What do systematic reviews say?

Chlorhexidine (mouthrinse or gel), as part of oral hygiene care vs placebo or usual care

Chlorhexidine (mouthrinse or gel), as part of oral hygiene care showed no clear difference in duration of ICU stay compared with placebo or usual care (low certainty).

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes

  Follow-up: mean 1 month
  MD -0.89 [-3.59, 1.82]
  5 studies · 627 participants
  Low

Chlorhexidine (mouthrinse or gel), as part of oral hygiene care vs placebo or usual care

The review found no eligible studies for this question.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  The outcome of cost was not reported by any study in this comparison.
  0 studies
  No studies found

Chlorhexidine (mouthrinse or gel), as part of oral hygiene care vs placebo or usual care

Chlorhexidine (mouthrinse or gel), as part of oral hygiene care showed no clear difference in duration of systemic antibiotic use compared with placebo or usual care; GRADE not reported.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  MD 0.65 [-0.58, 1.88]
  1 study · 146 participants
  GRADE not reported

Toothbrushing (with or without antiseptics), as part of oral hygiene care vs No toothbrushing (with or without antiseptics)

Toothbrushing (with or without antiseptics), as part of oral hygiene… showed no clear difference in mortality compared with no toothbrushing (with or without antiseptics) (low certainty).

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes

  Follow-up: mean 1 month
  RR 0.84 [0.67, 1.05]
  5 studies · 910 participants
  Low

Toothbrushing (with or without antiseptics), as part of oral hygiene care vs No toothbrushing (with or without antiseptics)

The review found no eligible studies for this question.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  This outcome was not reported by any of the studies in this comparison.
  0 studies
  No studies found

Toothbrushing (with or without antiseptics), as part of oral hygiene care vs No toothbrushing (with or without antiseptics)

Toothbrushing (with or without antiseptics), as part of oral hygiene… may leads to lower incidence of VAP compared with no toothbrushing (with or without antiseptics) (low certainty).

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes

  Follow-up: mean 1 month
  RR 0.61 [0.41, 0.91]
  5 studies · 910 participants
  Low

Toothbrushing (with or without antiseptics), as part of oral hygiene care vs No toothbrushing (with or without antiseptics)

Toothbrushing (with or without antiseptics), as part of oral hygiene… showed no clear difference in duration of mechanical ventilation compared with no toothbrushing (with or without antiseptics) (low certainty).

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes

  Follow-up: mean 1 month
  MD -0.43 [-1.17, 0.30]
  4 studies · 810 participants
  Low

Toothbrushing (with or without antiseptics), as part of oral hygiene care vs No toothbrushing (with or without antiseptics)

The review found no eligible studies for this question.

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  The outcome of cost was not reported by any study in this comparison.
  0 studies
  No studies found

Toothbrushing (with or without antiseptics), as part of oral hygiene care vs No toothbrushing (with or without antiseptics)

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
  Adverse effects: information from two studies, which stated that there were none; very low certainty. There is a lack of evidence about adverse effects.
  2 studies
  Very low

Toothbrushing (with or without antiseptics), as part of oral hygiene care vs No toothbrushing (with or without antiseptics)

It is very uncertain whether toothbrushing (with or without antiseptics), as part of oral hygiene… changes duration of ICU stay compared with no toothbrushing (with or without antiseptics) (very low certainty).

• Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes

  Follow-up: mean 1 month
  MD -1.89 [-3.52, -0.27]
  3 studies · 749 participants
  Very low

Oral hygiene interventions (mechanical plaque removal): knowledge-based, behavioural, or skills training for people with ID or their carers vs Usual care, no care, or a similar alternative intervention

The review found no eligible studies for this question.

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
  No studies measured dental caries levels. One RCT (Shaw 1991, Comparison 5) assessed DMFT at baseline only and did not report caries at any later time point.
  0 studies
  No studies found

Oral hygiene interventions (mechanical plaque removal): knowledge-based, behavioural, or skills training for people with ID or their carers vs Usual care, no care, or a similar alternative intervention

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
  Adverse/unintended effects addressed narratively: 10 of 34 studies investigated or reported negative unintended or adverse effects (e.g. difficulty with the electric or 3-headed toothbrushes, being frightened by the…
  10 studies
  GRADE not reported

Oral hygiene interventions (mechanical plaque removal): knowledge-based, behavioural, or skills training for people with ID or their carers vs Usual care, no care, or a similar alternative intervention

The review found no eligible studies for this question.

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes
  No studies measured quality of life changes or long-term, patient-centred outcomes as formal outcomes; some studies commented on quality of life only in the discussion or conclusion sections.
  0 studies
  No studies found

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… may leads to lower calculus (long term) compared with usual care (no specific treatment) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  MD -2.00 [-2.64, -1.36]
  1 study · 304 participants
  Low

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… may leads to lower gingival pocketing (long term) compared with usual care (no specific treatment) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  MD -0.60 [-0.97, -0.23]
  1 study · 304 participants
  Low

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… may leads to lower plaque (long term) compared with usual care (no specific treatment) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  MD -0.70 [-1.28, -0.12]
  1 study · 304 participants
  Low

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene instruction with or without scale and polish) plus daily supervised toothbrushing by carers vs usual care

Scheduled dental recall intervals (1-, 3- or 6-monthly; oral hygiene… showed no clear difference in gingival bleeding (long term) compared with usual care (no specific treatment) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  MD -0.20 [-0.86, 0.46]
  1 study · 304 participants
  Low

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

Educational intervention with information and practical components… showed no clear difference in denture plaque compared with (Optimised) usual care (low certainty).

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes

  3 to 60 months
  SMD -0.60 [-1.25, 0.05]
  5 studies · 816 participants
  Low

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes

  6 to 18 months
  SoF: Caries/root caries (follow-up 6 to 18 months). No meta-analysis. 178 participants (2 RCTs); low quality. Comment: 2 studies at unclear (Frenkel 2001) or high risk of bias (Mojon 1998) showed no apparent…
  2 studies · 178 participants
  Low

Educational intervention with information and practical components (theoretical oral health education plus practical skills training) for nursing staff and/or residents vs (Optimised) usual care

Educational intervention with information and practical components… showed no clear difference in nutritional status compared with (Optimised) usual care; GRADE not reported.

• Oral health educational interventions for nursing home staff and residents 2016 · Cochrane All outcomes
  OR 1.0 [0.3, 3.1]
  1 study
  GRADE not reported