Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

4,587 questions · 5,761 findings · 495 reviews

No studies found 1,011 · 17.5%GRADE not reported 1,797 · 31.2%Very low 1,100 · 19.1%Low 1,052 · 18.3%Moderate 649 · 11.3%High 152 · 2.6%

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Antibiotics vs no treatment or placebo on top of topical antibiotics

Resolution of ear discharge ‐ measured after 4 weeks · people with CSOM; one study included patients of unknown age; one study included children with CSOM who had not responded to initial…

It is very uncertain whether systemic antibiotics changes resolution of ear discharge ‐ measured after 4 weeks (6 weeks) (Oral… compared with no treatment or placebo on top of topical antibiotics (very low certainty).

1 finding from 1 review

Gum chewing (sugar-free) vs Pooled controls: no gum, placebo/control gum, probiotic, or fluoride varnish

Streptococcus mutans load in the oral cavity (saliva and/or dental plaque) · Adults and children (general population)

In a sensitivity analysis assuming a 0.95 baseline-to-endpoint correlation for the sugar-free gum arm, the effect remained significant (SMD -0.55, 95% CI -0.80 to -0.30; 13 trials, I2 73%); certainty not formally graded.

2 findings from 1 review

Xylitol-only sugar-free chewing gum vs Pooled controls: no gum, placebo/control gum, probiotic, or fluoride varnish

Streptococcus mutans load in the oral cavity (saliva and/or dental plaque) · Adults and children (general population)

Xylitol-only sugar-free gum significantly reduced Streptococcus mutans load versus pooled controls (SMD -0.46, 95% CI -0.64 to -0.28; 12 trials, I2 43%); certainty not formally graded.

1 finding from 1 review

Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to the patient or HCW before and/or after an AGP vs No treatment or saline or water

Changes in microbiome in oral cavity, nasal cavity, oro- or nasopharynx · Patients without suspected or confirmed COVID-19 infection undergoing aerosol-generating procedures (AGPs), and the healthcare workers…

The review found no eligible studies for this question.

1 finding from 1 review

Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to the patient or HCW before and/or after an AGP vs No treatment or saline or water

Other adverse events (allergy, irritation/burning of nasal, oral or oropharyngeal mucosa, long-term staining of mucous membranes or teeth, accidental ingestion) · Patients without suspected or confirmed COVID-19 infection undergoing aerosol-generating procedures (AGPs), and the healthcare workers…

The review found no eligible studies for this question.

1 finding from 1 review

Gastroesophageal or laryngopharyngeal reflux (GERD/LPR) vs Healthy controls

Salivary function impairment (buffering capacity, flow rate, oral pH) · Adults with gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR)

Reflux is associated with impaired salivary function (notably reduced buffering capacity) as a proposed pathophysiological mechanism, based on several ungraded studies.

1 finding from 1 review
  • Laryngopharyngeal reflux, gastroesophageal reflux and dental disorders: A systematic review. 2020 All outcomes
    Adult patients in gastroenterology, ENT and dental clinical settings
    Mixed/controversial salivary findings: reduced salivary buffering capacity supported in three studies (Correa, Holbrook, Filipi) with low oral pH and reduced flow as additional factors in GERD patients, but Meurman and Schroeder found no significant salivary abnormalities; no pooled estimate.
    6 studies
    GRADE not reported

Gastroesophageal or laryngopharyngeal reflux (GERD/LPR) vs Healthy controls

Oral/pharyngeal microbiota modifications · Adults with gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR)

No eligible studies investigated reflux-related modifications of the oral or pharyngeal microbiota; this is an evidence gap identified by the review.

1 finding from 1 review

Antimicrobial mouthwash and/or nasal spray (alone or in combination), any concentration, frequency or dosage vs No treatment or saline or water

Other adverse events (allergy, irritation/burning of nasal, oral or oropharyngeal mucosa, long-term staining of mucous membranes or teeth, accidental ingestion) · Patients with suspected or confirmed COVID-19 infection

The review found no eligible studies for this question.

1 finding from 1 review

Any antimicrobial mouthwash and/or nasal spray (alone or in combination), at any concentration, delivered to healthcare workers, with or without the same intervention given to the patients with COVID-19 vs No treatment or saline or water

Changes in microbiome in oral cavity, nasal cavity, oro- or nasopharynx · Healthcare workers (HCWs) treating patients with suspected or confirmed COVID-19 infection

The review found no eligible studies for this question.

1 finding from 1 review

High-volume evacuation (HVE) vs No HVE

Reduction in level of contamination in aerosols (CFU) at more than 1 foot from oral cavity (CCT) · People undergoing aerosol-generating procedures (AGPs) in a dental setting

High-volume evacuation (HVE) led to lower reduction in level of contamination in aerosols (CFU) at more than 1… compared with no HVE; GRADE not reported.

1 finding from 1 review

High-volume evacuation (HVE) vs No HVE

Reduction in level of contamination in aerosols (CFU) at less than 1 foot from oral cavity (CCTs) · People undergoing aerosol-generating procedures (AGPs) in a dental setting

High-volume evacuation (HVE) showed no clear difference in reduction in level of contamination in aerosols (CFU) at less than 1… compared with no HVE; GRADE not reported.

1 finding from 1 review

High-volume evacuation (HVE) vs No HVE

Reduction in level of contamination in aerosols (CFU) during ultrasonic scaling and air polishing at more than 1 foot from oral cavity (RCT) · People undergoing aerosol-generating procedures (AGPs) in a dental setting

It is very uncertain whether high-volume evacuation (HVE) changes reduction in level of contamination in aerosols (CFU) during… compared with no HVE (very low certainty).

1 finding from 1 review