Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

217 questions · 259 findings · 23 reviews

No studies found 55 · 21.2%GRADE not reported 17 · 6.6%Very low 50 · 19.3%Low 40 · 15.4%Moderate 69 · 26.6%High 28 · 10.8%

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary osmolality (hydration level) · Patients with drooling (sialorrhea) due to neurological disease

No included study reported salivary osmolality; this pre-planned outcome remains unassessed (no studies).

1 finding from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary S. mutans level · Patients with drooling (sialorrhea) due to neurological disease

BoNT injections were not associated with significant changes in salivary S. mutans counts across three studies (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    The RCT by Wu et al. reported no statistically significant changes in S. mutans CFU counts (p-values only). The studies of Tiigimae-Saar did not find statistically significant differences in S. mutans CFU counts either.
    3 studies
    GRADE not reported

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary pH · Patients with drooling (sialorrhea) due to neurological disease

BoNT injections were not associated with significant changes in oral/salivary pH across three studies (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    Wu et al. did not observe significant differences in participants' oral pH before and after BoNT-A injections between the active and control groups. There were also no statistically significant differences regarding…
    3 studies
    GRADE not reported

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Development of >=1 new carious lesion (caries incidence) · Patients with drooling (sialorrhea) due to neurological disease

In one RCT, BoNT-B 2500 U was not associated with a statistically significant increase in new caries versus placebo (RR 2.4, 95% CI 0.48 to 11.80; not significant).

2 findings from 1 review

Intraglandular botulinum neurotoxin (BoNT) injection vs No BoNT (placebo or pre-treatment baseline)

Salivary buffering capacity · Patients with drooling (sialorrhea) due to neurological disease

Salivary buffering capacity did not decrease after BoNT; one of two quasi-experimental studies reported a significant increase (ungraded; no effect estimate reported).

1 finding from 1 review
  • Oral health effects of botulinum toxin treatment for drooling: a systematic review. 2020 All outcomes
    Before vs after BoNT injection (2018 study: significant buffering increase at 1 month; 2017 study no change) · Neurological-disease populations with drooling (e.g., cerebral palsy, Parkinson disease, adults with sialorrhea); specialist clinical care
    The quasi-experimental studies of Tiigimae-Saar found different results concerning the changes in buffering capacity. For the analysis carried out in 2017, no statistically significant change was observed. By contrast,…
    2 studies
    GRADE not reported

Surgery vs botulinum neurotoxin injections

Treatment success: improvement in the angle of strabismus at 6 months · children with infantile esotropia

It is very uncertain whether surgery changes treatment success: improvement in the angle of strabismus at 6 months compared with botulinum neurotoxin injections (very low certainty).

1 finding from 1 review

Radiotherapy vs botulinum toxin

Reduction in the amount of saliva production in the short term using an objective measure · sialorrhea (excessive saliva) in people with motor neuron disease/amyotrophic lateral sclerosis

The review found no eligible studies for this question.

1 finding from 1 review

Radiotherapy vs botulinum toxin

Adverse events, reported as "negative experiences" · sialorrhea (excessive saliva) in people with motor neuron disease/amyotrophic lateral sclerosis

It is very uncertain whether radiotherapy changes adverse events, reported as "negative experiences" compared with botulinum toxin (very low certainty).

1 finding from 1 review

Occlusal splint vs Pharmacological interventions (benzodiazepines, anticonvulsants, beta blockers, dopamine agents, antidepressants, botulinum toxin A and B, analgesics)

Outcome not reported · People with sleep bruxism (tooth grinding or clenching); children (greater than 1 year old) and adults; diagnosis clinical,…

The review found no eligible studies for this question.

1 finding from 1 review

BoNT‐A vs usual care or physiotherapy

Instrumented gait analysis (kinematics) (not measured) · children with CP

The review found no eligible studies for this question.

3 findings from 1 review

BoNT‐A vs usual care or physiotherapy

Function · children with CP
3 findings from 1 review

BoNT‐A vs usual care or physiotherapy

Range of motion (passive ankle dorsiflexion) · children with CP
3 findings from 1 review

BoNT‐A vs usual care or physiotherapy

Satisfaction (not measured) · children with CP

The review found no eligible studies for this question.

2 findings from 1 review

BoNT‐A vs usual care or physiotherapy

Spasticity (ankle plantarflexors) · children with CP
3 findings from 1 review