Findings

What do systematic reviews say?

220 questions · 258 findings · 7 reviews · All outcomes

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No studies found 63 · 24.4%GRADE not reported 151 · 58.5%Very low 22 · 8.5%Low 18 · 7%Moderate 4 · 1.6%High 0 · 0%

Analgesic (any: NSAID, paracetamol, local anaesthetic or opioid) vs placebo or control

Failure to complete orthodontic treatment due to pain · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for pain relief during orthodontic treatment 2017 · Cochrane All outcomes
No studies reported this outcome.
0 studies
No studies found

Amifostine vs no treatment/placebo

Salivary flow rate (stimulated) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT to 12 months postRT
Insufficient evidence of a difference in stimulated salivary flow at any time point: end of RT MD -0.09 (95% CI -1.48 to 1.30); 3 months MD 0.38 (95% CI -1.43 to 2.19); 12 months MD 0.82 (95% CI -0.47 to 2.11);…
2 studies
GRADE not reported

Antimicrobial lozenge vs placebo

Side effects (other: dryness in mouth, diarrhoea, constipation) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Over 6 months
Insufficient evidence of a difference: dryness in mouth RR 1.18 (95% CI 0.97 to 1.42), diarrhoea RR 1.97 (95% CI 0.51 to 7.54), constipation RR 0.91 (95% CI 0.59 to 1.42) (Duncan 2005)
1 study
GRADE not reported

Antiseptic mouthrinse vs placebo

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No data on xerostomia were reported.
0 studies
No studies found

Pilocarpine vs no treatment/placebo

Speech difficulties (VAS 0-100 mm) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Pilocarpine led to higher speech difficulties (VAS 0-100 mm) compared with no treatment/placebo; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
MD 20.20 [1.93, 38.47]
1 study · 34 participants
GRADE not reported

Amifostine vs no treatment/placebo

Salivary flow rate · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine led to higher salivary flow rate (incidence of > 0.1 g saliva/5 min, unstimulated) compared with no treatment/placebo; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
12 months postRT
RR 1.45 [1.13, 1.86]
1 study · 175 participants
GRADE not reported

Amifostine 200 mg/m2 three times weekly vs Amifostine 200 mg/m2 five times weekly

Vomiting · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine 200 mg/m2 three times weekly showed no clear difference in vomiting (adverse effect) compared with amifostine 200 mg/m2 five times weekly; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
RR 0.25 [0.06, 1.08]
1 study · 60 participants
GRADE not reported

Pilocarpine vs no treatment/placebo

Adverse effects ‐ Sweating · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Pilocarpine may leads to higher sweating (adverse effect) compared with no treatment/placebo (low certainty).

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
RR 2.98 [1.43, 6.22]
5 studies · 389 participants
Low

Amifostine 200 mg/m2 three times weekly vs Amifostine 200 mg/m2 five times weekly

Quality of life · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT and 6, 12, 18, 24 months postRT
No significant differences between the three treatment arms (Jellema 2006)
1 study
GRADE not reported

Venalot Depot (coumarin plus troxerutin) vs placebo

Salivary flow rate · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
Sialometric data dropped to an unmeasurable level in both groups; abandoned as a marker of efficacy (Grotz 2001)
1 study
GRADE not reported

Amifostine vs no treatment/placebo

Adverse events: hypotension · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Amifostine may leads to higher hypotension (adverse effect) compared with no treatment/placebo (low certainty).

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
RR 9.20 [2.84, 29.83]
3 studies · 376 participants
Low

Biperiden plus pilocarpine vs no treatment

Dysphagia (WHO grade 3+) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

Biperiden plus pilocarpine showed no clear difference in dysphagia (WHO grade 3+) compared with no treatment; GRADE not reported.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
12 months postRT
RR 0.25 [0.03, 2.11]
1 study · 60 participants
GRADE not reported

Amifostine vs no treatment/placebo

Quality of life (Patient Benefit Questionnaire, 10-point scale) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

It is very uncertain whether amifostine changes quality of life (Patient Benefit Questionnaire, 10-point scale) compared with no treatment/placebo (very low certainty).

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
12 months postRT
MD 0.70 [0.20, 1.20]
1 study · 180 participants
Very low

Biperiden plus pilocarpine vs no treatment

Salivary flow rate (unstimulated) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
End of RT
Insufficient evidence, from a single trial of 60 participants, to determine the effect on unstimulated salivary flow rate at the end of RT (Rode 1999; Analysis 2.1)
1 study · 60 participants
GRADE not reported

Bethanechol vs Artificial saliva

Quality of life · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No data on either quality of life or other oral related symptoms were reported.
0 studies
No studies found

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)

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for pain relief during orthodontic treatment 2017 · Cochrane All outcomes
No studies in this comparison reported any adverse events.
0 studies
No studies found

Selenium vs no intervention

Salivary flow rate · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No data on salivary flow rates were reported.
0 studies
No studies found

Biperiden plus pilocarpine vs no treatment

Dry mouth (xerostomia) · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No xerostomia data related to the effectiveness of biperiden and pilocarpine were reported (Rode 1999).
0 studies
No studies found

Antimicrobial lozenge vs placebo

Salivary flow rate · Patients receiving radiotherapy on its own or in addition to chemotherapy to the head and neck region

The review found no eligible studies for this question.

1 finding from 1 review

Pharmacological interventions for preventing dry mouth and salivary gland dysfunction following radiotherapy 2017 · Cochrane All outcomes
No data on salivary flow rates were reported.
0 studies
No studies found

CBT vs No special instructions (control)

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · Adults undergoing orthodontic treatment

Cognitive behavioural therapy (CBT) led to lower patient‐reported pain intensity or pain relief (VAS, NRS or… compared with no special instructions (control); GRADE not reported.

3 findings from 1 review

Non‐pharmacological interventions for alleviating pain during orthodontic treatment 2016 · Cochrane All outcomes
3 days
MD -27.91 [-40.10, -15.72]
1 study · 24 participants
GRADE not reported
Non‐pharmacological interventions for alleviating pain during orthodontic treatment 2016 · Cochrane All outcomes
7 days
MD -6.50 [-17.64, 4.64]
1 study · 24 participants
GRADE not reported
Non‐pharmacological interventions for alleviating pain during orthodontic treatment 2016 · Cochrane All outcomes
24 hours
MD -20.67 [-32.12, -9.22]
1 study · 24 participants
Very low