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Evidence found and GRADE certainty

122 questions · 149 findings · 29 reviews · Oral Health

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No studies found 21 · 14.1%GRADE not reported 88 · 59.1%Very low 11 · 7.4%Low 27 · 18.1%Moderate 2 · 1.3%High 0 · 0%

Antiseptic mouthwash (e.g. chlorhexidine) vs Another topical agent or placebo

Adverse effects of long‐term use of available topical agents · HIV‐infected adults (> 13 years of age, per CDC) with one or more painful intraoral aphthous ulcers

The review found no eligible studies for this question.

1 finding from 1 review
  • Topical treatments for HIV‐related oral ulcers 2012 · Cochrane All outcomes
    No studies were included in this review. A total of 233 abstracts were retrieved; 25 were selected as potentially eligible but all were excluded (10 reported systemic rather than topical treatment; 3 non‐RCTs; 6…
    0 studies
    No studies found

Psychosocial interventions (cognitive behavioural therapy, biofeedback, combination CBT/biofeedback, physical self-regulation/posture self-control) vs usual care

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · Adults over 18 years of age with chronic orofacial pain (temporomandibular disorder (TMD))

Psychosocial interventions (cognitive behavioural therapy,… led to lower pain intensity (long term) compared with usual care (conservative treatment: education, counselling,…; GRADE not reported.

1 finding from 1 review

Psychosocial interventions (cognitive behavioural therapy, biofeedback, combination CBT/biofeedback, physical self-regulation/posture self-control) vs usual care

Muscle palpation pain (long term) · Adults over 18 years of age with chronic orofacial pain (temporomandibular disorder (TMD))

Psychosocial interventions (cognitive behavioural therapy,… showed no clear difference in muscle palpation pain (long term) compared with usual care (conservative treatment: education, counselling,…; GRADE not reported.

1 finding from 1 review
  • Psychosocial interventions for the management of chronic orofacial pain 2011 · Cochrane All outcomes
    Long term (more than 3 months)
    Muscle palpation pain long term (greater than 3 months): 3 studies; results not pooled owing to substantial heterogeneity (I2=64%); insufficient evidence to draw conclusions for any individual intervention. One study…
    3 studies
    GRADE not reported

Psychosocial interventions (cognitive behavioural therapy, biofeedback, combination CBT/biofeedback, physical self-regulation/posture self-control) vs usual care

Depression (long term) · Adults over 18 years of age with chronic orofacial pain (temporomandibular disorder (TMD))

Psychosocial interventions (cognitive behavioural therapy,… led to lower depression (long term) compared with usual care (conservative treatment: education, counselling,…; GRADE not reported.

1 finding from 1 review

Psychosocial interventions (cognitive behavioural therapy, biofeedback, combination CBT/biofeedback, physical self-regulation/posture self-control) vs usual care

Pain severity - impact: activity interference / disability (long term) · Adults over 18 years of age with chronic orofacial pain (temporomandibular disorder (TMD))

Psychosocial interventions (cognitive behavioural therapy,… led to lower pain severity - impact: activity interference / disability (long term) compared with usual care (conservative treatment: education, counselling,…; GRADE not reported.

1 finding from 1 review

Immediate-delayed implants (placed within 8 weeks after tooth extraction) vs Delayed implants (placed at least 2 months after extraction)

Patients' perception of how long treatment took · Patients with compromised teeth to be extracted who require single dental implants in fresh postextraction sockets

Immediate-delayed implants (placed within 8 weeks after tooth… led to lower patients' perception of how long treatment took compared with delayed implants (placed at least 2 months after extraction); GRADE not reported.

1 finding from 1 review

Direct resin composite veneer vs Indirect resin composite veneer

Restoration failure · Patients with permanent anterior teeth with intrinsic staining suitable for laminate veneer restorations
1 finding from 1 review
  • Direct versus indirect veneer restorations for intrinsic dental stains 2004 · Cochrane All outcomes
    2 years
    Meijering 1998 (data by restoration, not pooled; no statistical analysis possible). Failures over 2-year follow-up: direct resin composite (n=69) 4 absolute and 14 relative failures; indirect resin composite (n=54) 7…
    1 study · 123 participants
    GRADE not reported

Indirect veneer with no incisal edge reduction vs Indirect veneer with incisal edge reduction (1.5 mm plus short palatal bevel)

Restoration longevity · Patients receiving indirect laminate veneer restorations on permanent anterior teeth
1 finding from 1 review

Direct resin composite veneer vs Porcelain (indirect) veneer

Restoration failure · Patients with permanent anterior teeth with intrinsic staining suitable for laminate veneer restorations
1 finding from 1 review
  • Direct versus indirect veneer restorations for intrinsic dental stains 2004 · Cochrane All outcomes
    2 years
    Meijering 1998 (data by restoration, not pooled; no statistical analysis possible). Failures over 2-year follow-up: direct resin composite (n=69) 4 absolute and 14 relative failures; porcelain (n=56) 0 absolute and 3…
    1 study · 125 participants
    GRADE not reported

Ceramic inlays (all types) vs Gold inlay

Failure rate (longevity) at 5 years · Adults who require restorative treatment in posterior teeth

Ceramic inlays (all types) showed no clear difference in failure rate (longevity) at 5 years compared with gold inlay; GRADE not reported.

1 finding from 1 review

CBT vs alternative treatment

Reduction in pain intensity · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) showed no clear difference in pain intensity at treatment completion compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

2 findings from 1 review

Relaxation vs Occlusal (oral) appliance

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Relaxation showed no clear difference in pain intensity compared with occlusal (oral) appliance; GRADE not reported.

1 finding from 1 review
  • Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
    Treatment completion · Adolescents (12-19 years)
    Not pooled. Wahlund 2015: MD 3.70 (95% CI -1.21 to 8.61), n=57 (relaxation 28, appliance 29); Wahlund 2003: MD not reported, n=83 (relaxation 41, appliance 42). Both studies were in adolescents; the occlusal appliance…
    2 studies · 140 participants
    GRADE not reported

Oral care vs No oral care

Outcome not reported · Residents of nursing homes and other long-term care facilities

The review found no eligible studies for this question.

1 finding from 1 review

CBT vs alternative treatment

Mental distress · People aged 12 years and over with painful TMD lasting 3 months or longer

Cognitive behavioural therapy (CBT) may leads to lower psychological distress at follow-up compared with alternative (active) treatment (e.g. oral splint, medication,… (low certainty).

2 findings from 1 review

CBT vs inactive control (usual care care, attention control, waitlist)

Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review
  • Psychological therapies for temporomandibular disorders (TMDs) 2022 · Cochrane All outcomes
    Only 1 study reported adverse events as an outcome (Litt 2010): it found worsening symptoms in 13 people treated with an oral splint (as part of standard treatment) and 4 people treated with CBT.
    1 study · 101 participants
    Very low

Hope-based intervention vs Pain education

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People aged 12 years and over with painful TMD lasting 3 months or longer

Hope-based intervention showed no clear difference in pain intensity compared with pain education; GRADE not reported.

1 finding from 1 review

Professional oral care vs Usual oral care

Incidence of NHAP · Residents of nursing homes and other long-term care facilities
1 finding from 1 review
  • Oral care measures for preventing nursing home‐acquired pneumonia 2022 · Cochrane All outcomes
    8-30 months
    Incidence of NHAP, follow-up 8-30 months, 5018 (5 studies), Low. Not pooled (individual and cluster-randomised designs, varying effect measures and follow-up). Component estimates: Bourigault HR 0.65 (0.29 to 1.46;…
    5 studies · 5018 participants
    Low

Professional oral care vs Usual oral care

Mortality (all‐cause) · Residents of nursing homes and other long-term care facilities
1 finding from 1 review
  • Oral care measures for preventing nursing home‐acquired pneumonia 2022 · Cochrane All outcomes
    12-30 months
    All-cause mortality, follow-up 12-30 months, 3764 (3 studies), Very low. Not pooled. Adachi RR 0.80 (0.40 to 1.58; 88); Juthani-Mehta HR 1.16 (0.88 to 1.53; 834); Zimmerman adjusted IRR 0.83 (0.61 to 1.12; 1606).…
    3 studies · 3764 participants
    Very low

Hypnosis vs relaxation

Adverse events · People aged 12 years and over with painful TMD lasting 3 months or longer
1 finding from 1 review