What do systematic reviews say?

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
  Recurrence: outcome not reported in a usable way (Mehanna 2017: nodal recurrence 3 vs 1; distant metastases 21 vs 23).
  1 study
  GRADE not reported

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

PET-CT following chemoradiotherapy (neck dissection only if… showed no clear difference in total mortality compared with planned neck dissection before or after chemoradiotherapy (moderate certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes

  3 years
  HR 0.92 [0.65, 1.31]
  1 study · 564 participants
  Moderate

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

PET-CT following chemoradiotherapy (neck dissection only if… showed no clear difference in locoregional recurrence compared with planned neck dissection before or after chemoradiotherapy (moderate certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes

  3 years
  HR 1.00 [0.94, 1.06]
  1 study · 564 participants
  Moderate

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
  Adverse events: 22 surgical complications in the PET-CT group vs 83 in the planned-surgery group (Mehanna 2017).
  1 study · 564 participants
  Very low

PET-CT following chemoradiotherapy (neck dissection only if no/incomplete response) vs Planned neck dissection before or after chemoradiotherapy

• Interventions for the treatment of oral cavity and oropharyngeal cancers: surgical treatment 2023 · Cochrane All outcomes
  Disease-free survival: outcome not reported in a usable way (Mehanna 2017: disease-specific and other-cause mortality did not differ, P=0.80 and 0.41).
  1 study
  GRADE not reported

Tetracycline suspension (250 mg, held in mouth 2 minutes then swallowed, four times daily for 5 days) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  5 days per outbreak
  A statistically significant difference was shown, in favour of tetracycline, for adjusted maximum ulcer size (P=0.034) and adjusted maximum pain (P=0.017).
  1 study
  GRADE not reported

Tetracycline suspension (250 mg, held in mouth 2 minutes then swallowed, four times daily for 5 days) vs placebo

Tetracycline suspension (250 mg, held in mouth 2 minutes then… showed no clear difference in average number of new lesions per week compared with placebo; GRADE not reported.

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  5 days per outbreak
  MD -0.47 [-1.34, 0.40]
  1 study
  GRADE not reported

Tetracycline suspension (250 mg, held in mouth 2 minutes then swallowed, four times daily for 5 days) vs placebo

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes

  5 days per outbreak
  Adverse event rates were comparable between groups.
  1 study
  GRADE not reported

Pentoxifylline vs Placebo or no active treatment

Pentoxifylline led to lower difficulty in swallowing (participant-reported proxy) compared with placebo or no active treatment; GRADE not reported.

• Interventions for managing oral submucous fibrosis 2024 · Cochrane All outcomes
  OR 0.42 [0.19, 0.92]
  1 study · 106 participants
  GRADE not reported

Antioxidants (lycopene, curcumin, Oxitard) vs Placebo or no active treatment

Antioxidants (lycopene, curcumin, Oxitard) led to lower difficulty in swallowing (participant-reported proxy) compared with placebo or no active treatment; GRADE not reported.

• Interventions for managing oral submucous fibrosis 2024 · Cochrane All outcomes
  OR 0.24 [0.10, 0.60]
  2 studies · 220 participants
  GRADE not reported

Oxitard (antioxidant) vs Topical aloe vera gel

Oxitard (antioxidant) led to lower difficulty in swallowing (participant-reported proxy) compared with aloe vera gel; GRADE not reported.

• Interventions for managing oral submucous fibrosis 2024 · Cochrane All outcomes

  3 to 6 months
  OR 0.17 [0.07, 0.44]
  1 study · 120 participants
  GRADE not reported

Surgery +/- radiotherapy + (adjuvant) chemotherapy vs Surgery +/- radiotherapy alone (observation or adjuvant radiotherapy only)

Surgery +/- radiotherapy + (adjuvant) chemotherapy showed no clear difference in overall survival, adjuvant chemotherapy vs observation alone… compared with surgery +/- radiotherapy alone (observation or adjuvant radiotherapy… (moderate certainty).

• Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy 2021 · Cochrane All outcomes
  HR 0.95 [0.73, 1.22]
  5 studies · 353 participants
  Moderate

Pilocarpine vs placebo

• Parasympathomimetic drugs for the treatment of salivary gland dysfunction due to radiotherapy 2015 · Cochrane All outcomes
  Only two studies measured salivary flow rates (Johnson 1993; LeVeque 1993); no usable summary/pooled data reported.
  2 studies
  GRADE not reported

Consumption of xylitol chewing gum by women (mothers) vs Profylin lozenge (xylitol/sorbitol + CMC)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No change in stimulated whole saliva.
  1 study · 18 participants
  GRADE not reported

Saliva stimulant lozenge (sorbitol, Sorbee) vs Saliva substitute spray

Saliva stimulant lozenge (sorbitol, Sorbee) showed no clear difference in salivary flow (unstimulated whole saliva) compared with saliva substitute spray (MouthKote); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  MD -0.01 [-0.03, 0.02]
  1 study · 80 participants
  GRADE not reported

Various saliva stimulants (chewable tablet, lozenges, chewing gum, CMC mouthrinse/sprays; 8-arm) vs Saliva substitutes / other products

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No product had a long-term effect on stimulated whole saliva production.
  1 study · 106 participants
  GRADE not reported

Intraoral device releasing Biotene Oral Balance gel vs usual care without an aid

Intraoral device releasing Biotene Oral Balance gel showed no clear difference in salivary flow (unstimulated whole saliva) compared with usual care (no intraoral device); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  MD 0.05 [-0.04, 0.14]
  1 study · 30 participants
  GRADE not reported

Chewing gum vs Saliva substitute spray

Chewing gum (mechanical saliva stimulant) showed no clear difference in salivary flow (unstimulated whole saliva) compared with saliva substitute spray; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  MD 0.01 [-0.01, 0.04]
  2 studies
  GRADE not reported

Mucoadhesive disk (carbomer/triglycerides + antimicrobial agents) vs Placebo disk

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No difference in salivary flow rates between active and placebo disks.
  1 study
  GRADE not reported

Buffered 'Prophylin' prophylactic gel vs Placebo gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Attempts to measure saliva secretion failed because the elderly participants were unable to co-operate.
  1 study · 14 participants
  GRADE not reported