What do systematic reviews say?

Radiotherapy (morning) vs Radiotherapy (afternoon/evening)

Radiotherapy (morning) showed no clear difference in oral mucositis (moderate to severe) compared with radiotherapy (afternoon/evening); GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.7 [0.48, 1.01]
  1 study · 177 participants
  GRADE not reported

Radiotherapy (morning) vs Radiotherapy (afternoon/evening)

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  no estimate extracted
  2 studies
  GRADE not reported

Cryotherapy (ice chips) 30 minutes vs Cryotherapy (ice chips) 60 minutes

Cryotherapy (ice chips) 30 minutes showed no clear difference in oral mucositis (moderate to severe) compared with cryotherapy (ice chips) 60 minutes; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.68 [0.36, 1.3]
  1 study · 178 participants
  GRADE not reported

Cryotherapy (ice chips) 30 minutes vs Cryotherapy (ice chips) 60 minutes

Cryotherapy (ice chips) 30 minutes showed no clear difference in oral mucositis (any severity) compared with cryotherapy (ice chips) 60 minutes; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.89 [0.62, 1.29]
  1 study · 178 participants
  GRADE not reported

Cryotherapy (ice chips) 30 minutes vs Cryotherapy (ice chips) 60 minutes

Cryotherapy (ice chips) 30 minutes showed no clear difference in oral mucositis (severe) compared with cryotherapy (ice chips) 60 minutes; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.6 [0.23, 1.58]
  1 study · 178 participants
  GRADE not reported

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs no treatment

Cryotherapy (ice chips) led to lower oral mucositis (moderate to severe) compared with no treatment; GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.53 [0.31, 0.91]
  5 studies
  GRADE not reported

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs no treatment

Cryotherapy (ice chips) may leads to lower oral mucositis (severe) compared with no treatment (low certainty).

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.36 [0.17, 0.77]
  5 studies · 472 participants
  Low

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs no treatment

Cryotherapy (ice chips) may leads to lower oral mucositis (any severity) compared with no treatment (low certainty).

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 0.74 [0.57, 0.95]
  5 studies · 472 participants
  Low

Chlorhexidine vs Cryotherapy (ice chips) 60 minutes

Chlorhexidine showed no clear difference in oral mucositis (any severity) compared with cryotherapy (ice chips); GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 1.03 [0.76, 1.41]
  1 study · 133 participants
  GRADE not reported

Chlorhexidine vs Cryotherapy (ice chips) 60 minutes

Chlorhexidine showed no clear difference in oral mucositis (moderate to severe) compared with cryotherapy (ice chips); GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 1.13 [0.64, 1.97]
  1 study · 133 participants
  GRADE not reported

Chlorhexidine vs Cryotherapy (ice chips) 60 minutes

Chlorhexidine showed no clear difference in oral mucositis (severe) compared with cryotherapy (ice chips); GRADE not reported.

• Interventions for preventing oral mucositis for patients with cancer receiving treatment 2011 · Cochrane All outcomes

  Median 28 days
  RR 1.16 [0.46, 2.92]
  1 study · 133 participants
  GRADE not reported

Topical triamcinolone acetonide vs Cryotherapy

It is very uncertain whether topical triamcinolone acetonide changes pain (mean score, split-mouth) compared with cryotherapy (very low certainty).

• Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
  MD 1.48 [0.58, 2.38]
  1 study · 52 participants
  Very low

Topical triamcinolone acetonide vs Cryotherapy

Topical triamcinolone acetonide led to lower adverse events (split-mouth) compared with cryotherapy; GRADE not reported.

• Interventions for treating oral lichen planus: corticosteroid therapies 2020 · Cochrane All outcomes
  OR 0.01 [0.00, 0.16]
  1 study · 30 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 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

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
  Bjornstrom 1990 (8-arm crossover, high risk of bias, 106 enrolled, 55 used all 8 products): all products relieved dry mouth and difficulty talking/swallowing 'to some extent'; V6 chewing gum and Salivin lozenge ranked…
  1 study · 106 participants
  GRADE not reported

CMC spray / HCC spray / HCC gel vs Liquid margarine (and between each other)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Furumoto 1998 (crossover, n=28, medians/IQR): median day-10 oral dryness (lower = less dry): CMC spray 28.00 (3.06), HCC spray 28.75 (2.23), HCC gel 27.75 (3.62), margarine 29.25 (5.06). Only HCC gel showed a…
  1 study · 28 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
  Momm 2005 (crossover, n=123): all four treatments significantly reduced dryness vs baseline (mean xerostomia score, scale 1 to 6: baseline 4.5 +/- 0.11; post-treatment aloe vera 3.7 +/- 0.11, CMC 3.8 +/- 0.12, canola…
  1 study · 123 participants
  GRADE not reported

CMC spray / HCC spray / HCC gel vs Liquid margarine (and between each other)

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  HCC gel rated better than margarine for convenience, perceived value, minutes of relief and overall rating; no other significant between-group differences.
  1 study · 28 participants
  GRADE not reported

V6 chewing gum / mucin chewing gum vs Placebo chewing gum

• Interventions for the management of dry mouth: topical therapies 2011 · Cochrane All outcomes
  Aagaard 1992 (crossover, n=43): approximately 50% of participants had an increase in unstimulated whole saliva from all products; unclear how many completed the trial; no usable data.
  1 study · 43 participants
  GRADE not reported