Gap finder
Search review questions
Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.
342 questions in 11 reviews · Pain control and patient management
current versionsNo studies 158 · 46.2%Ungraded 53 · 15.5%Very low 87 · 25.4%Low 30 · 8.8%Moderate 10 · 2.9%High 4 · 1.2%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
NSAID (systemic) vs Paracetamol Adverse events · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | In one study, one participant (<1%) in the paracetamol group experienced drug hypersensitivity (a 'red, blotchy and itchy rash') that resolved without treatment within 1 week (Bradley 2007 / McAlinden 2005); 1 RCT;… | 1 study | Very low |
Topical NSAID (ketoprofen chewing gum) vs Local anaesthetic (benzocaine chewing gum) Failure to complete orthodontic treatment due to pain · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | The study did not report this outcome. | 0 studies | No studies |
NSAID (systemic) vs Paracetamol Time off school or work · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | No studies in this comparison reported this outcome. | 0 studies | No studies |
NSAID (systemic) vs Paracetamol Quality of life or participant satisfaction · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | No studies in this comparison reported this outcome. | 0 studies | No studies |
NSAID (systemic) vs Paracetamol Pain intensity (VAS 0-100 mm) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) · 6 hours Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | MD -5.17 [-11.71, 1.37] | 7 studies · 664 participants | Low |
Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs Control (placebo or no treatment) Rescue analgesia · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | Use of rescue analgesia recorded in 7 studies; only 2 reported counts (Tuncer 2014: 2 participants; Bruno 2011: 6 participants); no class/dose/timing reported; not pooled. SoF cell: 'Not reported'. | 7 studies | Ungraded |
Topical NSAID (ketoprofen lysinate mouthwash, 160 mg) vs Topical NSAID (benzidamine hydrochloride mouthwash, 22.5 mg) Quality of life or participant satisfaction · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | The study did not report this outcome. | 0 studies | No studies |
Topical NSAID (ketoprofen lysinate mouthwash, 160 mg) vs Topical NSAID (benzidamine hydrochloride mouthwash, 22.5 mg) Pain intensity (VAS) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) · 4 days (not usable) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | One study (Lauritano 2000) compared ketoprofen 160 mg with benzidamine chloride 22.5 mg mouthwashes; it presented data at 4 days only, so the data could not be used in this review; no GRADE rating. | 1 study | Ungraded |
Topical NSAID (ketoprofen chewing gum) vs Local anaesthetic (benzocaine chewing gum) Pain intensity (VAS 0-100 mm) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) · 2 hours Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | MD 13 [-3.45, 29.45] | 1 study · 48 participants | Very low |
Topical NSAID (ketoprofen chewing gum) vs Local anaesthetic (benzocaine chewing gum) Time off school or work · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | The study did not report this outcome. | 0 studies | No studies |
Ibuprofen taken pre-emptively (about 1 hour before treatment) vs Ibuprofen taken post-treatment Time off school or work · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | No studies in this comparison reported this outcome. | 0 studies | No studies |
Ibuprofen taken pre-emptively (about 1 hour before treatment) vs Ibuprofen taken post-treatment Failure to complete orthodontic treatment due to pain · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | No studies in this comparison reported this outcome. | 0 studies | No studies |
Ibuprofen taken pre-emptively (about 1 hour before treatment) vs Ibuprofen taken post-treatment Quality of life or participant satisfaction · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | No studies in this comparison reported this outcome. | 0 studies | No studies |
Topical NSAID (ketoprofen chewing gum) vs Local anaesthetic (benzocaine chewing gum) Quality of life or participant satisfaction · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | The study did not report this outcome. | 0 studies | No studies |
Ibuprofen taken pre-emptively (about 1 hour before treatment) vs Ibuprofen taken post-treatment Pain intensity (VAS 0-100 mm) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) · 2 hours Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | MD -11.30 [-16.27, -6.33] | 1 study · 41 participants | Very low |
Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs Control (placebo or no treatment) Pain intensity (VAS 0-100 mm) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) · 6 hours Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | MD -24.27 [-31.44, -17.11] | 9 studies · 535 participants | Moderate |
Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs Control (placebo or no treatment) Time off school or work · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | No studies in this comparison reported this outcome. | 0 studies | No studies |
Topical NSAID (ketoprofen lysinate mouthwash, 160 mg) vs Topical NSAID (benzidamine hydrochloride mouthwash, 22.5 mg) Adverse events · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | The study did not report this outcome. | 0 studies | No studies |
Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs Control (placebo or no treatment) Adverse events · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | No studies in this comparison reported any adverse events. SoF cell: 'Not reported'. | 0 studies | No studies |
NSAID (systemic) vs Paracetamol Pain intensity (VAS 0-100 mm) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) · 24 hours Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | MD -0.51 [-8.93, 7.92] | 9 studies · 734 participants | Low |
Ibuprofen taken pre-emptively (about 1 hour before treatment) vs Ibuprofen taken post-treatment Pain intensity (VAS 0-100 mm) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) · 6 hours Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | MD -8.43 [-30.37, 13.50] | 2 studies · 69 participants | Very low |
Topical NSAID (ketoprofen chewing gum) vs Local anaesthetic (benzocaine chewing gum) Adverse events · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | The study did not report this outcome. | 0 studies | No studies |
NSAID (systemic) vs Paracetamol Pain intensity (VAS 0-100 mm) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) · 2 hours Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | MD -2.92 [-8.48, 2.65] | 7 studies · 664 participants | Low |
NSAID (systemic) vs Paracetamol Failure to complete orthodontic treatment due to pain · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | No studies in this comparison reported this outcome. | 0 studies | No studies |
Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs Control (placebo or no treatment) Failure to complete orthodontic treatment due to pain · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | No studies reported this outcome. | 0 studies | No studies |
Ibuprofen taken pre-emptively (about 1 hour before treatment) vs Ibuprofen taken post-treatment Adverse events · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies) Pharmacological interventions for pain relief during orthodontic treatment (2017) · Cochrane | No studies in this comparison reported any adverse events. | 0 studies | No studies |
Preoperative analgesics (analgesics given before dental treatment) vs Placebo or no analgesics Preoperative and postoperative anxiety measures · Children and adolescents aged up to 17 years having dental treatment (orthodontic treatment, fillings, pulp treatment,… Preoperative analgesics for additional pain relief in children and adolescents having dental treatment (2016) · Cochrane | None of the included studies assessed anxiety or behaviour at baseline, and none recorded baseline anxiety. PUB3: 'The [three/four] studies did not measure ... preoperative and postoperative anxiety measures ...' | 0 studies | No studies |
Preoperative analgesics (analgesics given before dental treatment) vs Placebo or no analgesics Intraoperative pain · Children and adolescents aged up to 17 years having dental treatment (orthodontic treatment, fillings, pulp treatment,… Preoperative analgesics for additional pain relief in children and adolescents having dental treatment (2016) · Cochrane | None of the included studies measured intraoperative pain. PUB3: 'The [three/four] studies did not measure intraoperative pain, ... cost or completion of treatment.' | 0 studies | No studies |
Preoperative ibuprofen vs Placebo Postoperative pain (continuous measure: self report using visual analogue scale) · Children and adolescents having orthodontic separator placement (without local anaesthetic) · 2 hours Preoperative analgesics for additional pain relief in children and adolescents having dental treatment (2016) · Cochrane | MD -13.44 [-23.01, -3.88] | 2 studies · 85 participants | Low |
Preoperative ibuprofen vs Placebo Adverse events · Children and adolescents having orthodontic separator placement (without local anaesthetic) Preoperative analgesics for additional pain relief in children and adolescents having dental treatment (2016) · Cochrane | One participant from the ibuprofen group and one from the placebo group reported a lip or cheek biting injury (Bernhardt 2001). No other adverse events were recorded for Bernhardt 2001 and Law 2000. | 2 studies | Ungraded |
Preoperative analgesics (analgesics given before dental treatment) vs Placebo or no analgesics Cost · Children and adolescents aged up to 17 years having dental treatment (orthodontic treatment, fillings, pulp treatment,… Preoperative analgesics for additional pain relief in children and adolescents having dental treatment (2016) · Cochrane | None of the included studies reported cost. PUB3: 'The [three/four] studies did not measure ... cost or completion of treatment.' | 0 studies | No studies |
Preoperative analgesics (analgesics given before dental treatment) vs Placebo or no analgesics Completion of treatment (yes/no) · Children and adolescents aged up to 17 years having dental treatment (orthodontic treatment, fillings, pulp treatment,… Preoperative analgesics for additional pain relief in children and adolescents having dental treatment (2016) · Cochrane | None of the included studies measured completion of treatment. PUB3: 'The [three/four] studies did not measure intraoperative pain, preoperative and postoperative anxiety measures, patient satisfaction, parental… | 0 studies | No studies |
Preoperative paracetamol (acetaminophen) vs Placebo Postoperative pain (dichotomous measure: parent report of presence of pain-related behaviours) · Children and adolescents having dental treatment under local anaesthetic (restorative and extraction treatments) · Mean 6.5 hours Preoperative analgesics for additional pain relief in children and adolescents having dental treatment (2016) · Cochrane | RR 0.81 [0.53, 1.22] | 2 studies · 100 participants | Low |
Preoperative paracetamol (acetaminophen) vs Placebo Adverse events · Children and adolescents having dental treatment under local anaesthetic (restorative and extraction treatments) Preoperative analgesics for additional pain relief in children and adolescents having dental treatment (2016) · Cochrane | No adverse events were recorded in Primosch 1995. The other two studies did not mention adverse events. | 1 study | Ungraded |
Preoperative analgesics (analgesics given before dental treatment) vs Placebo or no analgesics Parental satisfaction · Children and adolescents aged up to 17 years having dental treatment (orthodontic treatment, fillings, pulp treatment,… Preoperative analgesics for additional pain relief in children and adolescents having dental treatment (2016) · Cochrane | None of the included studies reported parental satisfaction. PUB3: 'there was no reporting of participant or parent satisfaction in any included study.' | 0 studies | No studies |
Preoperative analgesics (analgesics given before dental treatment) vs Placebo or no analgesics Patient satisfaction · Children and adolescents aged up to 17 years having dental treatment (orthodontic treatment, fillings, pulp treatment,… Preoperative analgesics for additional pain relief in children and adolescents having dental treatment (2016) · Cochrane | None of the included studies reported patient satisfaction. PUB3: 'there was no reporting of participant or parent satisfaction in any included study.' | 0 studies | No studies |
Sedation (sedative agents administered via any route) vs General anaesthesia Outcome NR · Children and adolescents younger than 18 years having dental treatment (fillings, pulp treatment or tooth extraction);… Sedation versus general anaesthesia for provision of dental treatment to patients younger than 18 years (2015) · Cochrane | no estimate extracted | 0 studies | No studies |
Intraligamental injection local anaesthetic vs No treatment Postoperative anxiety · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | Anand 2005 used the Venham Picture Scale but, owing to the split-mouth design, postoperative anxiety could not be compared between the LA and no-treatment sides | 1 study | Ungraded |
Infiltration injection LA and intraligamental injection LA (3-arm) vs No treatment Postoperative pain or distress · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… · Up to 30 minutes postoperatively; parent-reported to first night Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | Because of substantial clinical and methodological heterogeneity in the studies, we were unable to determine an estimate of effect | 1 study · 54 participants | Very low |
Intraligamental injection local anaesthetic vs No treatment Lip or cheek biting, numbness or allergy · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | Anand 2005: no signs of postoperative soft tissue trauma, 21 children reported numbness on the LA (experimental) side; Sammons 2007: no adverse events reported | 2 studies | Ungraded |
Infiltration injection LA and intraligamental injection LA (3-arm) vs No treatment Participant satisfaction · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | The study did not report on patient or child satisfaction | 0 studies | No studies |
Infiltration injection LA and intraligamental injection LA (3-arm) vs No treatment Intraoperative or postoperative bleeding · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | None of the studies reported on this outcome | 0 studies | No studies |
Infiltration injection LA and intraligamental injection LA (3-arm) vs No treatment Physiological parameters (cardiac/respiratory events; type and volume of GA drug) · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | None of the studies reported on this outcome | 0 studies | No studies |
Topical local anaesthetic (spray or dental swab) vs Placebo or no treatment Postoperative pain or distress · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… · Postoperatively, typically up to discharge (5 to 60 minutes) Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | Because of substantial clinical and methodological heterogeneity in the studies, we were unable to determine an estimate of effect | 4 studies · 343 participants | Very low |
Infiltration injection local anaesthetic vs No treatment or placebo Lip or cheek biting · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | Coulthard 2006: lip/cheek biting 3/70 (LA) vs 1/69 (placebo), P=0.62; Townsend 2009: 4/11 vs 1/12, P=0.16; no statistically significant difference | 2 studies · 162 participants | Ungraded |
Topical local anaesthetic (spray or dental swab) vs Placebo or no treatment Physiological parameters (cardiac/respiratory events; type and volume of GA drug) · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | None of the studies reported on this outcome | 0 studies | No studies |
Topical local anaesthetic (spray or dental swab) vs Placebo or no treatment Lip or cheek biting · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | None of the studies reported on lip or cheek biting | 0 studies | No studies |
Infiltration injection local anaesthetic vs No treatment or placebo Parental satisfaction · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | No study reported parental satisfaction | 0 studies | No studies |
Intraligamental injection local anaesthetic vs No treatment Intraoperative or postoperative bleeding · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | None of the studies reported on this outcome | 0 studies | No studies |
Infiltration injection LA and intraligamental injection LA (3-arm) vs No treatment Parental satisfaction · Children and young people aged 17 years or younger having dental treatment (including extractions) under general… Intraoperative local anaesthesia for reduction of postoperative pain following general anaesthesia for… (2014) · Cochrane | No study reported parental satisfaction | 0 studies | No studies |