What do systematic reviews say?

Oral care protocol vs usual care or no treatment

Oral care protocol showed no clear difference in oral mucositis (moderate to severe) compared with no treatment/usual care; GRADE not reported.

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

  Median 28 days
  RR 0.91 [0.82, 1.02]
  1 study · 150 participants
  GRADE not reported

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

Intraoral device releasing Biotene Oral Balance gel led to lower xerostomia (Xerostomia Inventory) compared with manually administered bolus of the same gel; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  SMD -1.01 [-1.44, -0.58]
  1 study · 22 participants
  GRADE not reported

Hydrolytic enzymes vs no treatment

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

  Median 28 days
  no estimate extracted
  3 studies
  GRADE not reported

Shenqi-fanghou vs no treatment

Shenqi-fanghou showed no clear difference in 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 0.9 [0.8, 1]
  1 study · 140 participants
  GRADE not reported

Propantheline vs placebo

Propantheline showed no clear difference in oral mucositis (any severity) 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 0.4 [0.12, 1.31]
  1 study · 12 participants
  GRADE not reported

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

Sucralfate vs placebo or usual care

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

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

  Median 28 days
  RR 0.75 [0.54, 1.04]
  4 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

Amifostine vs placebo/no treatment

It is very uncertain whether amifostine changes oral mucositis (severe) compared with placebo/no treatment (very low certainty).

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

  Median 28 days
  RR 0.68 [0.45, 1.03]
  9 studies · 845 participants
  Very low

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)
  Taweechaisupapong 2006 (crossover): participants reported a statistically significant improvement in oral dryness after both 3 mg and 5 mg pilocarpine lozenges vs placebo (P <= 0.05); no usable data presented. No…
  1 study · 33 participants
  GRADE not reported

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

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Blixt-Johansen 1992 (parallel, elderly long-term care, poor oral mucosa): oral mucosa improved in both groups but a much greater reduction in oral pathology in the mucin spray group; no data presented.
  1 study
  GRADE not reported

GM-CSF vs placebo/no treatment

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

  Median 28 days
  no estimate extracted
  8 studies
  GRADE not reported

Indigo wood root vs saline placebo

Indigo wood root led to lower oral mucositis (severe) compared with saline (placebo); GRADE not reported.

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

  Median 28 days
  RR 0.14 [0.02, 0.93]
  1 study · 20 participants
  GRADE not reported

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