Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

2,227 questions · 2,562 findings · 156 reviews · Oral Health

No studies found 297 · 11.6%GRADE not reported 1,616 · 63.1%Very low 405 · 15.8%Low 144 · 5.6%Moderate 81 · 3.2%High 19 · 0.7%

Tempered cetylpyridinium chloride vs Cold cetylpyridinium chloride

Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them

It is very uncertain whether tempered cetylpyridinium chloride changes reduction in level of contamination by particles >5 um (droplets) at… compared with cold cetylpyridinium chloride (very low certainty).

2 findings from 1 review

Boric acid vs Water

Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them

It is very uncertain whether boric acid changes reduction in level of contamination by particles >5 um (droplets) at… compared with water (very low certainty).

2 findings from 1 review

Chlorhexidine vs Ozonated water

Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them

It is very uncertain whether chlorhexidine (CHX) changes reduction in level of contamination by particles >5 um (droplets) at… compared with ozonated water (very low certainty).

1 finding from 1 review

Cetylpyridinium chloride (CPC) vs Water

Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them

Cetylpyridinium chloride (CPC) may leads to lower reduction in level of contamination by particles >5 um (droplets) at… compared with water (low certainty).

3 findings from 1 review

Periodontal treatment (subgingival instrumentation, with or without antimicrobials/surgery) vs usual care or no treatment

Plaque index (PI) / oral hygiene · People with diabetes mellitus (type 1 or type 2, mostly type 2) and periodontitis, at least 16 years of age

Periodontal treatment (subgingival instrumentation, with or without… led to lower plaque index (PI) / oral hygiene compared with no active intervention/usual care; GRADE not reported.

1 finding from 1 review

Povidone iodine vs Normal saline

Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them

It is very uncertain whether povidone iodine changes reduction in level of contamination by particles >5 um (droplets) at… compared with saline (very low certainty).

1 finding from 1 review

Chlorhexidine vs Normal saline

Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them

Chlorhexidine (CHX) led to lower reduction in level of contamination by particles >5 um (droplets) at… compared with saline; GRADE not reported.

2 findings from 1 review

Essential oil mouthwash vs Water

Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them
3 findings from 1 review

Chlorhexidine vs boric acid

Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them

It is very uncertain whether chlorhexidine (CHX) changes reduction in level of contamination by particles >5 um (droplets) at… compared with boric acid (very low certainty).

2 findings from 1 review

Povidone iodine vs Ozonated water

Reduction in level of contamination by particles <=5 um (droplet nuclei) at >=2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them

It is very uncertain whether povidone iodine changes reduction in level of contamination by particles <=5 um (droplet… compared with ozonated water (very low certainty).

2 findings from 1 review

Chlorhexidine vs povidone‐iodine

Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them

It is very uncertain whether chlorhexidine (CHX) changes reduction in level of contamination by particles >5 um (droplets) at… compared with povidone iodine (very low certainty).

2 findings from 1 review

Chlorhexidine vs Ozonated water

Reduction in level of contamination by particles <=5 um (droplet nuclei) at >=2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them

It is very uncertain whether chlorhexidine (CHX) changes reduction in level of contamination by particles <=5 um (droplet… compared with ozonated water (very low certainty).

2 findings from 1 review

Tempered chlorhexidine vs Non-tempered chlorhexidine

Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them

It is very uncertain whether tempered chlorhexidine changes reduction in level of contamination by particles >5 um (droplets) at… compared with non-tempered chlorhexidine (very low certainty).

3 findings from 1 review

Chlorhexidine vs No rinsing

Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them
1 finding from 1 review

Gum chewing (sugar-free) vs Pooled controls: no gum, placebo/control gum, probiotic, or fluoride varnish

Streptococcus mutans load in the oral cavity (saliva and/or dental plaque) · Adults and children (general population)

In a sensitivity analysis assuming a 0.95 baseline-to-endpoint correlation for the sugar-free gum arm, the effect remained significant (SMD -0.55, 95% CI -0.80 to -0.30; 13 trials, I2 73%); certainty not formally graded.

2 findings from 1 review

Xylitol-only sugar-free chewing gum vs Pooled controls: no gum, placebo/control gum, probiotic, or fluoride varnish

Streptococcus mutans load in the oral cavity (saliva and/or dental plaque) · Adults and children (general population)

Xylitol-only sugar-free gum significantly reduced Streptococcus mutans load versus pooled controls (SMD -0.46, 95% CI -0.64 to -0.28; 12 trials, I2 43%); certainty not formally graded.

1 finding from 1 review

Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to the patient or HCW before and/or after an AGP vs No treatment or saline or water

Changes in microbiome in oral cavity, nasal cavity, oro- or nasopharynx · Patients without suspected or confirmed COVID-19 infection undergoing aerosol-generating procedures (AGPs), and the healthcare workers…

The review found no eligible studies for this question.

1 finding from 1 review

Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to the patient or HCW before and/or after an AGP vs No treatment or saline or water

Other adverse events (allergy, irritation/burning of nasal, oral or oropharyngeal mucosa, long-term staining of mucous membranes or teeth, accidental ingestion) · Patients without suspected or confirmed COVID-19 infection undergoing aerosol-generating procedures (AGPs), and the healthcare workers…

The review found no eligible studies for this question.

1 finding from 1 review

Gastroesophageal or laryngopharyngeal reflux (GERD/LPR) vs Healthy controls

Salivary function impairment (buffering capacity, flow rate, oral pH) · Adults with gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR)

Reflux is associated with impaired salivary function (notably reduced buffering capacity) as a proposed pathophysiological mechanism, based on several ungraded studies.

1 finding from 1 review
  • Laryngopharyngeal reflux, gastroesophageal reflux and dental disorders: A systematic review. 2020 All outcomes
    Adult patients in gastroenterology, ENT and dental clinical settings
    Mixed/controversial salivary findings: reduced salivary buffering capacity supported in three studies (Correa, Holbrook, Filipi) with low oral pH and reduced flow as additional factors in GERD patients, but Meurman and Schroeder found no significant salivary abnormalities; no pooled estimate.
    6 studies
    GRADE not reported