What do systematic reviews say?

Professional oral care vs Usual oral care

• Oral care measures for preventing nursing home‐acquired pneumonia 2022 · Cochrane All outcomes
  Measured in only 1 study (834 participants), which reported no serious events and 64 non-serious events, the most common of which were oral cavity disturbances (not defined) and dental staining.
  1 study · 834 participants
  GRADE not reported

Professional oral care vs Usual oral care

Professional oral care led to higher change in data on economics and quality of life compared with usual oral care; GRADE not reported.

• Oral care measures for preventing nursing home‐acquired pneumonia 2022 · Cochrane All outcomes

  24 months
  MD 1.5 [0.32, 2.68]
  1 study · 322 participants
  GRADE not reported

Professional oral care vs Usual oral care

The review found no eligible studies for this question.

• Oral care measures for preventing nursing home‐acquired pneumonia 2022 · Cochrane All outcomes
  No studies measured change in systemic antibiotic use.
  0 studies
  No studies found

Primary school-based behavioural intervention (both oral hygiene and dietary components) vs No treatment (or delayed treatment)

• Primary school‐based behavioural interventions for preventing caries 2013 · Cochrane All outcomes
  Worthington 2001 reported changes in oral health knowledge and skills: improvement was apparent in both intervention and control groups at the 4-month follow-up (phase one) but greater in the intervention group (34%…
  1 study
  GRADE not reported

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in conjunction with mechanical oral hygiene procedures vs Placebo/control mouthrinse, or no mouthrinse (mechanical oral hygiene alone); controls pooled (protocol's separate comparisons versus mechanical oral hygiene alone and versus placebo/control merged)

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in… showed no clear difference in supragingival calculus formation (various calculus indices) compared with placebo/control mouthrinse, or no mouthrinse (mechanical oral…; GRADE not reported.

• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  4 to 6 weeks
  SMD 0.02 [-0.09, 0.14]
  2 studies · 102 participants
  GRADE not reported
• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  7 to 12 weeks
  SMD 0.32 [-0.04, 0.69]
  6 studies · 425 participants
  GRADE not reported
• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  6 months
  SMD 0.80 [0.33, 1.26]
  4 studies · 323 participants
  GRADE not reported

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in conjunction with mechanical oral hygiene procedures vs Placebo/control mouthrinse, or no mouthrinse (mechanical oral hygiene alone); controls pooled (protocol's separate comparisons versus mechanical oral hygiene alone and versus placebo/control merged)

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in… leads to lower gingivitis (gingival inflammation) measured by Gingival Index of Loe… compared with placebo/control mouthrinse, or no mouthrinse (mechanical oral… (high certainty).

• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  4 to 6 weeks
  MD -0.21 [-0.31, -0.11]
  10 studies · 805 participants
  High
• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  6 months
  MD -0.20 [-0.30, -0.11]
  13 studies · 2616 participants
  High

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in conjunction with mechanical oral hygiene procedures vs Placebo/control mouthrinse, or no mouthrinse (mechanical oral hygiene alone); controls pooled (protocol's separate comparisons versus mechanical oral hygiene alone and versus placebo/control merged)

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in… led to lower gingival bleeding (various bleeding indices) compared with placebo/control mouthrinse, or no mouthrinse (mechanical oral…; GRADE not reported.

• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  4 to 6 weeks
  SMD -0.56 [-0.79, -0.33]
  8 studies · 649 participants
  GRADE not reported
• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  6 months
  SMD -0.72 [-1.02, -0.42]
  8 studies · 1132 participants
  GRADE not reported

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in conjunction with mechanical oral hygiene procedures vs Placebo/control mouthrinse, or no mouthrinse (mechanical oral hygiene alone); controls pooled (protocol's separate comparisons versus mechanical oral hygiene alone and versus placebo/control merged)

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in… leads to lower dental plaque (various plaque indices) compared with placebo/control mouthrinse, or no mouthrinse (mechanical oral… (high certainty).

• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  6 months
  SMD -1.43 [-1.76, -1.10]
  11 studies · 2075 participants
  High
• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  4 to 6 weeks
  SMD -1.45 [-1.90, -1.00]
  12 studies · 950 participants
  High

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in conjunction with mechanical oral hygiene procedures vs Placebo/control mouthrinse, or no mouthrinse (mechanical oral hygiene alone); controls pooled (protocol's separate comparisons versus mechanical oral hygiene alone and versus placebo/control merged)

Chlorhexidine mouthrinse (any concentration; 0.05% to 0.2%) used in… led to higher extrinsic tooth staining (various staining indices) compared with placebo/control mouthrinse, or no mouthrinse (mechanical oral…; GRADE not reported.

• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  6 months
  SMD 1.54 [1.22, 1.86]
  4 studies · 323 participants
  GRADE not reported
• Chlorhexidine mouthrinse as an adjunctive treatment for gingival health 2017 · Cochrane All outcomes

  4 to 6 weeks
  SMD 1.07 [0.80, 1.34]
  8 studies · 415 participants
  Moderate

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
  Two trials (Batliner 2018; Plutzer 2008) provided information on changes in mother oral health behaviours (other data): some benefit in favour of the intervention.
  2 studies
  GRADE not reported

Package of oral health education/promotion including oral hygiene advice for pregnant women, mothers, infants and young children, plus dietary and feeding practice advice for infants and young children vs usual care

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
  Three trials (Muhoozi 2017; Pereira 2021; Yu 2021) reported changes in child oral health behaviours (other data): some benefit in favour of the intervention.
  3 studies
  GRADE not reported

Oral cancer patients (cases) vs Healthy controls

Pooling all periodontal measures, oral cancer patients had worse periodontal status than controls (SMD 0.95, 95% CI 0.41-1.49; very high heterogeneity, I2=96.8%); ungraded. Note this pools clinically different measures.

• Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. 2024 All outcomes

  Not specified · Case-control studies conducted in Asia (n=6), Europe (n=5), USA (n=2) and other countries (n=3) · Overall (all periodontal measures pooled)
  SMD 0.95 [0.41, 1.49]
  5 studies
  GRADE not reported

Oral cancer patients (cases) vs Healthy controls

Periodontal pocket depth did not differ significantly between oral cancer patients and controls (SMD 1.64, 95% CI -0.20 to 3.47; very high heterogeneity); ungraded.

• Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. 2024 All outcomes

  Not specified · Case-control studies conducted in Asia (n=6), Europe (n=5), USA (n=2) and other countries (n=3) · PPD (periodontal pocket depth)
  SMD 1.64 [-0.20, 3.47]
  2 studies
  GRADE not reported

Oral cancer patients (cases) vs Healthy controls

Alveolar bone loss did not differ significantly between oral cancer patients and controls (SMD 0.18, 95% CI -2.34 to 2.69; extreme heterogeneity); ungraded.

• Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. 2024 All outcomes

  Not specified · Case-control studies conducted in Asia (n=6), Europe (n=5), USA (n=2) and other countries (n=3) · ABL (alveolar bone loss)
  SMD 0.18 [-2.34, 2.69]
  2 studies
  GRADE not reported

Oral health education/promotion (oral hygiene advice plus diet and feeding practice advice) combined with clinical treatment for mother's dentition (basic restorative and preventive; 1 trial included CHX varnish application) vs usual care

• Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries 2024 · Cochrane All outcomes
  One trial (Shenoy 2022) reported changes in child oral health behaviours (other data): some benefit in favour of the intervention.
  1 study
  GRADE not reported

Oral cancer patients (cases) vs Healthy controls

The DMFT index was significantly higher in oral cancer patients than controls (SMD 0.65, 95% CI 0.12-1.18); ungraded.

• Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. 2024 All outcomes

  Not specified · Case-control studies conducted in Asia (n=6), Europe (n=5), USA (n=2) and other countries (n=3) · DMFT (decayed, missing, filled teeth)
  SMD 0.65 [0.12, 1.18]
  2 studies
  GRADE not reported

Oral cancer patients (cases) vs Healthy controls

The mean number of missing teeth did not differ significantly between oral cancer patients and controls (SMD 0.59, 95% CI -0.04 to 1.22); ungraded.

• Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. 2024 All outcomes

  Not specified · Case-control studies conducted in Asia (n=6), Europe (n=5), USA (n=2) and other countries (n=3) · Missing teeth (mean count)
  SMD 0.59 [-0.04, 1.22]
  3 studies
  GRADE not reported

Oral cancer patients (cases) vs Healthy controls

Clinical attachment loss was significantly greater in oral cancer patients than controls (SMD 1.94, 95% CI 0.22-3.66), though heterogeneity was very high (I2=96.7%); ungraded.

• Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies. 2024 All outcomes

  Not specified · Case-control studies conducted in Asia (n=6), Europe (n=5), USA (n=2) and other countries (n=3) · CAL (clinical attachment loss)
  SMD 1.94 [0.22, 3.66]
  2 studies
  GRADE not reported

Systemic (oral) betamethasone vs Topical triamcinolone acetonide paste

It is very uncertain whether systemic (oral) betamethasone changes clinical score compared with topical triamcinolone acetonide paste (very low certainty).

• Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
  MD 1.13 [0.09, 2.17]
  1 study · 46 participants
  Very low

Systemic (oral) betamethasone vs Topical triamcinolone acetonide paste

It is very uncertain whether systemic (oral) betamethasone changes pain resolution compared with topical triamcinolone acetonide paste (very low certainty).

• Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
  RR 1.04 [0.60, 1.80]
  1 study · 49 participants
  Very low