7709 studies identified, 62 included after deduplication and assessment. Most studies were blinded with sample sizes ranging from 15 to 270 patients. 70 different plants from 44 families were identified. Risk of bias assessment showed 27 studies with concerns, 22 with low risk, and 13 with high risk. 62 papers identified 17 orofacial pain conditions categorized into six groups. Meta-analyses found herbal extracts more effective in reducing periodontal, oral surgery, oral neuropathic, endodontic, oral mucosal, and TMD pain compared to standard therapies.