Findings

What do systematic reviews say?

190 questions · 225 findings · 11 reviews · Dental public health and special care

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No studies found 37 · 16.4%GRADE not reported 85 · 37.8%Very low 68 · 30.2%Low 29 · 12.9%Moderate 6 · 2.7%High 0 · 0%

Saline rinse vs Saline-soaked swab

Duration of mechanical ventilation · Critically ill patients receiving mechanical ventilation in ICU

Saline rinse led to lower duration of mechanical ventilation compared with saline-soaked swab; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
MD -6.83 [-8.94, -4.72]
2 studies · 176 participants
GRADE not reported

Saline rinse plus swab vs Saline-soaked swab

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Saline rinse plus swab led to lower incidence of VAP compared with saline-soaked swab alone (usual care); GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 0.41 [0.23, 0.72]
2 studies · 153 participants
GRADE not reported

Chlorhexidine vs Nanosil (nanosilver)

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Chlorhexidine versus Nanosil (Khaky 2018): some evidence of a benefit for Nanosil; single study, not replicated, interpret with caution.
1 study
GRADE not reported

Triclosan rinse vs Saline rinse

Duration of ICU stay · Critically ill patients receiving mechanical ventilation in ICU

Triclosan rinse led to lower duration of ICU stay compared with saline rinse; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
MD -4.97 [-5.55, -4.39]
1 study · 324 participants
GRADE not reported

Hydrogen peroxide vs Normal saline

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Hydrogen peroxide versus normal saline (Nobahar 2016): a reduction in VAP was found; single study, not replicated, interpret with caution.
1 study
GRADE not reported

Potassium permanganate vs placebo

All‐cause mortality · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Potassium permanganate versus placebo (Meidani 2018, 100 participants): no evidence of a difference in mortality; single study.
1 study · 100 participants
GRADE not reported

Chlorhexidine vs Potassium permanganate

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Chlorhexidine showed no clear difference in incidence of VAP compared with potassium permanganate; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 0.87 [0.50, 1.52]
2 studies
GRADE not reported

Essential oil mouthwash vs Sodium bicarbonate rinse

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Listerine versus sodium bicarbonate (Berry 2013): no evidence of a difference in VAP incidence; single study, high risk of bias.
1 study
GRADE not reported

Saline rinse vs Saline-soaked swab

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Saline rinse led to lower incidence of VAP compared with saline-soaked swab; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 0.47 [0.37, 0.62]
4 studies · 488 participants
GRADE not reported

Povidone iodine rinse vs Saline rinse or placebo

All‐cause mortality · Critically ill patients receiving mechanical ventilation in ICU

Povidone iodine rinse showed no clear difference in mortality compared with saline rinse or placebo; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 1.00 [0.66, 1.50]
2 studies · 217 participants
GRADE not reported

Triclosan rinse vs Saline rinse

Duration of mechanical ventilation · Critically ill patients receiving mechanical ventilation in ICU

Triclosan rinse led to lower duration of mechanical ventilation compared with saline rinse; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
MD -5.24 [-5.64, -4.84]
1 study · 324 participants
GRADE not reported

Chlorhexidine vs Potassium permanganate

All‐cause mortality · Critically ill patients receiving mechanical ventilation in ICU

Chlorhexidine showed no clear difference in mortality compared with potassium permanganate; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 1.11 [0.89, 1.38]
2 studies
GRADE not reported

Saline rinse vs usual or supportive care

Duration of ICU stay · Critically ill patients receiving mechanical ventilation in ICU

Saline rinse showed no clear difference in duration of ICU stay compared with usual care (no rinse); GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
MD -1.17 [-3.95, 1.60]
2 studies · 324 participants
GRADE not reported

Essential oil mouthwash vs Sterile water rinse

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Listerine versus sterile water (Berry 2013): no evidence of a difference in VAP incidence; single study, high risk of bias.
1 study
GRADE not reported

Saline rinse vs Saline-soaked swab

All‐cause mortality · Critically ill patients receiving mechanical ventilation in ICU

Saline rinse led to lower mortality compared with saline-soaked swab; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 0.29 [0.12, 0.69]
2 studies · 270 participants
GRADE not reported

Sodium bicarbonate rinse (plus toothbrushing) vs Water rinse (plus toothbrushing)

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Sodium bicarbonate rinse (plus toothbrushing) showed no clear difference in incidence of VAP compared with water rinse (plus toothbrushing); GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 1.57 [0.62, 3.99]
2 studies · 347 participants
GRADE not reported

Saline rinse vs usual or supportive care

Duration of mechanical ventilation · Critically ill patients receiving mechanical ventilation in ICU

Saline rinse showed no clear difference in duration of mechanical ventilation compared with usual care (no rinse); GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
MD -0.40 [-2.55, 1.75]
2 studies · 324 participants
GRADE not reported

Chlorhexidine vs Nanosil (nanosilver)

All‐cause mortality · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Chlorhexidine versus Nanosil (Khaky 2018): no evidence of a difference in mortality; single study.
1 study
GRADE not reported

Triclosan rinse vs Saline rinse

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

Triclosan rinse showed no clear difference in incidence of VAP compared with saline rinse; GRADE not reported.

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
RR 0.89 [0.71, 1.12]
1 study · 324 participants
GRADE not reported

Chlorhexidine vs Miswak

Incidence of VAP · Critically ill patients receiving mechanical ventilation in ICU

1 finding from 1 review

Oral hygiene care for critically ill patients to prevent ventilator‐associated pneumonia 2020 · Cochrane All outcomes
Chlorhexidine versus miswak (Irani 2019): no evidence of a difference in incidence of VAP; single study. Also no difference in number treated with systemic antibiotics.
1 study
GRADE not reported