (plus surgery) vs Surgery alone Total mortality · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and… Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy (2010) · Cochrane | HR 0.83 [0.64, 1.07] | 1 study | Ungraded |
Morphine vs Tricyclic antidepressant (nortriptyline) Average pain scores (0-100 VAS) · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis Interventions for treating oral mucositis for patients with cancer receiving treatment (2010) · Cochrane | MD -19.10 [-31.01, -7.19] | 1 study · 39 participants | Ungraded |
Accelerated radiotherapy (no split, boost or hyperfractionation) vs Conventional (standard) fractionation radiotherapy Locoregional control · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and… Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy (2010) · Cochrane | Accelerated vs conventional, locoregional control: one trial (Skladowski 2006); a statistically significant difference in favour of the altered fractionation was shown (Analysis 1.2). No numeric estimate given. | 1 study | Ungraded |
Higher total dose radiotherapy (76.8 Gy over 6.4 weeks) vs Conventional/standard total dose radiotherapy (72 Gy) Locoregional control · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and… Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy (2010) · Cochrane | HR 0.78 [0.55, 1.11] | 1 study | Ungraded |
Hyperfractionated/accelerated/split-course radiotherapy vs Conventional (standard) fractionation radiotherapy Locoregional control · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and… Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy (2010) · Cochrane | HR 0.86 [0.74, 1.01] | 4 studies · 1299 participants | Ungraded |
Hyperfractionated/accelerated radiotherapy vs Conventional (standard) fractionation radiotherapy Total mortality · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and… Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy (2010) · Cochrane | HR 0.87 [0.75, 1.00] | 4 studies · 1071 participants | Ungraded |
Clotrimazole 50 mg (partially absorbed) vs Clotrimazole 10 mg (partially absorbed) Mycological: eradication of oral candidiasis · Patients with cancer receiving chemotherapy and/or radiotherapy with overt oral candidiasis Interventions for treating oral candidiasis for patients with cancer receiving treatment (2010) · Cochrane | RR 2.00 [1.11, 3.60] | 1 study · 52 participants | Ungraded |
Pre-operative and post-operative radiotherapy vs Post-operative radiotherapy alone Total mortality · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and… Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy (2010) · Cochrane | HR 0.67 [0.35, 1.28] | 1 study | Ungraded |
Altered fractionation radiotherapy plus chemotherapy vs Chemoradiotherapy with standard (conventional) fractionation Outcome NR · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and… Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy (2010) · Cochrane | Discussion: 'there are no completed trials of altered fractionation plus chemotherapy versus chemoradiotherapy with standard fractionation.' | 0 studies | No studies |
Granulocyte macrophage-colony stimulating factor (GM-CSF) vs Povidone iodine Time to heal mucositis (days) · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis Interventions for treating oral mucositis for patients with cancer receiving treatment (2010) · Cochrane | MD -3.50 [-4.14, -2.86] | 1 study · 31 participants | Ungraded |
Accelerated radiotherapy (no split, boost or hyperfractionation) vs Conventional (standard) fractionation radiotherapy Disease free survival · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and… Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy (2010) · Cochrane | Accelerated vs conventional, disease free survival: both trials reported this, but substantial clinical and statistical heterogeneity (P = 0.0004, I2 = 92%) meant a pooled analysis was not reported (Analysis 1.3). | 2 studies | Ungraded |
Hyperfractionated/accelerated split-course radiotherapy vs Accelerated radiotherapy with concomitant boost Disease free survival · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and… Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy (2010) · Cochrane | Fu 1995: no significant difference in disease free survival; data not presented in a way that allows calculation of an HR. | 1 study · 75 participants | Ungraded |
Altered fractionation radiotherapy (hyperfractionated and/or accelerated) vs Conventional (standard) fractionation radiotherapy Locoregional control · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and… Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy (2010) · Cochrane | HR 0.79 [0.70, 0.89] | 11 studies | Ungraded |
Pre-operative radiotherapy (plus surgery) vs Surgery alone Locoregional control · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and… · Timing unclear Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy (2010) · Cochrane | RR 0.63 [0.28, 1.46] | 1 study | Ungraded |
Altered fractionation radiotherapy vs Chemoradiotherapy (concurrent, standard fractionation) Outcome NR · People with primary squamous cell carcinoma of the oral cavity (ICD-O C01-C06) or oropharynx (ICD-O C09-C10); head and… Interventions for the treatment of oral cavity and oropharyngeal cancer: radiotherapy (2010) · Cochrane | Discussion: altered fractionation radiotherapy 'has not been directly compared to chemoradiotherapy'. No eligible head-to-head trials. | 0 studies | No studies |
Polyvariant intramuscular immunoglobulin vs Placebo Improvement in mucositis · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis Interventions for treating oral mucositis for patients with cancer receiving treatment (2010) · Cochrane | RR 1.81 [1.24, 2.65] | 1 study · 80 participants | Ungraded |
Aciclovir (oral or intravenous) for treatment vs Placebo Time to complete healing of lesions · Patients being treated for cancer with established oral HSV infection (bone marrow transplant recipients /… Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | Two studies. Median time to total healing was shorter for patients receiving oral or intravenous aciclovir than placebo: median of 8 days versus 21 days, P = 0.01 (Shepp 1985); 13.9 days versus 20.7 days, P = 0.08… | 2 studies | Ungraded |
Prophylactic aciclovir (oral or intravenous) vs Placebo Amount of analgesia · Patients being treated for cancer (predominantly haematological malignancies) Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | None of the prophylactic aciclovir versus placebo trials reported on amount of analgesia. For prevention or treatment, no trials reported on duration of hospital stay, amount of analgesia or patient quality of life. | 0 studies | No studies |
Aciclovir (oral or intravenous) for treatment vs Placebo Recurrence of lesions · Patients being treated for cancer with established oral HSV infection (bone marrow transplant recipients /… Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | For the treatment comparison (aciclovir versus placebo), no data were available for recurrence of lesions, amount of analgesia, days of stay in hospital, cost of oral care or patient quality of life. | 0 studies | No studies |
Aciclovir (oral or intravenous) for treatment vs Placebo Duration of viral shedding · Patients being treated for cancer with established oral HSV infection (bone marrow transplant recipients /… Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | Two studies. Statistically significant difference in median duration of virus shedding in favour of intravenous aciclovir (2.5 days versus 17.0 days, P = 0.0002; Meyers 1982) and oral aciclovir (2 days versus more than… | 2 studies | Ungraded |
Prophylactic aciclovir (oral or intravenous) vs Placebo Patient quality of life · Patients being treated for cancer (predominantly haematological malignancies) Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | None of the prophylactic aciclovir versus placebo trials reported on patient quality of life. For prevention or treatment, no trials reported on duration of hospital stay, amount of analgesia or patient quality of life. | 0 studies | No studies |
Aciclovir (oral or intravenous) for treatment vs Placebo Relief of pain · Patients being treated for cancer with established oral HSV infection (bone marrow transplant recipients /… Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | Time to first decrease in pain was significantly shorter in favour of oral aciclovir (median 3 days versus 16 days, P = 0.04; Shepp 1985). Time to complete resolution of pain was shorter with oral aciclovir than… | 2 studies | Ungraded |
Prophylactic valaciclovir (lower dose) vs Prophylactic valaciclovir (higher dose) Presence/absence of HSV oral lesions · Patients being treated for cancer (acute leukaemia; chemotherapy or stem-cell transplantation) Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | RR 0.23 [0.05, 1.03] | 2 studies · 181 participants | Ungraded |
Aciclovir (oral or intravenous) for treatment vs Placebo Days stay in hospital · Patients being treated for cancer with established oral HSV infection (bone marrow transplant recipients /… Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | For the treatment comparison (aciclovir versus placebo), no data were available for recurrence of lesions, amount of analgesia, days of stay in hospital, cost of oral care or patient quality of life. | 0 studies | No studies |
Prophylactic aciclovir (oral or intravenous) vs Placebo Viral isolates (HSV isolates identified, with or without clinical symptoms) · Patients being treated for cancer (predominantly haematological malignancies) Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | RR 0.17 [0.07, 0.37] | 9 studies · 511 participants | Ungraded |
Aciclovir (oral or intravenous) for treatment vs Placebo Amount of analgesia · Patients being treated for cancer with established oral HSV infection (bone marrow transplant recipients /… Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | For the treatment comparison (aciclovir versus placebo), no data were available for recurrence of lesions, amount of analgesia, days of stay in hospital, cost of oral care or patient quality of life. | 0 studies | No studies |
Prophylactic valaciclovir (lower dose) vs Prophylactic valaciclovir (higher dose) Viral isolates · Patients being treated for cancer (acute leukaemia; chemotherapy or stem-cell transplantation) Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | Orlowski 2004: 182 throat swabs performed for patients receiving 500 mg of valaciclovir (n = 40) and 198 swabs for those receiving 1000 mg (n = 41); all of the cultures proved negative (1 trial, 81; not estimable). | 1 study · 81 participants | Ungraded |
Prophylactic aciclovir (oral or intravenous) vs Prophylactic valaciclovir (oral) Presence/absence of HSV oral lesions · Patients being treated for cancer (predominantly haematological malignancies) Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | RR 0.78 [0.26, 2.38] | 2 studies · 181 participants | Ungraded |
Prophylactic aciclovir (oral or intravenous) vs Placebo Presence/absence of HSV oral lesions · Patients being treated for cancer (predominantly haematological malignancies) Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | RR 0.16 [0.08, 0.31] | 9 studies · 398 participants | Ungraded |
Prophylactic aciclovir (oral or intravenous) vs Placebo Days stay in hospital · Patients being treated for cancer (predominantly haematological malignancies) Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | For prevention or treatment, no trials reported on duration of hospital stay, amount of analgesia or patient quality of life. | 0 studies | No studies |
Aciclovir (oral or intravenous) for treatment vs Placebo Patient quality of life · Patients being treated for cancer with established oral HSV infection (bone marrow transplant recipients /… Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | For the treatment comparison (aciclovir versus placebo), no data were available for recurrence of lesions, amount of analgesia, days of stay in hospital, cost of oral care or patient quality of life. | 0 studies | No studies |
Prophylactic aciclovir (oral or intravenous) vs Placebo Recurrence of lesions · Patients being treated for cancer (predominantly haematological malignancies) Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | Recurrence of lesions was a planned secondary outcome; no included trial reported data for this outcome in the prophylactic aciclovir versus placebo comparison. | 0 studies | No studies |
Prophylactic valaciclovir (lower dose) vs Prophylactic valaciclovir (higher dose) Adverse effects · Patients being treated for cancer (acute leukaemia; chemotherapy or stem-cell transplantation) Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | One study reported adverse effects (Warkentin 2002). Twenty patients allocated to receive high dose valaciclovir reported adverse effects (42%); for the low dose group this number was 27 (52%). Adverse effects were… | 1 study · 100 participants | Ungraded |
Prophylactic aciclovir (oral or intravenous) vs Prophylactic valaciclovir (oral) Cost of oral care · Patients being treated for cancer (predominantly haematological malignancies) Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | Only one trial reported on the cost of prophylaxis for HSV (Liesveld 2002). The reported mean pharmacy costs for those randomised to receive aciclovir were $1080 compared to $320 for those initially randomised to… | 1 study · 30 participants | Ungraded |
Aciclovir (oral or intravenous) for treatment vs Placebo Adverse effects · Patients being treated for cancer with established oral HSV infection (bone marrow transplant recipients /… Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | Adverse effects were assessed in both studies. For intravenous aciclovir the most commonly reported adverse effect was a reaction at the injection site (8 (16%) aciclovir versus 3 (7%) placebo; all patients, n = 97);… | 2 studies | Ungraded |
Aciclovir (oral or intravenous) for treatment vs Placebo Cost of oral care · Patients being treated for cancer with established oral HSV infection (bone marrow transplant recipients /… Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | For the treatment comparison (aciclovir versus placebo), no data were available for recurrence of lesions, amount of analgesia, days of stay in hospital, cost of oral care or patient quality of life. | 0 studies | No studies |
Prophylactic prostaglandin E (oral) vs Placebo Viral isolates · Patients being treated for cancer (leukaemia) Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | RR 1.87 [1.12, 3.14] | 1 study · 60 participants | Ungraded |
Prophylactic aciclovir (oral or intravenous) vs Placebo Adverse effects · Patients being treated for cancer (predominantly haematological malignancies) Interventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer (2009) · Cochrane | Adverse effects were reported in nine trials. Diagnosis was by evaluation of clinical signs and symptoms (e.g. rash, neurological impairment) and by laboratory tests including renal and hepatic function. None of the… | 9 studies | Ungraded |
Two-phase oil-water mouthrinse (0.05% cetylpyridinium chloride) vs Essential oils mouthrinse (Listerine) Organoleptic assessment of halitosis · Adults over 18 years with a clinical or self-assessed diagnosis of halitosis, without significant comorbidity (e.g.… · 6 weeks Mouthrinses for the treatment of halitosis (2008) · Cochrane | Kozlovsky 1996 (6-week parallel comparison): mean organoleptic score (scale 0 to 5). Two-phase oil-water (0.05% cetylpyridinium chloride): 2.14 (SD 0.88) at baseline to 0.42 (SD 0.55) at week 6 (about 80% reduction);… | 1 study · 50 participants | Ungraded |
Cetylpyridinium chloride + essential oils + chlorine dioxide + zinc mouthrinse (Breath Rx) vs Placebo Adverse events · Adults over 18 years with a clinical or self-assessed diagnosis of halitosis, without significant comorbidity (e.g.… · 4 weeks Mouthrinses for the treatment of halitosis (2008) · Cochrane | Borden 2002: 13 adverse events were reported in the trial, but the investigators concluded that none were likely to be related to product usage. | 1 study | Ungraded |
Minimal incision palatopharyngoplasty (MIPP) vs MIPP with additional individualised velopharyngeal surgery (pharyngeal flap or sphincter pharyngoplasty) Quality of life (self or carer evaluated, validated questionnaires) · Children or adolescents aged 3 years or older with velopharyngeal insufficiency (VPI) associated with non-syndromic… Interventions for the management of submucous cleft palate (2008) · Cochrane | No data were available for this patient-reported outcome in the single included trial. | 0 studies | No studies |
Systemic oral acyclovir vs Placebo or no treatment Number of individuals with oral lesions (8 days after administration); time to healing of oral lesions · Children and young adults under 25 years with primary herpetic gingivostomatitis (with or without herpes labialis) · 8 days after administration Acyclovir for treating primary herpetic gingivostomatitis (2008) · Cochrane | RR 0.10 [0.02, 0.38] | 1 study · 72 participants | Ungraded |
Minimal incision palatopharyngoplasty (MIPP) vs MIPP with additional individualised velopharyngeal surgery (pharyngeal flap or sphincter pharyngoplasty) Instrumental assessment: nasalance score (nasometry and pressure-flow measure) · Children or adolescents aged 3 years or older with velopharyngeal insufficiency (VPI) associated with non-syndromic… Interventions for the management of submucous cleft palate (2008) · Cochrane | Nasalance score by nasometry and pressure-flow measure: the single included trial (Ysunza 2001) provided no data for this outcome. | 0 studies | No studies |
Systemic oral acyclovir vs Placebo or no treatment Number of individuals who developed new extraoral lesions after administration; duration of extraoral lesions · Children and young adults under 25 years with primary herpetic gingivostomatitis (with or without herpes labialis) · After administration Acyclovir for treating primary herpetic gingivostomatitis (2008) · Cochrane | RR 0.04 [0.00, 0.65] | 1 study · 72 participants | Ungraded |
Cetylpyridinium chloride + essential oils + chlorine dioxide + zinc mouthrinse (Breath Rx) vs Placebo Halimeter-assessed volatile sulphur compounds (VSC) (mean change from baseline) · Adults over 18 years with a clinical or self-assessed diagnosis of halitosis, without significant comorbidity (e.g.… · 4 weeks Mouthrinses for the treatment of halitosis (2008) · Cochrane | Borden 2002: mean change in halimeter-assessed VSC (ppb). Breath Rx: -66.84 at 2 weeks (67.65% reduction), -77.87 at 4 weeks (78.82% reduction); Placebo: -39.86 at 2 weeks, -36.77 at 4 weeks (41.75%). No between-group… | 1 study | Ungraded |
Chlorine dioxide + zinc mouthrinse (Oxygene) vs Placebo Halimeter-assessed volatile sulphur compounds (VSC) (mean change from baseline) · Adults over 18 years with a clinical or self-assessed diagnosis of halitosis, without significant comorbidity (e.g.… · 4 weeks Mouthrinses for the treatment of halitosis (2008) · Cochrane | Borden 2002: mean change in halimeter-assessed VSC (ppb). Oxygene: -47.63 at 2 weeks (64.97% reduction), -53.28 at 4 weeks (72.67% reduction); Placebo: -39.86 at 2 weeks, -36.77 at 4 weeks (41.75%). No between-group… | 1 study | Ungraded |