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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.
288 questions in 13 reviews · Dental public health and special care
current versionsNo studies 73 · 25.3%Ungraded 90 · 31.3%Very low 90 · 31.3%Low 29 · 10.1%Moderate 6 · 2.1%High 0 · 0%
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 |
|---|---|---|---|
Antimicrobial mouthwash and/or nasal spray (alone or in combination), any concentration, frequency or dosage vs No treatment, saline, or water COVID-19 viral content of aerosol (when present) · Patients with suspected or confirmed COVID-19 infection Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed… (2020) · Cochrane | No data available (no included studies) | 0 studies | No studies |
Ozonisation vs No ozonisation / standard operatory Outcome NR · Dental healthcare providers (dentist, dental surgery assistant, dental hygienist, dental technologist, dental… Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | no estimate extracted | 0 studies | No studies |
High-volume evacuation (HVE) vs Conventional dental suction (low-volume evacuator / saliva ejector) Reduction in level of contamination in aerosols (CFU) during ultrasonic scaling at 40 cm from mouth · People undergoing aerosol-generating procedures (AGPs) in a dental setting Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | MD -2.30 [-5.32, 0.72] | 1 study · 6 participants | Very low |
Toothbrushing (with or without antiseptics), as part of oral hygiene care vs No toothbrushing (with or without antiseptics) Incidence of VAP · Critically ill adults receiving mechanical ventilation in ICU · Follow-up: mean 1 month Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | RR 0.61 [0.41, 0.91] | 5 studies · 910 participants | Low |
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 Change in COVID-19 viral load at site(s) of irrigation · Patients without suspected or confirmed COVID-19 infection undergoing aerosol-generating procedures (AGPs), and the… Antimicrobial mouthwashes (gargling) and nasal sprays to protect healthcare workers when undertaking… (2020) · Cochrane | No data available (no included studies) | NR | No studies |
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 Anosmia (or disturbance in sense of smell) · Patients without suspected or confirmed COVID-19 infection undergoing aerosol-generating procedures (AGPs), and the… · Assessed at a minimum of 2 weeks Antimicrobial mouthwashes (gargling) and nasal sprays to protect healthcare workers when undertaking… (2020) · Cochrane | No data available (no included studies) | NR | No studies |
Chlorhexidine vs Potassium permanganate Mortality · Critically ill patients receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | RR 1.11 [0.89, 1.38] | 2 studies | Ungraded |
Saline rinse vs Usual care (no rinse) Duration of ICU stay · Critically ill patients receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | MD -1.17 [-3.95, 1.60] | 2 studies · 324 participants | Ungraded |
Ultraviolet (UV) light air decontamination vs No UV light / standard operatory Outcome NR · Dental healthcare providers (dentist, dental surgery assistant, dental hygienist, dental technologist, dental… Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | no estimate extracted | 0 studies | No studies |
Listerine (essential oils) rinse vs Sterile water rinse Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | Listerine versus sterile water (Berry 2013): no evidence of a difference in VAP incidence; single study, high risk of bias. | 1 study | Ungraded |
Saline rinse vs Saline-soaked swab Mortality · Critically ill patients receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | RR 0.29 [0.12, 0.69] | 2 studies · 270 participants | Ungraded |
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 Incidence of symptomatic or test-positive COVID-19 infection in HCWs or patients · Patients without suspected or confirmed COVID-19 infection undergoing aerosol-generating procedures (AGPs), and the… · Assessed at a minimum of 2 weeks Antimicrobial mouthwashes (gargling) and nasal sprays to protect healthcare workers when undertaking… (2020) · Cochrane | No data available (no included studies) | NR | No studies |
Antimicrobial mouthwash and/or nasal spray (alone or in combination), any concentration, frequency or dosage vs No treatment, 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 with suspected or confirmed COVID-19 infection Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed… (2020) · Cochrane | No data available (no included studies) | 0 studies | No studies |
Sodium bicarbonate rinse (plus toothbrushing) vs Water rinse (plus toothbrushing) Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | RR 1.57 [0.62, 3.99] | 2 studies · 347 participants | Ungraded |
Antimicrobial coolant A (chlorhexidine) vs Antimicrobial coolant B (povidone iodine) Reduction in level of contamination in aerosols (CFU): chlorhexidine vs povidone iodine coolant during ultrasonic scaling · People undergoing aerosol-generating procedures (AGPs) in a dental setting Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | MD -59.30 [-64.16, -54.44] | 1 study · 20 participants | Very low |
Saline rinse vs Usual care (no rinse) Duration of mechanical ventilation · Critically ill patients receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | MD -0.40 [-2.55, 1.75] | 2 studies · 324 participants | Ungraded |
Antimicrobial coolant A (chlorhexidine) vs Antimicrobial coolant B (cinnamon extract) Reduction in level of contamination in aerosols (CFU): chlorhexidine vs cinnamon extract coolant during ultrasonic scaling · People undergoing aerosol-generating procedures (AGPs) in a dental setting Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | MD -11.90 [-35.88, 12.08] | 1 study · 40 participants | Very low |
Chlorhexidine vs Nanosil (nanosilver) Mortality · Critically ill patients receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | Chlorhexidine versus Nanosil (Khaky 2018): no evidence of a difference in mortality; single study. | 1 study | Ungraded |
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 Changes in microbiome in oral cavity, nasal cavity, oro- or nasopharynx · Healthcare workers (HCWs) treating patients with suspected or confirmed COVID-19 infection Use of antimicrobial mouthwashes (gargling) and nasal sprays by healthcare workers to protect them when… (2020) · Cochrane | No data available (no included studies) | 0 studies | No studies |
Antimicrobial mouthwash and/or nasal spray (alone or in combination), any concentration, frequency or dosage vs No treatment, saline, or water Incidence of symptomatic or test-positive COVID-19 infection in healthcare workers · Patients with suspected or confirmed COVID-19 infection · Minimum 2 weeks Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed… (2020) · Cochrane | No data available (no included studies) | 0 studies | No studies |
Triclosan rinse vs Saline rinse Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | RR 0.89 [0.71, 1.12] | 1 study · 324 participants | Ungraded |
Powered toothbrushing (as part of comprehensive oral care) vs Manual toothbrushing (standard oral care) Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | RR 0.84 [0.37, 1.91] | 1 study · 78 participants | Ungraded |
High-volume evacuation (HVE) vs No HVE Reduction in level of contamination in aerosols (CFU) at more than 1 foot from oral cavity (CCT) · People undergoing aerosol-generating procedures (AGPs) in a dental setting Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | MD -13.56 [-23.18, -3.94] | 1 study · 30 participants | Ungraded |
Cinnamon extract coolant vs Distilled water coolant Reduction in level of contamination in aerosols (CFU): cinnamon extract coolant vs distilled water during ultrasonic scaling · People undergoing aerosol-generating procedures (AGPs) in a dental setting Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | MD -644.55 [-668.70, -620.40] | 1 study · 40 participants | Very low |
Any method, procedure or policy to reduce contaminated aerosols in dental clinics vs Any other method, no treatment or combination of methods Acceptability and feasibility of the intervention to patients and dentists · Dental healthcare providers (dentist, dental surgery assistant, dental hygienist, dental technologist, dental… Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | no estimate extracted | 0 studies | No studies |
Combination system (Isolite) vs Saliva ejector (low-volume evacuator) Reduction in contamination of aerosols (CFU) after ultrasonic scaling / AGP · People undergoing aerosol-generating procedures (AGPs) in a dental setting · After AGP Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | MD -0.35 [-0.99, 0.29] | 1 study · 50 participants | Very low |
Chlorhexidine (mouthrinse or gel), as part of oral hygiene care vs Placebo or usual care Oral health indices (plaque index) · Critically ill patients (adults and children) receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | Plaque index: Fu 2019 found a significant reduction in the chlorhexidine group; Ozcaka 2012 and Scannapieco 2009 found no difference; 3 studies; no usable pooled estimate. | 3 studies | Ungraded |
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 Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | MD -2.80 [-4.65, -0.95] | 1 study · 20 participants | Ungraded |
Fumigation or fogging vs No fumigation or fogging / standard operatory Outcome NR · Dental healthcare providers (dentist, dental surgery assistant, dental hygienist, dental technologist, dental… Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | no estimate extracted | 0 studies | No studies |
Rubber dam vs No rubber dam Reduction in level of contamination in aerosols (CFU) during restorative procedures at 1 metre from mouth (CCT) · People undergoing aerosol-generating procedures (AGPs) in a dental setting Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | MD -10.10 [-19.72, -0.48] | 1 study · 20 participants | Ungraded |
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 Incidence of symptomatic or test-positive COVID-19 infection in HCWs · Healthcare workers (HCWs) treating patients with suspected or confirmed COVID-19 infection · Minimum 2 weeks Use of antimicrobial mouthwashes (gargling) and nasal sprays by healthcare workers to protect them when… (2020) · Cochrane | No data available (no included studies) | 0 studies | No studies |
High-volume evacuation (HVE) vs No HVE Reduction in level of contamination in aerosols (CFU) at less than 1 foot from oral cavity (CCTs) · People undergoing aerosol-generating procedures (AGPs) in a dental setting Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | MD -50.19 [-109.71, 9.33] | 2 studies · 45 participants | Ungraded |
Biotene OralBalance vs Control Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | Biotene OralBalance versus control (Stefanescu 2013, 41 participants): no difference in incidence of VAP; single study, high risk of bias. | 1 study · 41 participants | Ungraded |
High-volume evacuation (HVE) vs No HVE Reduction in level of contamination in aerosols (CFU) during ultrasonic scaling and air polishing at more than 1 foot from oral cavity (RCT) · People undergoing aerosol-generating procedures (AGPs) in a dental setting Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | MD -1.00 [-2.56, 0.56] | 1 study · 80 participants | Very low |
Antimicrobial mouthwash and/or nasal spray (alone or in combination), any concentration, frequency or dosage vs No treatment, saline, or water Anosmia (or disturbance in sense of smell) · Patients with suspected or confirmed COVID-19 infection · Minimum 2 weeks Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed… (2020) · Cochrane | No data available (no included studies) | 0 studies | No studies |
Chlorhexidine vs Miswak Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | Chlorhexidine versus miswak (Irani 2019): no evidence of a difference in incidence of VAP; single study. Also no difference in number treated with systemic antibiotics. | 1 study | Ungraded |
Chlorhexidine (mouthrinse or gel), as part of oral hygiene care vs Placebo or usual care Duration of mechanical ventilation · Critically ill patients (adults and children) receiving mechanical ventilation in ICU · Follow-up: mean 1 month Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | MD -1.10 [-3.20, 1.00] | 4 studies · 594 participants | Very low |
Chlorhexidine coolant vs Distilled water coolant Reduction in level of contamination in aerosols (CFU): chlorhexidine coolant vs distilled water during ultrasonic scaling · People undergoing aerosol-generating procedures (AGPs) in a dental setting Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | MD -124.00 [-135.78, -112.22] | 1 study · 20 participants | Very low |
Chlorhexidine (mouthrinse or gel), as part of oral hygiene care vs Placebo or usual care Duration of ICU stay · Critically ill patients (adults and children) receiving mechanical ventilation in ICU · Follow-up: mean 1 month Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | MD -0.89 [-3.59, 1.82] | 5 studies · 627 participants | Low |
Laminar air flow with HEPA filter vs Without laminar flow or filter Reduction in level of contamination in aerosols (CFU per cubic feet/min/patient) using Reyniers slit sampler 30 inches (76 cm) from floor · People undergoing aerosol-generating procedures (AGPs) in a dental setting Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | MD -319.14 [-385.60, -252.68] | 1 study · 50 participants | Very low |
Rubber dam vs No rubber dam Reduction in level of contamination in aerosols (CFU) during restorative procedures at operator's left ear (RCT) · People undergoing aerosol-generating procedures (AGPs) in a dental setting Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | MD 0.96 [-0.08, 2.00] | 1 study · 47 participants | Ungraded |
Powered toothbrushing (as part of comprehensive oral care) vs Manual toothbrushing (standard oral care) Duration of ICU stay · Critically ill patients receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | MD -2.00 [-5.93, 1.93] | 1 study · 78 participants | Ungraded |
Any method, procedure or policy to reduce contaminated aerosols in dental clinics vs Any other method, no treatment or combination of methods Reduction in volume of contaminated aerosols in the operative environment · Dental healthcare providers (dentist, dental surgery assistant, dental hygienist, dental technologist, dental… Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | Reduction in volume of contaminated aerosols in the operative environment: Not reported (row present in all Summary of findings tables) | 0 studies | No studies |
Chlorhexidine (mouthrinse or gel), as part of oral hygiene care vs Placebo or usual care Cost / economic data · Critically ill patients (adults and children) receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | The outcome of cost was not reported by any study in this comparison. | 0 studies | No studies |
Potassium permanganate vs Placebo Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | Potassium permanganate versus placebo (Meidani 2018): no evidence of a difference in VAP incidence; single study. | 1 study | Ungraded |
Antimicrobial mouthwash and/or nasal spray (alone or in combination), any concentration, frequency or dosage vs No treatment, saline, or water Change in COVID-19 viral load in patients · Patients with suspected or confirmed COVID-19 infection Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed… (2020) · Cochrane | No data available (no included studies) | 0 studies | No studies |
Antimicrobial mouthwash and/or nasal spray (alone or in combination), any concentration, frequency or dosage vs No treatment, saline, or water RECOVERY trial outcomes (mortality; hospitalisation status; use of ventilation; use of renal dialysis or haemofiltration) · Patients with suspected or confirmed COVID-19 infection · Minimum 2 weeks Antimicrobial mouthwashes (gargling) and nasal sprays administered to patients with suspected or confirmed… (2020) · Cochrane | No data available (no included studies) | 0 studies | No studies |
Toothbrushing (with or without antiseptics), as part of oral hygiene care vs No toothbrushing (with or without antiseptics) Oral health indices (plaque score) · Critically ill adults receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | Plaque score: one study (Yao 2011) showed evidence of reduced plaque in the toothbrushing group; no usable pooled estimate. | 1 study | Ungraded |
Combination system (Isolite) vs Saliva ejector (low-volume evacuator) Reduction in level of contamination in aerosols (CFU) during ultrasonic scaling / AGP · People undergoing aerosol-generating procedures (AGPs) in a dental setting · During AGP Interventions to reduce contaminated aerosols produced during dental procedures for preventing infectious… (2020) · Cochrane | MD -0.31 [-0.82, 0.20] | 1 study · 50 participants | Very low |
Biotene OralBalance vs Control Adverse effects · Critically ill patients receiving mechanical ventilation in ICU Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia (2020) · Cochrane | Adverse effects (Stefanescu 2013): no significant difference between groups with respect to adverse events in buccal mucosa. | 1 study | Ungraded |