Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

70 questions · 92 findings · 6 reviews · Periodontology · All outcomes

No studies found 2 · 2.2%GRADE not reported 82 · 89.1%Very low 0 · 0%Low 4 · 4.3%Moderate 4 · 4.3%High 0 · 0%

Systemic oral acyclovir vs placebo or no treatment

Duration and time of healing of intraoral (oral) lesions; number of individuals with oral lesions · Children and young adults under 25 years with primary herpetic gingivostomatitis (with or without herpes labialis)

Systemic oral acyclovir led to lower number of individuals with oral lesions (8 days after… compared with placebo or no treatment; GRADE not reported.

1 finding from 1 review

Systemic oral acyclovir vs placebo or no treatment

Duration and time of healing of extraoral lesions; development of new extraoral lesions · Children and young adults under 25 years with primary herpetic gingivostomatitis (with or without herpes labialis)

Systemic oral acyclovir led to lower number of individuals who developed new extraoral lesions after… compared with placebo or no treatment; GRADE not reported.

1 finding from 1 review

Systemic oral acyclovir vs placebo or no treatment

Number of individuals with eating difficulties (8 days after administration); duration of eating difficulties · Children and young adults under 25 years with primary herpetic gingivostomatitis (with or without herpes labialis)

Systemic oral acyclovir led to lower number of individuals with eating difficulties (8 days after… compared with placebo or no treatment; GRADE not reported.

1 finding from 1 review

Systemic oral acyclovir vs placebo or no treatment

Difficulty in drinking (number with drinking difficulties) · Children and young adults under 25 years with primary herpetic gingivostomatitis (with or without herpes labialis)

Systemic oral acyclovir led to lower number of individuals with drinking difficulties (8 days after… compared with placebo or no treatment; GRADE not reported.

1 finding from 1 review

Systemic oral acyclovir vs placebo or no treatment

Number of individuals admitted to hospital after administration · Children and young adults under 25 years with primary herpetic gingivostomatitis (with or without herpes labialis)

Systemic oral acyclovir showed no clear difference in number of individuals admitted to hospital after administration compared with placebo or no treatment; GRADE not reported.

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Gingival index (GI) · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Persons with orofacial cleft have a higher gingival index than healthy controls (MD 0.15, 95% CI 0.11 to 0.19; low certainty).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Clinical attachment level (CAL) · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Clinical attachment level loss is greater in persons with orofacial cleft than in healthy controls (p<0.00001), but no pooled effect size was reported (ungraded).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Bleeding Index (BI) · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Bleeding index is significantly higher in persons with orofacial cleft than in healthy controls (p<0.0001), but no pooled effect size was reported (ungraded).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Oral microbiota composition · Individuals assessed for oral microbiota (mainly children and adolescents)

Oral microbiota composition differs between persons with orofacial cleft and healthy controls, synthesized qualitatively across 8 studies but not meta-analyzed (ungraded).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Probing pocket depth · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Persons with orofacial cleft have a greater probing pocket depth than healthy controls (MD 0.88, 95% CI 0.82 to 0.95; low certainty).

1 finding from 1 review

Cleft lip and/or palate (CL/P) vs Healthy controls without cleft

Plaque · Individuals assessed for periodontal health (mainly children and adolescents, age >2 years)

Persons with orofacial cleft have a higher plaque index than healthy controls (MD 0.29, 95% CI 0.24 to 0.34; low certainty).

1 finding from 1 review

Periodontitis vs Individuals without periodontal disease (by LOA)

Malignant transformation (oral cancer development) · Adults in case-control studies of oral cancer; people assessed for periodontitis

Periodontitis is associated with roughly a threefold higher odds of oral cancer (pooled OR 2.94, 95% CI 2.13-4.07; low certainty of evidence), though heterogeneity is moderate (I2=52.4%).

1 finding from 1 review

Placebo rinse vs Pre-treatment (baseline, same group)

Lactobacillus count (pre- vs post-treatment) · Medically healthy individuals (adults and children, 6-60 years)

Placebo rinse did not significantly change Lactobacillus counts relative to baseline; not GRADE-rated.

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Pre-treatment (baseline, same group)

Lactobacillus count (pre- vs post-treatment) · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced Lactobacillus counts relative to baseline; not GRADE-rated.

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Chlorhexidine mouthrinse

Plaque · Medically healthy individuals (adults and children, 6-60 years)

When usual mechanical plaque control continued, Salvadora persica and chlorhexidine did not differ significantly for plaque; not GRADE-rated.

8 findings from 1 review
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Salvadora persica (miswak) mouthrinse vs Chlorhexidine 0.2% mouthrinse

Plaque · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica was less effective than 0.2% chlorhexidine at reducing plaque (favours chlorhexidine); not GRADE-rated.

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Placebo rinse

Lactobacillus count (CFU/mL) · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced Lactobacillus counts more than placebo (favours Salvadora persica); not GRADE-rated.

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Pre-treatment (baseline, same group)

Streptococcus mutans count · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced Streptococcus mutans counts relative to baseline; not GRADE-rated.

1 finding from 1 review

Salvadora persica (miswak) mouthrinse vs Placebo rinse

Streptococcus mutans count · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced Streptococcus mutans counts more than placebo (favours Salvadora persica); not GRADE-rated.

1 finding from 1 review