Findings

What do systematic reviews say?

1,127 questions · 1,590 findings · 132 reviews · Oral Health

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No studies found 189 · 11.9%GRADE not reported 1,166 · 73.3%Very low 130 · 8.2%Low 69 · 4.3%Moderate 25 · 1.6%High 11 · 0.7%

Antibiotic prophylaxis before dental procedure vs placebo or no prophylaxis

Cost implications of antibiotic provision · Adults or children at increased risk of bacterial endocarditis (pre-existing cardiac condition) undergoing an invasive dental procedure

The review found no eligible studies for this question.

1 finding from 1 review

Antibiotic prophylaxis for preventing bacterial endocarditis following dental procedures 2022 · Cochrane All outcomes
The study did not provide any data on mortality, adverse events requiring hospitalisation, adverse effects of antibiotics or cost implications of treatment.
0 studies
No studies found

Antibiotic prophylaxis before dental procedure vs placebo or no prophylaxis

Development of endocarditis (in those with definite indication for prophylaxis) · Adults or children at increased risk of bacterial endocarditis (pre-existing cardiac condition) undergoing an invasive dental procedure

It is very uncertain whether antibiotic prophylaxis before dental procedure changes development of endocarditis (in those with definite indication for… compared with no antibiotic prophylaxis or placebo (very low certainty).

1 finding from 1 review

Antibiotic prophylaxis for preventing bacterial endocarditis following dental procedures 2022 · Cochrane All outcomes
within 180 days · Definite indication for prophylaxis
OR 1.62 [0.57, 4.57]
1 study · 248 participants
Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Presence of dry socket · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

Systemic antibiotic prophylaxis (any regimen; topical therapy… may leads to lower dry socket compared with placebo (low certainty).

1 finding from 1 review

Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
1st to 7th day
RR 0.66 [0.45, 0.97]
13 studies · 1882 participants
Low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Infectious complications · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

Systemic antibiotic prophylaxis (any regimen; topical therapy… may leads to lower postsurgical infectious complications compared with placebo (low certainty).

1 finding from 1 review

Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
1st to 14th day
RR 0.34 [0.19, 0.64]
12 studies · 1728 participants
Low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Swelling (7th day) · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes swelling (7th day) compared with placebo (very low certainty).

1 finding from 1 review

Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
7th day
RR 0.80 [0.50, 1.27]
4 studies · 452 participants
Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes pain (continuous, VAS 0-10 cm, 7th day) compared with placebo (very low certainty).

1 finding from 1 review

Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
6th to 7th day
MD -0.26 [-0.59, 0.07]
4 studies · 422 participants
Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Pain (dichotomous, present/absent on 6th-7th day) · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes presence of pain (dichotomous, yes/no on 6th-7th day) compared with placebo (very low certainty).

1 finding from 1 review

Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
6th to 7th day
RR 0.59 [0.31, 1.12]
3 studies · 675 participants
Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Adverse effects · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes adverse effects compared with placebo (very low certainty).

1 finding from 1 review

Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
1st to 7th day
RR 1.46 [0.81, 2.64]
8 studies · 1277 participants
Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Trismus (dichotomous, 7th day) · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes trismus (dichotomous, 7th day) compared with placebo (very low certainty).

1 finding from 1 review

Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
7th day
RR 0.77 [0.42, 1.41]
3 studies · 199 participants
Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs Placebo

Outcome not reported · Immunosuppressed / immunocompromised patients (e.g. HIV infection, AIDS, diabetes, transplants) undergoing tooth extraction

The review found no eligible studies for this question.

1 finding from 1 review

Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
No studies: none of the 23 included trials evaluated tooth extraction in immunocompromised patients; subgroup analysis based on immune status was not possible as no such studies were identified.
0 studies
No studies found

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs placebo

Fever · People undergoing tooth extraction (21 of 23 trials: healthy patients undergoing impacted third molar extraction; 1 routine intra-alveolar…

It is very uncertain whether systemic antibiotic prophylaxis (any regimen; topical therapy… changes fever (6th-7th day) compared with placebo (very low certainty).

1 finding from 1 review

Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
6th to 7th day
RR 0.66 [0.24, 1.79]
4 studies · 475 participants
Very low

Systemic antibiotic prophylaxis (any regimen; topical therapy excluded) administered before and/or after tooth extraction vs Placebo

Outcome not reported · Patients undergoing tooth extraction for severe dental caries or periodontal disease in general dental practice (non-third-molar / decayed…

The review found no eligible studies for this question.

1 finding from 1 review

Antibiotics to prevent complications following tooth extractions 2021 · Cochrane All outcomes
No studies in general dental practice for removal of decayed teeth. PUB3 added one routine intra-alveolar extraction trial and one complex oral surgery trial (2 of 23 non-third-molar), but the single intra-alveolar…
0 studies
No studies found

Preterm birth (<37 weeks gestation) vs Full-term birth (37 weeks or more gestation)

Early childhood caries (ECC) · Children aged 6 years or younger (preschool children)

In children aged 3 years or younger, preterm birth was not associated with early childhood caries (OR 0.90, 95% CI 0.59 to 1.37); certainty not graded.

2 findings from 1 review

Relationship between preterm, low birth weight and early childhood caries: a meta-analysis of the case-control and… 2020 All outcomes
Community/epidemiological studies of preschool children (multiple countries) · Children aged 3 years or younger
OR 0.90 [0.59, 1.37]
2 studies
GRADE not reported
Relationship between preterm, low birth weight and early childhood caries: a meta-analysis of the case-control and… 2020 All outcomes
Community/epidemiological studies of preschool children (multiple countries) · Overall
OR 1.59 [1.36, 1.87]
16 studies · 21279 participants
GRADE not reported

Bethanechol vs Artificial saliva

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Bethanechol showed no clear difference in xerostomia (dry mouth, yes/no) compared with artificial saliva; GRADE not reported.

2 findings from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
8 to 40 weeks postRT
RR 0.56 [0.30, 1.05]
1 study · 30 participants
GRADE not reported
Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
RR 0.63 [0.30, 1.29]
1 study · 36 participants
GRADE not reported

Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs placebo

Progression‐free survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Palifermin showed no clear difference in progression-free survival compared with placebo; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
42 to 72 months from baseline
HR 1.06 [0.80, 1.42]
3 studies
GRADE not reported

Bethanechol vs Artificial saliva

Overall survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Bethanechol showed no clear difference in overall survival compared with artificial saliva; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
40 weeks postRT
RR 1.59 [0.43, 5.84]
1 study · 43 participants
GRADE not reported

Amifostine vs no treatment/placebo

Dysphagia (grade >= 3, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine showed no clear difference in dysphagia (grade >= 3, 0-4 scale) compared with no treatment/placebo; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT; up to 3 months postRT
RR 0.50 [0.17, 1.48]
2 studies · 73 participants
GRADE not reported

Polaprezinc vs Azulene oral rinse

Side effects · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No data on adverse events were reported.
0 studies
No studies found

Polaprezinc vs Azulene oral rinse

Survival · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Tumour response by RECIST criteria reported for a specific group of patients only; no usable survival data (Watanabe 2010)
1 study
GRADE not reported

Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs placebo

Xerostomia (grade >= 2, 0-4 scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Palifermin showed no clear difference in xerostomia (grade >= 2, 0-4 scale) compared with placebo (low certainty).

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Up to and including 3 months postRT
RR 0.97 [0.77, 1.22]
3 studies · 471 participants
Low