What do systematic reviews say?

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

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

Prednisone vs placebo

Prednisone 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 0.64 [0.17, 2.45]
  1 study · 66 participants
  GRADE not reported

Buffered 'Prophylin' prophylactic gel vs Placebo gel

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No difference between buffered gel, unbuffered gel and water for oral pH, cariogenic bacteria or Candida species.
  1 study · 14 participants
  GRADE not reported

Iseganan vs placebo

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

  Median 28 days
  no estimate extracted
  2 studies
  GRADE not reported

Xanthum gum-containing spray (Xialine) vs Placebo spray

Xanthum gum-containing spray (Xialine) showed no clear difference in xerostomia (EORTC dry mouth score) compared with placebo spray (base without xanthum); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Jellema 2001 (crossover, n=30, post-radiotherapy): no statistically significant difference between Xialine (xanthum gum) spray and placebo on the EORTC dry mouth score (Analysis 1.2). van der Reijden 1996: xanthum…
  2 studies · 30 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 halitosis; the review notes it may be important to measure in future trials.
  0 studies
  No studies found

Antibiotic pastille or paste (PTA) vs placebo

Antibiotic pastille or paste (PTA) led to lower 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 0.87 [0.78, 0.96]
  2 studies · 356 participants
  GRADE not reported

Fluoride supplementation (tablets, drops, lozenges or chewing gum) vs No fluoride supplement (placebo or no treatment)

• Fluoride supplements (tablets, drops, lozenges or chewing gums) for preventing dental caries in children 2011 · Cochrane All outcomes

  55 months
  % of children with fluorotic teeth (questionable to severe), follow-up 55 months. Assumed risk 32/212 = 15%; corresponding risk 40/202 = 20% (APF once a day) and 43/197 = 22% (APF twice a day). Relative effect: Not…
  1 study · 611 participants
  Very low

Epidermal growth factor vs placebo

Epidermal growth factor 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 0.67 [0.45, 0.99]
  1 study · 103 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 estimable (0 studies). See comment: No included study assessed calculus as an outcome.
  0 studies
  No studies found

Glutamine vs placebo or usual care

Glutamine 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 0.88 [0.69, 1.12]
  5 studies
  GRADE not reported

Mucin-containing lozenge vs placebo control

Mucin-containing lozenge showed no clear difference in xerostomia (VAS mouth dryness) compared with placebo lozenge; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Gravenmade 1993 (crossover, high risk of bias, n=42, Sjogren's syndrome): no statistically significant difference between mucin lozenge and placebo for mouth dryness on a VAS (Analysis 1.2).
  1 study · 42 participants
  GRADE not reported

Indomethacin vs placebo

Indomethacin 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 1 [0.82, 1.23]
  1 study · 18 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 estimable (0 studies). See comment: No included study assessed quality of life as an outcome.
  0 studies
  No studies found

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