Evidence map›Paper›PMID 39300203›Full record

ArticleEvidence-based dentistry2025

Nicotine replacement therapy and oral health: a network meta-analysis of adverse effects in randomized trials.

Gowri Sivaramakrishnan, Kannan Sridharan

Abstract readNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Article in Evidence-based dentistry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Gowri SivaramakrishnanBahrain Defence Force Royal Medical Services, Riffa, Bahrain. Gowri.sivaramakrishnan@gmail.com.ORCID http://orcid.org/0000-0002-5877-205X
Kannan SridharanDepartment of Pharmacology and Therapeutics, College of Medicine and Health Sciences, Arabian Gulf University, Manama, Bahrain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNicotine replacement therapies (NRTs) are the primary pharmacological option for smokers looking to quit. However, they can lead to oral health issues, including aphthous ulcers, gastric irritation resulting in tooth wear, mouth irritation, soreness, and dryness, which may decrease patient adherence. Dentists should be integrated into the tobacco cessation team to prevent, detect, and manage these oral side effects associated with NRT use. Therefore, the objective of this network meta-analysis is to examine the relationship between different forms of NRTs and their oral side effects. METHODOLOGY: Databases were screened for literature and full text articles were obtained for eligible studies. Relevant data was extracted. NMA Studio was used to perform random-effects network meta-analysis to generate mixed treatment comparison pooled estimates from odds ratios (OR) and 95% confidence intervals (CI). The forest plot was generated, and the network diagram was drawn for key comparisons. The OR and 95% CI were estimated from the data on the number of patients that reported the oral side effects in the included studies.

resultsA total of 21 articles were included. The Risk of Bias assessment revealed a moderate to low risk across all domains for the included studies. The mixed treatment comparison pooled estimates indicated that nicotine gum was significantly associated with the occurrence of aphthous ulcers [2.25 (1.03, 4.90)] and gastric reflux/vomiting [4.40 (1.51, 12.80)]. Additionally, the results showed that nasal spray significantly caused mouth/throat irritation [5.37 (1.03, 27.92)] and taste disturbance [4.87 (2.83, 8.37)] in comparison to tested NRT interventions.

conclusionSignificant oral side effects are associated with NRT use, as demonstrated in this study. Dentists should implement tobacco cessation methods in their practices, including pharmacotherapy, to effectively monitor these patients. Continuous education and certification programs should be mandatory for dentists who want to practice tobacco cessation. This should also be included in the undergraduate dental curriculum to help dentists gain confidence in prescribing NRT. Standard evidence-based guidelines should be published to outline possible methods for encouraging tobacco cessation in dental settings.

Indexed as

Mouth DiseasesNicotineOral HealthTobacco Use Cessation DevicesHumansNicotine Replacement TherapyRandomized Controlled Trials as TopicSmoking CessationNicotine

Identifiers

PMID39300203

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.