What do systematic reviews say?

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs no treatment

Cryotherapy (ice chips) may leads to lower oral mucositis (any severity) compared with no treatment (low certainty).

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

  Median 28 days
  RR 0.74 [0.57, 0.95]
  5 studies · 472 participants
  Low

Carbopol (polyacrylic acid/acetate) spray vs Placebo spray

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Patient preference for active sprays vs placebo nearly attained significance (Chi2 7.259, df=3; P = 0.064); 15/43 participants expressed no desire to continue any spray after the trial.
  1 study · 43 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

Prednisone vs placebo

Prednisone showed no clear difference in oral mucositis (moderate to 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 0.71 [0.47, 1.07]
  1 study · 66 participants
  GRADE not reported

Low‐level laser therapy vs Placebo or no active treatment

Laser (low level) led to lower oral mucositis (severe) compared with placebo/sham/no treatment; GRADE not reported.

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

  Median 28 days
  RR 0.2 [0.06, 0.62]
  2 studies
  GRADE not reported

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

Commercial mouthcare system (Biotene Oral Balance / Xerostom) led to higher xerostomia (VAS mouth dryness) compared with usual care or CMC-based control; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  SMD 1.11 [0.33, 1.89]
  1 study
  GRADE not reported

Camomile vs placebo

Camomile 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 1.14 [0.43, 3.01]
  1 study · 164 participants
  GRADE not reported

Glutamine vs placebo or usual care

Glutamine showed no clear difference in oral mucositis (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 0.69 [0.37, 1.29]
  5 studies
  GRADE not reported

Commercial mouthcare system (Biotene Oral Balance / Xerostom) vs Bioxtra mouthcare system

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No difference between systems for overall xerostomia-related quality of life (15-item survey). Bioxtra rated better for taste; no difference for mouth 'feel'. Trial likely underpowered.
  1 study · 20 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

CMC spray / HCC spray / HCC gel vs Liquid margarine (and between each other)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  HCC gel rated better than margarine for convenience, perceived value, minutes of relief and overall rating; no other significant between-group differences.
  1 study · 28 participants
  GRADE not reported

Keratinocyte GF vs placebo

Keratinocyte GF may leads to lower oral mucositis (any severity) compared with placebo (low certainty).

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

  Median 28 days
  RR 0.82 [0.71, 0.94]
  2 studies · 160 participants
  Low

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

Intraoral device releasing Biotene Oral Balance gel showed no clear difference in patient satisfaction 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
  Patient satisfaction scores favoured the gel bolus over the intraoral device (Analysis 3.4).
  1 study · 22 participants
  GRADE not reported

Low‐level laser therapy vs Povidone

Laser (low level) led to lower oral mucositis (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 0.02 [0, 0.31]
  1 study · 50 participants
  GRADE not reported

Acyclovir vs placebo

Acyclovir 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 1.33 [0.85, 2.08]
  1 study · 57 participants
  GRADE not reported

Carboxymethylcellulose (CMC) spray vs Placebo (spray base without CMC / water)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Patient preference evenly split between CMC spray and spray base.
  1 study · 15 participants
  GRADE not reported

Cryotherapy (ice chips) 30 minutes vs Cryotherapy (ice chips) 60 minutes

Cryotherapy (ice chips) 30 minutes showed no clear difference in oral mucositis (severe) compared with cryotherapy (ice chips) 60 minutes; GRADE not reported.

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

  Median 28 days
  RR 0.6 [0.23, 1.58]
  1 study · 178 participants
  GRADE not reported

Superoxide dismutase (SOD) vs placebo

Superoxide dismutase 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 1.17 [0.78, 1.75]
  1 study · 159 participants
  GRADE not reported

Histamine gel vs placebo

Histamine gel 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 0.95 [0.15, 6.08]
  1 study · 39 participants
  GRADE not reported

Salinum (linseed) mouthwash vs Salinum plus chlorhexidine mouthwash

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Johansson 2001 (crossover, n=33, Sjogren's syndrome): both products improved oral dryness and chewing/swallowing; Salinum alone reduced speaking problems and burning mouth. Paired data not accounted for; no usable…
  1 study · 33 participants
  GRADE not reported