What do systematic reviews say?

250 questions · 288 findings · 13 reviews · Dental public health and special care

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No studies found 73 · 25.3%GRADE not reported 90 · 31.3%Very low 90 · 31.3%Low 29 · 10.1%Moderate 6 · 2.1%High 0 · 0%

Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to the patient or HCW before and/or after an AGP vs No treatment or saline or water

Changes in microbiome in oral cavity, nasal cavity, oro- or nasopharynx · Patients without suspected or confirmed COVID-19 infection undergoing aerosol-generating procedures (AGPs), and the healthcare workers…

The review found no eligible studies for this question.

1 finding from 1 review

Antimicrobial mouthwashes (gargling) and nasal sprays to protect healthcare workers when undertaking… 2020 · Cochrane All outcomes
No data available (no included studies)
Studies not reported
No studies found

Saline rinse vs Saline-soaked swab

Duration of mechanical ventilation · Critically ill patients receiving mechanical ventilation in ICU

Saline rinse led to lower duration of mechanical ventilation compared with saline-soaked swab; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
MD -6.83 [-8.94, -4.72]
2 studies · 176 participants
GRADE not reported

Saline rinse plus swab vs Saline-soaked swab

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Saline rinse plus swab led to lower incidence of VAP compared with saline-soaked swab alone (usual care); GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 0.41 [0.23, 0.72]
2 studies · 153 participants
GRADE not reported

Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to the patient or HCW before and/or after an AGP vs No treatment or saline or water

Other adverse events (allergy, irritation/burning of nasal, oral or oropharyngeal mucosa, long-term staining of mucous membranes or teeth, accidental ingestion) · Patients without suspected or confirmed COVID-19 infection undergoing aerosol-generating procedures (AGPs), and the healthcare workers…

The review found no eligible studies for this question.

1 finding from 1 review

Antimicrobial mouthwashes (gargling) and nasal sprays to protect healthcare workers when undertaking… 2020 · Cochrane All outcomes
No data available (no included studies)
Studies not reported
No studies found

General ventilation (e.g. natural ventilation, exhaust fans, opening windows) vs No general ventilation / standard operatory

Outcome not reported · Dental healthcare providers (dentist, dental surgery assistant, dental hygienist, dental technologist, dental laboratory staff, dental…

The review found no eligible studies for this question.

1 finding from 1 review

Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases 2020 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

High-volume evacuation (HVE) vs No HVE

Reduction in contamination of aerosols on operator's face shield/mask (RCTs) · People undergoing aerosol-generating procedures (AGPs) in a dental setting

High-volume evacuation (HVE) showed no clear difference in reduction in contamination of aerosols on operator's face… compared with no HVE; GRADE not reported.

1 finding from 1 review

Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases 2020 · Cochrane All outcomes
MD -15.71 [-46.37, 14.95]
2 studies · 42 participants
GRADE not reported

Rubber dam vs No rubber dam

Reduction in level of contamination in aerosols (CFU) during restorative procedures at operator's submental region (RCT) · People undergoing aerosol-generating procedures (AGPs) in a dental setting

Rubber dam showed no clear difference in reduction in level of contamination in aerosols (CFU) during… compared with no rubber dam; GRADE not reported.

1 finding from 1 review

Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases 2020 · Cochrane All outcomes
MD 0.52 [-0.11, 1.16]
1 study · 47 participants
GRADE not reported

Any method, procedure or policy to reduce contaminated aerosols in dental clinics vs Any other method, no treatment or combination of methods

Cost of the intervention · Dental healthcare providers (dentist, dental surgery assistant, dental hygienist, dental technologist, dental laboratory staff, dental…

The review found no eligible studies for this question.

1 finding from 1 review

Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases 2020 · Cochrane All outcomes
no estimate extracted
0 studies
No studies found

Rubber dam vs No rubber dam

Reduction in level of contamination in aerosols (CFU) during restorative procedures at operator's occiput (RCT) · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether rubber dam changes reduction in level of contamination in aerosols (CFU) during… compared with no rubber dam (very low certainty).

1 finding from 1 review

Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases 2020 · Cochrane All outcomes
MD 0.77 [-0.46, 2.00]
1 study · 47 participants
Very low

Rubber dam vs No rubber dam

Reduction in level of contamination in aerosols (CFU) during restorative procedures at 2 metres from mouth (CCT) · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether rubber dam changes reduction in level of contamination in aerosols (CFU) during… compared with no rubber dam (very low certainty).

2 findings from 1 review

Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases 2020 · Cochrane All outcomes
MD -11.70 [-15.82, -7.58]
1 study · 10 participants
Very low
Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious diseases 2020 · Cochrane All outcomes
MD -2.80 [-4.65, -0.95]
1 study · 20 participants
GRADE not reported

Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to healthcare workers, with or without the same intervention given to the patients with COVID-19 vs No treatment or saline or water

Anosmia (or disturbance in sense of smell) · Healthcare workers (HCWs) treating patients with suspected or confirmed COVID-19 infection

The review found no eligible studies for this question.

1 finding from 1 review

Use of antimicrobial mouthwashes (gargling) and nasal sprays by healthcare workers to protect them when treating… 2020 · Cochrane All outcomes
Minimum 2 weeks
No data available (no included studies)
0 studies
No studies found

Chlorhexidine vs Nanosil (nanosilver)

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Chlorhexidine versus Nanosil (Khaky 2018): some evidence of a benefit for Nanosil; single study, not replicated, interpret with caution.
1 study
GRADE not reported

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

Incidence of VAP · Critically ill patients (adults and children) receiving mechanical ventilation in ICU

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).

1 finding from 1 review

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

Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to healthcare workers, with or without the same intervention given to the patients with COVID-19 vs No treatment or saline or water

Viral content of aerosol · Healthcare workers (HCWs) treating patients with suspected or confirmed COVID-19 infection

The review found no eligible studies for this question.

1 finding from 1 review

Use of antimicrobial mouthwashes (gargling) and nasal sprays by healthcare workers to protect them when treating… 2020 · Cochrane All outcomes
No data available (no included studies)
0 studies
No studies found

Triclosan rinse vs Saline rinse

Duration of ICU stay · Critically ill patients receiving mechanical ventilation in ICU

Triclosan rinse led to lower duration of ICU stay compared with saline rinse; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
MD -4.97 [-5.55, -4.39]
1 study · 324 participants
GRADE not reported

Hydrogen peroxide vs Normal saline

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Hydrogen peroxide versus normal saline (Nobahar 2016): a reduction in VAP was found; single study, not replicated, interpret with caution.
1 study
GRADE not reported

Potassium permanganate vs placebo

All‐cause mortality · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

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

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

Caregivers' preferences for oral hygiene care · Critically ill patients (adults and children) receiving mechanical ventilation in ICU

The review found no eligible studies for this question.

1 finding from 1 review

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

Chlorhexidine vs Potassium permanganate

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Chlorhexidine showed no clear difference in incidence of VAP compared with potassium permanganate; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 0.87 [0.50, 1.52]
2 studies
GRADE not reported

Essential oil mouthwash vs Sodium bicarbonate rinse

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Listerine versus sodium bicarbonate (Berry 2013): no evidence of a difference in VAP incidence; single study, high risk of bias.
1 study
GRADE not reported