What do systematic reviews say?

Glutamine (intravenous) vs placebo

Glutamine (intravenous) 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 0.25 [0.1, 0.62]
  3 studies · 93 participants
  GRADE not reported

Chlorhexidine vs placebo/no treatment

Chlorhexidine showed no clear difference in oral mucositis (severe) compared with placebo/no treatment (low certainty).

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

  Median 28 days
  RR 0.82 [0.54, 1.23]
  4 studies · 244 participants
  Low

Carbopol (polyacrylic acid/acetate) spray vs Placebo spray

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  van der Reijden 1996 (crossover, Sjogren's syndrome): carbopol spray found partially effective; none of the sprays were completely effective; no data suitable for inclusion.
  1 study
  GRADE not reported

Honey vs no treatment

Honey 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 0.48 [0.31, 0.74]
  3 studies
  GRADE not reported

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

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Frost 2002 (crossover, n=30, Sjogren's syndrome): overall mouth dryness favoured the device but only nearly significant (median 4 (IQR 2 to 4) device vs 3 (2 to 4) control; P = 0.056). Speech (P = 0.003) and swallowing…
  1 study · 30 participants
  GRADE not reported

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

Mucin spray (Saliva Orthana) showed no clear difference in duration of relief of 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: no difference between mucin spray and placebo in the duration of relief of dryness (Analysis 1.4).
  1 study
  GRADE not reported

Chewing gum vs Saliva substitute spray

Chewing gum (mechanical saliva stimulant) led to lower patient preference compared with saliva substitute spray; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Bots 2005: statistically significant preference for chewing gum over Xialine spray, 39/49 (80%) preferred gum vs 10/49 (20%) spray (Chi2 17.16, df=1; P < 0.001) (Analysis 2.3). Davies 2000: more people preferred gum,…
  1 study · 65 participants
  GRADE not reported

Prednisone vs placebo

Prednisone showed no clear difference in 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 0.64 [0.17, 2.45]
  1 study · 66 participants
  GRADE not reported

Buffered 'Prophylin' prophylactic gel vs Placebo gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No difference between buffered gel, unbuffered gel and water for oral pH, cariogenic bacteria or Candida species.
  1 study · 14 participants
  GRADE not reported

GM-CSF vs sucralfate

GM-CSF showed no clear difference in oral mucositis (severe) compared with sucralfate; GRADE not reported.

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

  Median 28 days
  RR 0.54 [0.24, 1.21]
  1 study · 40 participants
  GRADE not reported

Betaine (BET) toothpaste (4%) vs SLS toothpaste (1%) and combined BET+SLS toothpaste

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Rantanen 2003 (crossover): relief of oral dryness BET 44% vs BET+SLS 22% (P = 0.002) vs SLS 18% (P = 0.022) vs reference toothpaste 7% (P < 0.001); betaine-only significantly better than the other toothpastes. No…
  1 study
  GRADE not reported

Low‐level laser therapy vs Povidone

Laser (low level) led to lower oral mucositis (moderate to severe) compared with povidone; GRADE not reported.

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

  Median 28 days
  RR 0.29 [0.16, 0.54]
  1 study · 50 participants
  GRADE not reported

Honey vs no treatment

Honey led to lower oral mucositis (any severity) 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 0.7 [0.56, 0.88]
  3 studies
  GRADE not reported

Beta‐carotene vs no treatment

Beta carotene showed no clear difference in oral mucositis (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 0.38 [0.14, 1.02]
  1 study · 20 participants
  GRADE not reported

Iseganan vs placebo

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

  Median 28 days
  no estimate extracted
  2 studies
  GRADE not reported

Xanthum gum-containing spray (Xialine) vs Placebo spray

Xanthum gum-containing spray (Xialine) showed no clear difference in xerostomia (EORTC dry mouth score) compared with placebo spray (base without xanthum); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Jellema 2001 (crossover, n=30, post-radiotherapy): no statistically significant difference between Xialine (xanthum gum) spray and placebo on the EORTC dry mouth score (Analysis 1.2). van der Reijden 1996: xanthum…
  2 studies · 30 participants
  GRADE not reported

Polaprezinc vs Azulene

Polaprezinc led to lower oral mucositis (severe) compared with azulene; GRADE not reported.

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

  Median 28 days
  RR 0.09 [0.01, 0.65]
  1 study · 31 participants
  GRADE not reported

Carboxymethylcellulose (CMC) spray vs Salinum linseed oil spray

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Statistically significant preference for linseed spray: of 17 with a preference, more favoured linseed (Chi2 4.77, df=1; P = 0.029); 3 expressed no preference.
  1 study · 20 participants
  GRADE not reported

CMC spray / aloe vera gel / canola oil spray vs Mucin spray (and between each other)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Momm 2005 (crossover, n=123): all four treatments significantly reduced dryness vs baseline (mean xerostomia score, scale 1 to 6: baseline 4.5 +/- 0.11; post-treatment aloe vera 3.7 +/- 0.11, CMC 3.8 +/- 0.12, canola…
  1 study · 123 participants
  GRADE not reported

Honey vs no treatment

Honey led to lower oral mucositis (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 0.26 [0.13, 0.52]
  3 studies
  GRADE not reported