Efficacy of Antioxidant Mouthwash in the Reduction of Halitosis: A Randomized, Double Blind, Controlled Crossover Clinical Trial

Overview

Journal J Dent Sci

Specialty Dentistry

Date 2021 Apr 15

PMID 33854711

Citations 3

Authors

Duaa Alsaffar

Hamad Alzoman

Affiliations

Soon will be listed here.

Abstract

Background/purpose: Halitosis is the unpleasant and offensive odour in exhaled air, which is linked to the presence of volatile sulphur compounds (VSC). Different mouthwashes have been used to treat halitosis. The objective of this study was to test the effect of an antioxidant (AO) mouthwash, and mouthwash containing [0.05% chlorhexidine, 0.05% cetylpyridinium chloride, and 0.14% zinc lactate (CHX-CPC-Zn)] on VSC.

Material And Methods: Thirty-five subjects with halitosis participated in this clinical trial. At the baseline visit, a breath sample was taken and analyzed for the level of hydrogen sulphide (HS), methyl mercaptan (CHSH), and dimethyl sulphide (CHSCH) using portable gas chromatography (OralChroma™). Two mouthwashes were randomly provided to each subject in addition to saline solution (NaCl 0.9%) as control. Subjects were instructed to rinse with 20 ml of the mouthwash for 1 min twice daily for 2 weeks. At second visit, post-treatment breath sample was taken. Afterward, the patient was asked to refrain from using mouthwash for a washout period of 1 week. A similar procedure was repeated for each mouthwash interval.

Results: No significant differences in VSC level between all three groups were detected at baseline. A significant reduction in VSC level was obtained after using CHX-CPC-Zn mouthwash. On other hand, both AO mouthwash and saline had no significant impact on the level of VSC.

Conclusion: CHX-CPC-Zn mouthwash has a significant effect on VSC level reduction in subjects with confirmed halitosis. Besides, using AO mouthwash regularly for 2 weeks did not have any impact on improving the level of halitosis.

Citing Articles

Development of a novel, entirely herbal-based mouthwash effective against common oral bacteria and SARS-CoV-2.

Bencze B, Temesfoi V, Das S, Papp H, Kaltenecker P, Kuczmog A BMC Complement Med Ther. 2023; 23(1):138.

PMID: 37127611 PMC: 10150350. DOI: 10.1186/s12906-023-03956-3.

Evaluation of the Efficacy of Lacer Hali Treatment on the Management of Halitosis: A Randomized Double-Blind Clinical Trial.

Xiang L, Rojo R, Prados-Frutos J J Clin Med. 2021; 10(11).

PMID: 34071005 PMC: 8197132. DOI: 10.3390/jcm10112256.

Efficacy of Arabic Coffee and Black Tea in Reducing Halitosis: A Randomized, Double-Blind, Controlled, Crossover Clinical Trial.

Alzoman H, Alzahrani A, Alwehaiby K, Alanazi W, AlSarhan M Healthcare (Basel). 2021; 9(3).

PMID: 33804328 PMC: 8000802. DOI: 10.3390/healthcare9030250.

References

Roldan S, Winkel E, Herrera D, Sanz M, van Winkelhoff A . The effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc lactate on the microflora of oral halitosis patients: a dual-centre, double-blind placebo-controlled study. J Clin Periodontol. 2003; 30(5):427-34. DOI: 10.1034/j.1600-051x.2003.20004.x. View

TONZETICH J . Production and origin of oral malodor: a review of mechanisms and methods of analysis. J Periodontol. 1977; 48(1):13-20. DOI: 10.1902/jop.1977.48.1.13. View

van den Broek A, Feenstra L, de Baat C . A review of the current literature on management of halitosis. Oral Dis. 2008; 14(1):30-9. DOI: 10.1111/j.1601-0825.2006.01350.x. View

Tangerman A, Winkel E . The portable gas chromatograph OralChroma™: a method of choice to detect oral and extra-oral halitosis. J Breath Res. 2011; 2(1):017010. DOI: 10.1088/1752-7155/2/1/017010. View

RATCLIFF P, Johnson P . The relationship between oral malodor, gingivitis, and periodontitis. A review. J Periodontol. 1999; 70(5):485-9. DOI: 10.1902/jop.1999.70.5.485. View

Flotra L, Gjermo P, Rolla G, WAERHAUG J . Side effects of chlorhexidine mouth washes. Scand J Dent Res. 1971; 79(2):119-25. DOI: 10.1111/j.1600-0722.1971.tb02001.x. View

Loe H, SILNESS J . PERIODONTAL DISEASE IN PREGNANCY. I. PREVALENCE AND SEVERITY. Acta Odontol Scand. 1963; 21:533-51. DOI: 10.3109/00016356309011240. View

Santos S, Herrera D, Lopez E, OConnor A, Gonzalez I, Sanz M . A randomized clinical trial on the short-term clinical and microbiological effects of the adjunctive use of a 0.05% chlorhexidine mouth rinse for patients in supportive periodontal care. J Clin Periodontol. 2004; 31(1):45-51. DOI: 10.1111/j.0303-6979.2004.00438.x. View

Fleiss J, Park M, CHILTON N, Alman J, FELDMAN R, CHAUNCEY H . Representativeness of the "Ramfjord teeth" for epidemiologic studies of gingivitis and periodontitis. Community Dent Oral Epidemiol. 1987; 15(4):221-4. DOI: 10.1111/j.1600-0528.1987.tb00525.x. View

10.

Dadamio J, Van Tournout M, Teughels W, Dekeyser C, Coucke W, Quirynen M . Efficacy of different mouthrinse formulations in reducing oral malodour: a randomized clinical trial. J Clin Periodontol. 2013; 40(5):505-13. DOI: 10.1111/jcpe.12090. View

11.

Rolla G, Jonski G, Young A . The significance of the source of zinc and its anti-VSC effect. Int Dent J. 2002; 52 Suppl 3:233-5. DOI: 10.1002/j.1875-595x.2002.tb00931.x. View

12.

Winkel E, Roldan S, van Winkelhoff A, Herrera D, Sanz M . Clinical effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc-lactate on oral halitosis. A dual-center, double-blind placebo-controlled study. J Clin Periodontol. 2003; 30(4):300-6. DOI: 10.1034/j.1600-051x.2003.00342.x. View

13.

Aizawa F, Kishi M, Moriya T, Takahashi M, Inaba D, Yonemitsu M . The analysis of characteristics of elderly people with high VSC level. Oral Dis. 2005; 11 Suppl 1:80-2. DOI: 10.1111/j.1601-0825.2005.01099.x. View

14.

Farina V, de Lima A, Balducci I, Brandao A . Effects of the medicinal plants Curcuma zedoaria and Camellia sinensis on halitosis control. Braz Oral Res. 2012; 26(6):523-9. DOI: 10.1590/s1806-83242012005000022. View

15.

van Steenberghe D, Avontroodt P, Peeters W, Pauwels M, Coucke W, Lijnen A . Effect of different mouthrinses on morning breath. J Periodontol. 2001; 72(9):1183-91. DOI: 10.1902/jop.2000.72.9.1183. View

16.

Gjermo P, Baastad K, Rolla G . The plaque=inhibiting capacity of 11 antibacterial compounds. J Periodontal Res. 1970; 5(2):102-9. DOI: 10.1111/j.1600-0765.1970.tb00700.x. View

17.

OLeary T, Drake R, Naylor J . The plaque control record. J Periodontol. 1972; 43(1):38. DOI: 10.1902/jop.1972.43.1.38. View

18.

Wigger-Alberti W, Gysen K, Axmann E, Wilhelm K . Efficacy of a new mouthrinse formulation on the reduction of oral malodour in vivo. A randomized, double-blind, placebo-controlled, 3 week clinical study. J Breath Res. 2011; 4(1):017102. DOI: 10.1088/1752-7155/4/1/017102. View

19.

Quirynen M, Avontroodt P, Soers C, Zhao H, Pauwels M, Coucke W . The efficacy of amine fluoride/stannous fluoride in the suppression of morning breath odour. J Clin Periodontol. 2002; 29(10):944-54. DOI: 10.1034/j.1600-051x.2002.291010.x. View

20.

Mendes L, Coimbra J, Pereira A, Resende M, Pinto M . Comparative effect of a new mouthrinse containing chlorhexidine, triclosan and zinc on volatile sulphur compounds: a randomized, crossover, double-blind study. Int J Dent Hyg. 2015; 14(3):202-8. DOI: 10.1111/idh.12132. View