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Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.
288 questions in 13 reviews · Dental public health and special care
current versionsNo studies 73 · 25.3%Ungraded 90 · 31.3%Very low 90 · 31.3%Low 29 · 10.1%Moderate 6 · 2.1%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Chlorhexidine (CHX) vs Essential oils/herbal mouthwash Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · 15 cm from mouth (essential oil mouthwash B) Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -44.1 [-59.12, -29.08] | 1 study · 20 participants | Ungraded |
Essential oil mouthwash C (Listerine) vs Coloured and flavoured 5% hydroalcohol mouthwash Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · operator level; aerobic culture (cross-over; graph-only, not analysed) Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | One study (Fine 1993a) compared essential oil mouthwash C (Listerine) with coloured and flavoured 5% hydroalcohol mouthwash in a cross-over design for reduction in contamination by particles >5 um at operator level… | 1 study | Ungraded |
Povidone iodine vs Ozonated water Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · operator level; aerobic cultures Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD 3.5 [-17.1, 24.1] | 1 study · 40 participants | Very low |
Chlorhexidine (CHX) vs Cetylpyridinium chloride (CPC) Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · cold CHX vs cold CPC; assistant level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD 8.8 [2.7, 14.9] | 1 study · 20 participants | Very low |
Chlorhexidine (CHX) vs Water (distilled) Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · operator level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | At operator level, because of high heterogeneity (I2 = 98%), the results were not meta-analysed (6 studies, 196 participants). No pooled estimate or GRADE rating. | 6 studies · 196 participants | Ungraded |
Cetylpyridinium chloride (CPC) vs No rinsing Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · CPC + domiphen bromide + quaternary ammonium vs no rinsing; combined Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -0.75 [-1.32, -0.18] | 2 studies · 200 participants | Very low |
Chlorhexidine (CHX) vs Povidone iodine Reduction in level of contamination by particles <=5 um (droplet nuclei) at >=2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · droplet nuclei; anaerobic cultures (9 feet behind patient) Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -0.8 [-11.65, 10.05] | 1 study · 40 participants | Very low |
Chlorhexidine (CHX) vs Water (distilled) Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · combined patient and operator level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -632.94 [-1267.33, 1.45] | 3 studies · 80 participants | Very low |
Tempered cetylpyridinium chloride vs Cold cetylpyridinium chloride Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · operator level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -9.3 [-16.17, -2.43] | 1 study · 20 participants | Very low |
Chlorhexidine (CHX) vs Cetylpyridinium chloride (CPC) Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · cold CHX vs tempered CPC; assistant level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD 17.4 [11.3, 23.5] | 1 study · 20 participants | Very low |
Chlorhexidine (CHX) vs Water (distilled) Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · tempered CHX; combined operator, assistant and patient level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -101.1 [-107.01, -95.19] | 1 study · 20 participants | Low |
Oral care vs No oral care Outcome NR · Residents of nursing homes and other long-term care facilities Oral care measures for preventing nursing home‐acquired pneumonia (2022) · Cochrane | No studies evaluated oral care versus no oral care. | 0 studies | No studies |
Chlorhexidine (CHX) vs Cetylpyridinium chloride (CPC) Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · tempered CHX vs cold CPC; operator level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -11.5 [-18.37, -4.63] | 1 study · 20 participants | Very low |
Chlorhexidine (CHX) vs Essential oils/herbal mouthwash Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · pharynx level (patient level; not analysed) Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | Bay 1993 compared 0.12% CHX with essential oil mouthwash C (Listerine) at pharynx level (Andersen's level 2), which was considered patient level and hence was not analysed. No pooled estimate or GRADE rating. | 1 study | Ungraded |
Boric acid vs Water Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · operator level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -29.3 [-32.65, -25.95] | 1 study · 60 participants | Very low |
Any preprocedural mouth rinse vs Placebo, no rinsing or control Adverse events such as transient discolouration, altered taste, allergic reaction, hypersensitivity · Dental patients undergoing aerosol-generating procedures (AGPs) Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | SoF tables state 'Not reported'; no included study reported adverse events. | 0 studies | No studies |
Any preprocedural mouth rinse vs Placebo, no rinsing or control Incidence of infection of dental healthcare providers · Dental patients undergoing aerosol-generating procedures (AGPs) Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | Primary outcome. Not measured by any of the 17 included studies (SoF tables state 'Not reported'); remained a total evidence gap from the protocol. | 0 studies | No studies |
Chlorhexidine (CHX) vs Ozonated water Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · operator level; aerobic cultures Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -17.8 [-33.7, -1.9] | 1 study · 40 participants | Very low |
Professional oral care vs Usual oral care Incidence of NHAP · Residents of nursing homes and other long-term care facilities · 8-30 months Oral care measures for preventing nursing home‐acquired pneumonia (2022) · Cochrane | Incidence of NHAP, follow-up 8-30 months, 5018 (5 studies), Low. Not pooled (individual and cluster-randomised designs, varying effect measures and follow-up). Component estimates: Bourigault HR 0.65 (0.29 to 1.46;… | 5 studies · 5018 participants | Low |
Professional oral care vs Usual oral care Mortality (all-cause) · Residents of nursing homes and other long-term care facilities · 12-30 months Oral care measures for preventing nursing home‐acquired pneumonia (2022) · Cochrane | All-cause mortality, follow-up 12-30 months, 3764 (3 studies), Very low. Not pooled. Adachi RR 0.80 (0.40 to 1.58; 88); Juthani-Mehta HR 1.16 (0.88 to 1.53; 834); Zimmerman adjusted IRR 0.83 (0.61 to 1.12; 1606).… | 3 studies · 3764 participants | Very low |
Cetylpyridinium chloride (CPC) vs Water Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · CPC+Zn+F vs water; operator level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -246 [-437.96, -54.04] | 1 study · 30 participants | Low |
Povidone iodine vs Saline Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · operator level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -16.5 [-32.65, -0.35] | 1 study · 12 participants | Very low |
Cetylpyridinium chloride (CPC) vs No rinsing Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · CPC vs no rinsing; operator level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -34.8 [-65.92, -3.68] | 1 study · 30 participants | Very low |
Chlorhexidine (CHX) vs Saline Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · 3 feet from patient's mouth Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -668.4 [-1044.45, -292.35] | 1 study · 20 participants | Ungraded |
Cetylpyridinium chloride (CPC) vs No rinsing Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · CPC+Zn+F vs no rinsing; operator level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -583 [-958.36, -207.64] | 1 study · 30 participants | Low |
Essential oil/herbal mouthwash vs Water Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · patient level (pharynx; not analysed) Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | Bay 1993 compared essential oil mouthwash C (Listerine) with distilled water and reported combined CFUs at different levels using Andersen's air sampler; level 2 (pharynx) was considered patient level and was not… | 1 study | Ungraded |
Cetylpyridinium chloride (CPC) vs Water Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · CPC + domiphen bromide + quaternary ammonium vs water; combined Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -0.78 [-1.24, -0.31] | 1 study · 105 participants | Very low |
Chlorhexidine (CHX) vs Boric acid Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · assistant level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -8.03 [-9.65, -6.41] | 1 study · 60 participants | Very low |
Antibiotic prophylaxis before dental procedure vs No antibiotic prophylaxis or placebo Mortality or serious adverse events requiring hospitalisation · Adults or children at increased risk of bacterial endocarditis (pre-existing cardiac condition) undergoing an invasive… Antibiotic prophylaxis for preventing bacterial endocarditis following dental procedures (2022) · Cochrane | Mortality or serious adverse events requiring hospitalisation | No data reported | 248 (1 study) | - | - | 0 studies | No studies |
Tempered cetylpyridinium chloride vs Cold cetylpyridinium chloride Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · assistant level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -8.6 [-14.7, -2.5] | 1 study · 20 participants | Very low |
Chlorhexidine (CHX) vs Povidone iodine Reduction in level of contamination by particles <=5 um (droplet nuclei) at >=2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · droplet nuclei; aerobic cultures (9 feet behind patient) Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD 0.2 [-7.28, 7.68] | 1 study · 40 participants | Very low |
Professional oral care vs Usual oral care Mortality (pneumonia-associated) · Residents of nursing homes and other long-term care facilities · 24 months Oral care measures for preventing nursing home‐acquired pneumonia (2022) · Cochrane | RR 0.43 [0.25, 0.76] | 2 studies · 454 participants | Low |
Povidone iodine vs Ozonated water Reduction in level of contamination by particles <=5 um (droplet nuclei) at >=2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · droplet nuclei; aerobic cultures Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -12.5 [-26.33, 1.33] | 1 study · 40 participants | Very low |
Chlorhexidine (CHX) vs Povidone iodine Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · operator level; aerobic and anaerobic cultures combined Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -4.7 [-7.01, -2.39] | 1 study · 30 participants | Very low |
Chlorhexidine (CHX) vs Cetylpyridinium chloride (CPC) Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · tempered CHX vs cold CPC; assistant level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -8.8 [-14.9, -2.7] | 1 study · 20 participants | Very low |
Any preprocedural mouth rinse vs Placebo, no rinsing or control Change of microbiota in the patient's mouth · Dental patients undergoing aerosol-generating procedures (AGPs) Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | No included study reported change of oral microbiota. | 0 studies | No studies |
Professional oral care vs Usual oral care Incidence or prevalence of fever · Residents of nursing homes and other long-term care facilities · 24 months Oral care measures for preventing nursing home‐acquired pneumonia (2022) · Cochrane | RR 0.49 [0.33, 0.75] | 1 study · 366 participants | Ungraded |
Chlorhexidine (CHX) vs Saline Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · operator level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -21.33 [-36.8, -5.86] | 1 study · 12 participants | Very low |
Professional oral care vs Usual oral care Adverse effects of interventions · Residents of nursing homes and other long-term care facilities Oral care measures for preventing nursing home‐acquired pneumonia (2022) · Cochrane | Measured in only 1 study (834 participants), which reported no serious events and 64 non-serious events, the most common of which were oral cavity disturbances (not defined) and dental staining. | 1 study · 834 participants | Ungraded |
Any preprocedural mouth rinse vs Placebo, no rinsing or control Acceptability and feasibility of the intervention to patients and dental healthcare providers · Dental patients undergoing aerosol-generating procedures (AGPs) Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | No included study assessed acceptability or feasibility. | 0 studies | No studies |
Essential oil/herbal mouthwash vs Water Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · operator level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | At operator level, because of high heterogeneity (I2 = 98%), the results were not meta-analysed (3 studies; Gupta 2014, Nayak 2020, Shetty 2013). No pooled estimate or GRADE rating. | 3 studies | Ungraded |
Essential oil/herbal mouthwash vs Water Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · assistant level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | At assistant level, because of high heterogeneity (I2 = 99%), the results were not meta-analysed (3 studies; Gupta 2014, Nayak 2020, Shetty 2013). No pooled estimate or GRADE rating. | 3 studies | Ungraded |
Povidone iodine vs Ozonated water Reduction in level of contamination by particles <=5 um (droplet nuclei) at >=2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · droplet nuclei; anaerobic cultures Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -2.6 [-9.54, 4.34] | 1 study · 40 participants | Very low |
Chlorhexidine (CHX) vs Cetylpyridinium chloride (CPC) Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · tempered CHX vs tempered CPC; operator level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -2.2 [-9.07, 4.67] | 1 study · 20 participants | Very low |
Boric acid vs Water Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · assistant level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -14.04 [-16.47, -11.61] | 1 study · 60 participants | Very low |
Chlorhexidine (CHX) vs Boric acid Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · operator level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -26.6 [-28.24, -24.96] | 1 study · 60 participants | Very low |
Antibiotic prophylaxis before dental procedure vs No antibiotic prophylaxis or placebo Development of endocarditis due to other (non-dental) causes · Adults or children at increased risk of bacterial endocarditis (pre-existing cardiac condition) undergoing an invasive… Antibiotic prophylaxis for preventing bacterial endocarditis following dental procedures (2022) · Cochrane | Only four cases developed endocarditis following non-dental medical interventions (within the past 180 days and with pre-existing cardiac indications for the use of prophylaxis), so assessment of the effects of… | 0 studies | No studies |
Chlorhexidine (CHX) vs Ozonated water Reduction in level of contamination by particles <=5 um (droplet nuclei) at >=2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · droplet nuclei; anaerobic cultures Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -3.4 [-14.66, 7.86] | 1 study · 40 participants | Very low |
Chlorhexidine (CHX) vs Cetylpyridinium chloride (CPC) Reduction in level of contamination by particles >5 um (droplets) at <2 m from patient's oral cavity · Dental patients undergoing aerosol-generating procedures (AGPs) and the dental healthcare providers treating them · CHX 0.12% vs CPC+Zn+F; operator level Preprocedural mouth rinses for preventing transmission of infectious diseases through aerosols in dental… (2022) · Cochrane | MD -30 [-85.86, 25.86] | 1 study · 30 participants | Very low |
Professional oral care vs Usual oral care Change in data on economics and quality of life · Residents of nursing homes and other long-term care facilities · 24 months Oral care measures for preventing nursing home‐acquired pneumonia (2022) · Cochrane | MD 1.5 [0.32, 2.68] | 1 study · 322 participants | Ungraded |