What do systematic reviews say?

Histamine gel vs placebo

Histamine gel 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 1.35 [0.91, 1.99]
  1 study · 39 participants
  GRADE not reported

Chlorhexidine vs placebo/no treatment

Chlorhexidine showed no clear difference in oral mucositis (any severity) 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 0.76 [0.47, 1.24]
  4 studies · 454 participants
  Low

Aloe vera vs placebo

Aloe vera led to lower 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 0.74 [0.58, 0.96]
  2 studies · 119 participants
  GRADE not reported

Mucoadhesive disk (carbomer/triglycerides + antimicrobial agents) vs Placebo disk

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Kerr 2010 (crossover, high risk of bias): no difference in oral dryness between active and placebo disks; increase in subjective oral moistness with both, persisting up to 2 weeks after last use (likely carryover);…
  1 study
  GRADE not reported

Cognitive behavioural (group psychotherapy) therapy vs Placebo pill

Cognitive behavioural (group psychotherapy) therapy showed no clear difference in improvement in burning mouth symptoms compared with placebo pill; GRADE not reported.

• Psychosocial interventions for the management of chronic orofacial pain 2011 · Cochrane All outcomes

  Not specified
  RR 1.77 [0.98, 3.21]
  1 study
  GRADE not reported

Buffered 'Prophylin' prophylactic gel vs Placebo gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Persson 2007 (crossover, n=14, institutionalised elderly): no dry mouth symptom data after treatment were presented.
  1 study · 14 participants
  GRADE not reported

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

Mucin spray (Saliva Orthana) showed no clear difference in xerostomia (VAS mouth 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 (crossover): statistically significant improvement in dry mouth on a VAS favouring the mucin spray group (Analysis 1.2; SMD not numerically reported).
  1 study
  GRADE not reported

Physostigmine gel (1.8 mg) vs Placebo gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Khosravani 2009 (crossover, low risk of bias, n=17): reduction in oral dryness (VAS area-under-curve over first 180 minutes) after 1.8 mg physostigmine gel; reported graphically, not usable for meta-analysis.
  1 study · 17 participants
  GRADE not reported

Benzydamine vs placebo

Benzydamine 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 0.55 [0.38, 0.82]
  1 study · 81 participants
  GRADE not reported

Allopurinol mouthrinse vs placebo/no treatment

Allopurinol mouthrinse led to lower oral mucositis (moderate to severe) compared with placebo/no treatment; GRADE not reported.

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

  Median 28 days
  RR 0.66 [0.5, 0.86]
  2 studies
  GRADE not reported

Prostaglandin vs placebo

Prostaglandin 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 0.95 [0.81, 1.11]
  1 study · 83 participants
  GRADE not reported

Mucoadhesive disk (carbomer/triglycerides + antimicrobial agents) vs Placebo disk

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No difference in salivary flow rates between active and placebo disks.
  1 study
  GRADE not reported

Mucin-containing lozenge vs placebo control

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Patient preference strongly favoured the mucin lozenge (P < 0.001, binomial test).
  1 study · 42 participants
  GRADE not reported

Zinc sulphate vs placebo

Zinc sulphate led to lower 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 0.36 [0.18, 0.71]
  1 study · 27 participants
  GRADE not reported

Flossing plus toothbrushing (self-performed; manual or automated floss) vs Toothbrushing alone

The review found no eligible studies for this question.

• Flossing for the management of periodontal diseases and dental caries in adults 2011 · Cochrane All outcomes
  Not reported. No included study measured the economic or resource cost of flossing; the review notes it may be important to measure in future trials.
  0 studies
  No studies found

G‐CSF vs placebo/no treatment

G-CSF showed no clear difference in oral mucositis (moderate to severe) compared with placebo/no treatment; GRADE not reported.

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

  Median 28 days
  RR 0.81 [0.51, 1.3]
  1 study · 40 participants
  GRADE not reported

Allopurinol mouthrinse vs placebo/no treatment

Allopurinol mouthrinse showed no clear difference in oral mucositis (any severity) compared with placebo/no treatment; GRADE not reported.

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

  Median 28 days
  RR 0.77 [0.5, 1.19]
  4 studies
  GRADE not reported

Buffered 'Prophylin' prophylactic gel vs Placebo gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Attempts to measure saliva secretion failed because the elderly participants were unable to co-operate.
  1 study · 14 participants
  GRADE not reported

Amifostine vs placebo/no treatment

Amifostine led to lower oral mucositis (moderate to severe) compared with placebo/no treatment; GRADE not reported.

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

  Median 28 days
  RR 0.75 [0.58, 0.96]
  6 studies
  GRADE not reported

Keratinocyte GF vs placebo

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

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

  Median 28 days
  RR 0.72 [0.58, 0.9]
  6 studies · 559 participants
  Low