What do systematic reviews say?

Topical ciclosporin 1.5% gel vs Topical clobetasol propionate 0.025% gel

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  Topical clobetasol gave less stable results than ciclosporin when therapy ended and showed a higher incidence of side-effects (Conrotto 2006, n=40).
  1 study · 40 participants
  GRADE not reported

1% pimecrolimus cream vs Placebo (vehicle cream)

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  In Passeron 2007 (n=12), all participants who improved during treatment relapsed within 1 month of ceasing treatment.
  1 study · 12 participants
  GRADE not reported

Systemic oral acyclovir vs placebo or no treatment

The review found no eligible studies for this question.

• Acyclovir for treating primary herpetic gingivostomatitis 2008 · Cochrane All outcomes
  No data available in either included study.
  Studies not reported
  No studies found

Powered toothbrush (any mode of action) vs Manual toothbrush

Powered toothbrush showed no clear difference in unstimulated whole saliva (UWS) compared with manual toothbrush; GRADE not reported.

• Interventions for the management of dry mouth: non‐pharmacological interventions 2013 · Cochrane All outcomes

  45 minutes after brushing
  MD -0.07 [-0.74, 0.60]
  1 study
  GRADE not reported

Powered toothbrush (any mode of action) vs Manual toothbrush

Powered toothbrush showed no clear difference in stimulated whole saliva (SWS) compared with manual toothbrush; GRADE not reported.

• Interventions for the management of dry mouth: non‐pharmacological interventions 2013 · Cochrane All outcomes

  5 minutes after brushing
  MD -0.13 [-1.92, 1.66]
  1 study
  GRADE not reported

Powered toothbrush (any mode of action) vs Manual toothbrush

• Interventions for the management of dry mouth: non‐pharmacological interventions 2013 · Cochrane All outcomes
  Papas 2006 used a VAS to measure mouth dryness but did not report dry mouth outcome data
  1 study
  GRADE not reported

Carboxymethylcellulose (CMC) spray vs Placebo (spray base without CMC / water)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Donatsky 1982 (crossover, n=15, Sjogren's syndrome): CMC spray had a similar effect on oral dryness to the spray base, but was more effective than water. Paired crossover data not presented; effect size not estimable.
  1 study · 15 participants
  GRADE not reported

Reservoir biteguard device releasing a saliva substitute (with KY jelly + Saliva Orthana) vs Biteguard without reservoir (with KY jelly + Saliva Orthana)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  More in the reservoir group experienced relief of an oral impact and fewer a new impact (OIDP), but no difference in the total impact score between groups.
  1 study · 86 participants
  GRADE not reported

Saliva stimulant lozenge (sorbitol, Sorbee) vs Saliva substitute spray

Saliva stimulant lozenge (sorbitol, Sorbee) led to lower patient preference compared with saliva substitute spray (MouthKote); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Stewart 1998: no statistically significant difference in patient preference between lozenge and spray (Analysis 2.3).
  1 study · 80 participants
  GRADE not reported

Consumption of xylitol chewing gum by women (mothers) vs Profylin lozenge (xylitol/sorbitol + CMC)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Patients ranked gum and lozenge equal for preference.
  1 study · 18 participants
  GRADE not reported

Consumption of xylitol chewing gum by women (mothers) vs Profylin lozenge (xylitol/sorbitol + CMC)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No change in stimulated whole saliva.
  1 study · 18 participants
  GRADE not reported

Carboxymethylcellulose (CMC) spray vs Salinum linseed oil spray

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Mean plaque and gingival indices were reduced during the Salinum (linseed) period; incomplete comparative data.
  1 study · 20 participants
  GRADE not reported

Carboxymethylcellulose (CMC) mouthwash vs Glycerin mouthwash

Carboxymethylcellulose (CMC) mouthwash led to higher improvement in dry mouth ('excellent benefit', dichotomous) compared with glycerin mouthwash; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  RR 3.95 [1.17, 13.36]
  1 study · 148 participants
  GRADE not reported

Saliva stimulant lozenge (sorbitol, Sorbee) vs Saliva substitute spray

Saliva stimulant lozenge (sorbitol, Sorbee) showed no clear difference in salivary flow (unstimulated whole saliva) compared with saliva substitute spray (MouthKote); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  MD -0.01 [-0.03, 0.02]
  1 study · 80 participants
  GRADE not reported

Various saliva stimulants (chewable tablet, lozenges, chewing gum, CMC mouthrinse/sprays; 8-arm) vs Saliva substitutes / other products

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No product had a long-term effect on stimulated whole saliva production.
  1 study · 106 participants
  GRADE not reported

CMC/sorbitol pre-moistened swabs vs Lemon glycerin swabs

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  CMC/sorbitol also improved dentition and gingival scores; no supporting data presented.
  1 study · 20 participants
  GRADE not reported

CMC spray / aloe vera gel / canola oil spray vs Mucin spray (and between each other)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  No significant difference in patient preference between the treatments (Chi2 3.67, df=3; P = 0.30).
  1 study · 123 participants
  GRADE not reported

Reservoir biteguard device releasing a saliva substitute (with KY jelly + Saliva Orthana) vs Biteguard without reservoir (with KY jelly + Saliva Orthana)

Reservoir biteguard device releasing a saliva substitute (with KY… showed no clear difference in xerostomia (Xerostomia Inventory) compared with biteguard without reservoir (with KY jelly + Saliva Orthana); GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  SMD -0.06 [-0.48, 0.37]
  1 study · 86 participants
  GRADE not reported

Mucoadhesive disk (carbomer/triglycerides + antimicrobial agents) vs Placebo disk

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Kerr 2010 (crossover, high risk of bias): no difference in oral dryness between active and placebo disks; increase in subjective oral moistness with both, persisting up to 2 weeks after last use (likely carryover);…
  1 study
  GRADE not reported

Chewing gum vs Saliva substitute spray

Chewing gum (mechanical saliva stimulant) showed no clear difference in xerostomia (mouth dryness, VAS/scale) compared with saliva substitute spray; GRADE not reported.

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  SMD -0.11 [-0.33, 0.11]
  2 studies
  GRADE not reported