What do systematic reviews say?

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

Dental stent vs no treatment

Dental stent showed no clear difference in oral mucositis (moderate to severe) compared with no treatment; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.84 [0.62, 1.15]
  1 study · 43 participants
  GRADE not reported

Mucin spray (Saliva Orthana) vs Placebo spray (base without mucin)

Mucin spray (Saliva Orthana) showed no clear difference in xerostomia (VAS mouth dryness) compared with placebo spray (base without mucin); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Duxbury 1989 (crossover): statistically significant improvement in dry mouth on a VAS favouring the mucin spray group (Analysis 1.2; SMD not numerically reported).
  1 study
  GRADE not reported

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs no treatment

Cryotherapy (ice chips) led to lower oral mucositis (moderate to severe) compared with no treatment; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.53 [0.31, 0.91]
  5 studies
  GRADE not reported

Chlorhexidine vs Cryotherapy (ice chips) 60 minutes

Chlorhexidine showed no clear difference in oral mucositis (any severity) compared with cryotherapy (ice chips); GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 1.03 [0.76, 1.41]
  1 study · 133 participants
  GRADE not reported

Physostigmine gel (1.8 mg) vs Placebo gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Khosravani 2009 (crossover, low risk of bias, n=17): reduction in oral dryness (VAS area-under-curve over first 180 minutes) after 1.8 mg physostigmine gel; reported graphically, not usable for meta-analysis.
  1 study · 17 participants
  GRADE not reported

Commercial mouthcare system (Biotene Oral Balance / Xerostom) vs Usual care or CMC-based control

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Ship 2007 reported xerostomia-related quality of life; no usable comparative data.
  1 study
  GRADE not reported

Benzydamine vs placebo

Benzydamine led to lower oral mucositis (severe) compared with placebo; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.55 [0.38, 0.82]
  1 study · 81 participants
  GRADE not reported

Allopurinol mouthrinse vs placebo/no treatment

Allopurinol mouthrinse led to lower oral mucositis (moderate to severe) compared with placebo/no treatment; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.66 [0.5, 0.86]
  2 studies
  GRADE not reported

Prostaglandin vs placebo

Prostaglandin showed no clear difference in oral mucositis (moderate to severe) compared with placebo; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.95 [0.81, 1.11]
  1 study · 83 participants
  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

Mucin-containing lozenge vs placebo control

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Patient preference strongly favoured the mucin lozenge (P < 0.001, binomial test).
  1 study · 42 participants
  GRADE not reported

Chinese herbal medicines vs Control (Dobell's solution)

Chinese herbs (medicine) led to lower oral mucositis (moderate to severe) compared with control (Dobell's solution); GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.27 [0.09, 0.77]
  1 study · 147 participants
  GRADE not reported

Zinc sulphate vs placebo

Zinc sulphate led to lower oral mucositis (moderate to severe) compared with placebo; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.36 [0.18, 0.71]
  1 study · 27 participants
  GRADE not reported

G‐CSF vs placebo/no treatment

G-CSF showed no clear difference in oral mucositis (moderate to severe) compared with placebo/no treatment; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.81 [0.51, 1.3]
  1 study · 40 participants
  GRADE not reported

Allopurinol mouthrinse vs placebo/no treatment

Allopurinol mouthrinse showed no clear difference in oral mucositis (any severity) compared with placebo/no treatment; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.77 [0.5, 1.19]
  4 studies
  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

Amifostine vs placebo/no treatment

Amifostine led to lower oral mucositis (moderate to severe) compared with placebo/no treatment; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.75 [0.58, 0.96]
  6 studies
  GRADE not reported

Keratinocyte GF vs placebo

Keratinocyte GF may leads to lower oral mucositis (severe) compared with placebo (low certainty).

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.72 [0.58, 0.9]
  6 studies · 559 participants
  Low