METHODS Medline, CENTRAL and Embase and the reference lists of included articles. METHODS Randomised controlled clinical trials (RCTs) or controlled clinical trials (CCTs) conducted in adults over 18 that compared CHX-V against placebo or control that reported root caries incidence and/or root caries activity were included. Only papers written in English were included. METHODS Study selection and data abstraction were carried out independently by two reviewers with disagreements resolved by discussion with third reviewer if required. Where appropriate, a meta-analysis was carried out using a 'random effect' model. As only a few studies could be included in the meta-analysis, data were also presented in a descriptive manner. RESULTS Searches identified 32 papers with six meeting the inclusion criteria. Data extraction provided no conclusive evidence that the application of CHX-V is effective in patients when regular professional oral prophylaxis is performed. If effective, the 40% CHX-V was found to provide a benefit over a control or fluoride varnish. CHX-V at lower concentrations (1 and 10%) may provide protection against root caries in high-risk patients (such as geriatric and xerostomia patients) in the absence of regular professional oral prophylaxis. CONCLUSIONS Within the limitations of this review, it may be concluded that in the absence of regular professional tooth cleaning and oral hygiene instructions, CHX-V may provide a beneficial effect in patients in need of special care. The strength of this recommendation is graded as 'weak'.