What do systematic reviews say?

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

Commercial mouthcare system (Biotene Oral Balance / Xerostom) showed no clear difference in salivary flow (unstimulated whole saliva) compared with usual care or CMC-based control; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  MD 0.02 [-0.02, 0.06]
  2 studies
  GRADE not reported

V6 chewing gum / mucin chewing gum vs PTC chewing gum (xylitol/sorbitol/mannitol)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Olsson 1991 (crossover, high risk of bias, n=14): both gums increased saliva secretion, peaking 17.5 minutes after chewing started; significant treatment-by-period interaction; no per-group data presented.
  1 study · 14 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
  Approximately fivefold increase in saliva secretion; mean AUC salivary volume 43.4 +/- 9.4 (physostigmine) vs 8.3 +/- 6.6 (placebo), P < 0.001. Adverse effects: 8 mild gastrointestinal upsets, 1 sweating.
  1 study · 17 participants
  GRADE not reported

Pilocarpine lozenge (3 mg or 5 mg) vs placebo control

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes

  Single dose (up to 3 hours)
  Statistically significant increase in saliva production vs placebo (P <= 0.05); maximum salivary output 60 to 90 minutes post-lozenge; no data presented.
  1 study · 33 participants
  GRADE not reported

Intraoral device releasing Biotene Oral Balance gel vs Manually administered bolus of the same gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No difference between device and bolus in unstimulated whole saliva, oral microbial profile or generalised inflammation.
  1 study · 22 participants
  GRADE not reported

V6 chewing gum / mucin chewing gum vs Placebo chewing gum

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Aagaard 1992 (crossover, n=43): approximately 50% of participants had an increase in unstimulated whole saliva from all products; unclear how many completed the trial; no usable data.
  1 study · 43 participants
  GRADE not reported

Minimal incision palatopharyngoplasty (MIPP) vs MIPP with additional individualised velopharyngeal surgery (pharyngeal flap or sphincter pharyngoplasty)

The review found no eligible studies for this question.

• Interventions for the management of submucous cleft palate 2008 · Cochrane All outcomes
  Nasalance score by nasometry and pressure-flow measure: the single included trial (Ysunza 2001) provided no data for this outcome.
  0 studies
  No studies found

Oral cytology (e.g. OralCDx brush biopsy, CytID) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Oral cytology (e.g. brush biopsy) was added to the list of eligible index tests in this update; no eligible studies evaluated it (evidence gap).
  0 studies
  No studies found

COE with blood/salivary (biomarker) analysis vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  There were no eligible studies evaluating blood or salivary sample analysis (which tests for the presence of biomarkers for OPMD and OSCC).
  0 studies
  No studies found

Remote screening of the oral cavity (mobile application/telemedicine) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 4 (no pooled analysis): specificity 0.99 (95% CI 0.99 to 1.00), 1.00 (95% CI 0.91 to 1.00), and 0.72 (95% CI 0.63 to 0.80) across the 3 studies. Certainty VERY LOW.
  3 studies · 3600 participants
  Very low

Remote screening of the oral cavity (mobile application/telemedicine) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 4 (no pooled analysis): sensitivity 0.85 (95% CI 0.81 to 0.88), 0.82 (95% CI 0.57 to 0.96), and 0.94 (95% CI 0.70 to 1.00) across the 3 studies. Prevalence 12.2% to 30.9%. Certainty VERY LOW.
  3 studies · 3600 participants
  Very low

COE with light-based detection (e.g. ViziLite Plus, Microlux/DL, VELscope, Identafi 3000) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  There were no eligible studies evaluating light-based detection.
  0 studies
  No studies found

COE with vital rinsing (toluidine blue/tolonium chloride) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

The review found no eligible studies for this question.

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  No eligible study evaluated COE with vital rinse as a stand-alone screen against the reference standard in this version.
  0 studies
  No studies found

Mouth self-examination (MSE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 2 (no pooled analysis): specificity 1.00 (95% CI 1.00 to 1.00), 0.95 (95% CI 0.88 to 0.99), 0.44 (95% CI 0.20 to 0.70), and 0.54 (95% CI 0.37 to 0.69) across the 4 studies. Certainty VERY LOW.
  4 studies · 35059 participants
  Very low

Visual examination (VE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 1 (no pooled analysis): for the 7 low-prevalence studies specificity ranged from 0.94 (95% CI 0.88 to 0.97) to 0.99 (95% CI 0.98 to 1.00); for the 3 higher-prevalence studies specificity ranged from…
  10 studies · 25568 participants
  Low

Mouth self-examination (MSE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 2 (no pooled analysis): sensitivity 0.18 (95% CI 0.13 to 0.24), 0.09 (95% CI 0.04 to 0.15), 0.43 (95% CI 0.24 to 0.63), and 0.33 (95% CI 0.10 to 0.65) across the 4 studies. Prevalence 0.6% to 63.6%.…
  4 studies · 35059 participants
  Very low

Visual examination (VE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative)

• Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in apparently healthy… 2021 · Cochrane All outcomes
  Summary of findings 1 (no pooled analysis): for the 7 studies with low prevalence (<=10%) sensitivity ranged from 0.50 (95% CI 0.07 to 0.93) to 0.99 (95% CI 0.97 to 1.00); for the 3 higher-prevalence studies…
  10 studies · 25568 participants
  Low

Clobetasol propionate ointment vs Low-level laser therapy (LLLT)

It is very uncertain whether clobetasol propionate ointment changes pain (mean score) compared with low-level laser therapy (LLLT) (very low certainty).

• Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
  MD 0.62 [0.42, 0.82]
  1 study · 42 participants
  Very low

Clobetasol propionate ointment vs Low-level laser therapy (LLLT)

It is very uncertain whether clobetasol propionate ointment changes clinical score compared with low-level laser therapy (LLLT) (very low certainty).

• Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
  MD 0.56 [0.50, 0.62]
  1 study · 42 participants
  Very low

Clobetasol propionate ointment vs Low-level laser therapy (LLLT)

It is very uncertain whether clobetasol propionate ointment changes clinical resolution compared with low-level laser therapy (LLLT) (very low certainty).

• Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
  RR 0.46 [0.22, 0.98]
  1 study · 42 participants
  Very low