Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

129 questions · 133 findings · 13 reviews · All outcomes

No studies found 29 · 21.8%GRADE not reported 46 · 34.6%Very low 56 · 42.1%Low 2 · 1.5%Moderate 0 · 0%High 0 · 0%

Cognitive behaviour therapy vs Attention placebo

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · Adults over 18 years of age with chronic orofacial pain (burning mouth syndrome)

Cognitive (behavioural) therapy led to lower burning mouth pain intensity (6-month follow-up) compared with attention placebo; GRADE not reported.

1 finding from 1 review

Cognitive behaviour therapy vs Attention placebo

Burning mouth pain intensity (post-treatment) · Adults over 18 years of age with chronic orofacial pain (burning mouth syndrome)

Cognitive (behavioural) therapy led to lower burning mouth pain intensity (post-treatment) compared with attention placebo; GRADE not reported.

1 finding from 1 review

Multivitamin vs placebo

Average mouth pain during RAS episodes · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…

Daily multivitamin showed no clear difference in average mouth pain during RAS episodes compared with placebo; GRADE not reported.

1 finding from 1 review

Topical NSAID (ketoprofen lysinate mouthwash, 160 mg) vs Topical NSAID (benzidamine hydrochloride mouthwash, 22.5 mg)

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

Topical NSAID (ketoprofen lysinate mouthwash, 160 mg) vs Topical NSAID (benzidamine hydrochloride mouthwash, 22.5 mg)

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · People undergoing orthodontic treatment (any age; 9 to 34 years in included studies)
1 finding from 1 review

Chlorhexidine mouthwash vs Salt and soda mouthwash

Average pain scores (0-100 VAS) · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis

Chlorhexidine mouthwash showed no clear difference in average pain scores (0-100 VAS) compared with salt and soda mouthwash; GRADE not reported.

1 finding from 1 review

Antiseptic mouthwash (e.g. chlorhexidine) vs Another topical agent or placebo

Patient‐reported pain intensity or pain relief (VAS, NRS or categorical scale) · HIV‐infected adults (> 13 years of age, per CDC) with one or more painful intraoral aphthous ulcers

The review found no eligible studies for this question.

1 finding from 1 review
  • No studies were included in this review. A total of 233 abstracts were retrieved; 25 were selected as potentially eligible but all were excluded (10 reported systemic rather than topical treatment; 3 non‐RCTs; 6…
    0 studies
    No studies found

'Magic' mouthwash (lidocaine, diphenhydramine, aluminium hydroxide) vs Salt and soda mouthwash

Average pain scores (0-100 VAS) · People with cancer receiving chemotherapy or radiotherapy (or both) who have oral mucositis

'Magic' mouthwash (lidocaine, diphenhydramine, aluminium hydroxide) showed no clear difference in average pain scores (0-100 VAS) compared with salt and soda mouthwash; GRADE not reported.

1 finding from 1 review

Tetracycline suspension (250 mg, held in mouth 2 minutes then swallowed, four times daily for 5 days) vs placebo

Adjusted maximum ulcer size and adjusted maximum pain · Participants with a previous or current history of recurrent aphthous stomatitis (RAS), diagnosed on history and clinical examination;…
1 finding from 1 review

Dietary supplements (alpha lipoic acid +/- vitamins/lycopene/green tea; hypericum; Catuama; lycopene) vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
1 finding from 1 review
  • Interventions for treating burning mouth syndrome 2016 · Cochrane All outcomes
    short-term (up to 3 months)
    SoF5 Dietary supplements vs placebo. Symptom relief short-term: insufficient or contradictory evidence regarding benefit of any evaluated dietary supplement; 628 participants (12 RCTs); very low. Subgroups: ALA without…
    12 studies · 628 participants
    Very low

Topical treatments (benzydamine hydrochloride oral rinse) vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
1 finding from 1 review
  • Interventions for treating burning mouth syndrome 2016 · Cochrane All outcomes
    short-term (up to 3 months) · benzydamine hydrochloride
    SoF9 Topical treatments vs placebo. Symptom relief short-term: insufficient or contradictory evidence regarding benefit of any evaluated topical treatment; 150 participants (4 RCTs); very low. Subgroups: benzydamine (1…
    4 studies · 150 participants
    Very low

Benzodiazepines (topical clonazepam) vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether benzodiazepines (topical clonazepam) changes relief of burning/discomfort (symptom relief; pain intensity) compared with placebo (very low certainty).

2 findings from 1 review

Anticonvulsants (gabapentin 300 mg/day, +/- alpha lipoic acid) vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether anticonvulsants (gabapentin 300 mg/day, +/- alpha lipoic acid) changes relief of burning/discomfort (symptom relief; pain intensity) compared with placebo (very low certainty).

1 finding from 1 review

Low‐level laser therapy vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether electromagnetic radiation (low-level laser therapy) changes relief of burning/discomfort (symptom relief; pain intensity) compared with placebo (very low certainty).

1 finding from 1 review

Benzodiazepines (systemic clonazepam 0.5 mg/day) vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether benzodiazepines (systemic clonazepam 0.5 mg/day) changes relief of burning/discomfort (symptom relief; pain intensity) compared with placebo (very low certainty).

1 finding from 1 review

Benzodiazepines (topical clonazepam) vs placebo

Adverse effects: dry mouth · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether benzodiazepines (topical clonazepam) changes adverse effects: dry mouth compared with placebo (very low certainty).

1 finding from 1 review

Cholinergics (bethanechol 15 mg/day) vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether cholinergics (bethanechol 15 mg/day) changes relief of burning/discomfort (symptom relief; pain intensity) compared with placebo (very low certainty).

1 finding from 1 review

Psychological therapies (cognitive therapy) vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms

It is very uncertain whether psychological therapies (cognitive therapy) changes relief of burning/discomfort (symptom relief; pain intensity) compared with placebo (very low certainty).

1 finding from 1 review

Topical treatments (capsaicin oral rinse) vs placebo

Relief of burning/discomfort (symptom relief; pain intensity) · People with primary burning mouth syndrome (BMS), that is, oral mucosal pain with no dental or medical cause for such symptoms
2 findings from 1 review
  • Interventions for treating burning mouth syndrome 2016 · Cochrane All outcomes
    short-term (up to 3 months) · capsaicin oral rinse
    Capsaicin oral rinse (Marino 2010; Silvestre 2012) contributes to the topical treatments short-term symptom-relief comparison (insufficient/contradictory). Silvestre 2012 data not presented due to 23% first-phase…
    1 study
    GRADE not reported
  • Interventions for treating burning mouth syndrome 2016 · Cochrane All outcomes
    long-term (>3 to 6 months) · capsaicin oral rinse
    MD -2.60 [-5.11, -0.09]
    1 study · 18 participants
    Very low