The effect of mouthrinses on oral malodor: a systematic review

Authors' affiliations: T Blom, School of Dental Hygiene, INHOLLAND University of Applied sciences, Amsterdam, and Dental practice Blom Ltd., Limmen, The Netherlands DE Slot, GA Van der Weijden, Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands M Quirynen, Department of Periodontology, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium.
International Journal of Dental Hygiene (Impact Factor: 0.68). 03/2012; 10(3):209-22. DOI: 10.1111/j.1601-5037.2012.00546.x
Source: PubMed

ABSTRACT To cite this article: Int J Dent Hygiene10, 2012; 209-222 DOI: 10.1111/j.1601-5037.2012.00546.x Blom T, Slot DE, Quirynen M, Van der Weijden GA. The effect of mouthrinses on oral malodor: a systematic review. Abstract:  Objective: The objective of this study is to systematically review the literature regarding the impact of mouthrinses on oral malodor and present evidence for the treatment effects of mouthrinses on oral malodor. Material and methods: PubMed-MEDLINE, the Cochrane-CENTRAL and EMBASE were searched through February 10, 2012 to identify appropriate studies. Volatile sulphur compound measurements, organoleptic measurements and tongue coating were selected as outcome variables. Search results: The independent screenings of 333 unique titles and paper abstracts revealed 12 publications (12 experiments) that met the eligibility criteria. Means and standard deviations were extracted. The results were separated into short-term (<3 weeks) and longer-term (≥3 weeks) studies. Conclusion: In this review, nearly all mouthwashes with active ingredients had beneficial effects in reducing oral malodor in both short- and longer-term studies. The most compelling evidence was provided for chlorhexidine mouthwashes, and those that contained a combination of cetyl pyridinum chloride and zinc provided the best evidence profile on oral malodor. Little data with respect to tongue coating were available, and none of the studies showed a beneficial effect for this parameter.

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    ABSTRACT: Commercialized cetylpyridinium chloride (CPC) mouthrinses were compared for antimicrobial substantivity/bioavailability in an in vitro disk retention assay (DRA) and clinical antimicrobial activity in vivo in the plaque glycolysis and regrowth method (PGRM). Formulations compared in this testing included commercially available CPC mouthrinses: Crest Pro Health (CPH), (containing 700 ppm formulated CPC); Colgate Total Puerto Rico (CT450), (containing 450 ppm formulated CPC); Colgate Total US (CT750), (containing 750 ppm formulated CPC); and Scope Mouthwash (SCP), (containing 450 ppm formulated CPC). A water control (CTR) was included in one of the PGRM clinical trials. Two separate clinical PGRM studies employed a controlled, double-blind, randomized, crossover design where qualified adult PGRM panelists were supplied with acclimation NaF dentifrice for use throughout the trials. On treatment days, subjects sampled baseline plaque and then rinsed with assigned mouthrinse following morning toothbrushing. Treated plaque samples were collected 15 and 45 minutes after rinsing. Sampled plaques were vortexed, normalized for biomass and incubated under standard conditions to assess glycolysis. pH response of treated plaques in incubation buffers were compared to baseline untreated plaque values and an Area Under Curve (AUC) composite/aggregate analysis of glycolysis inhibition was used for treatment comparisons. A laboratory disk retention substantivity/bioavailability assay measured adsorption affinity of CPC in mouthrinse for anionic cellulose disks in vitro. Clinical PGRM studies showed significant differences in antibacterial clinical efficacy of commercialized mouthrinses. Combining clinical study results reveals rank ordered efficacy CPH > CT750 > SCP > CT450 > CTR. Comparison of DRA to PGRM glycolysis showed a linear relation highlighting correlation of CPC bioavailability to clinical antimicrobial performance of CPC mouthrinses.
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    ABSTRACT: Zinc (Zn) reduces the formation of volatile sulphur compounds (VSCs) associated with oral malodour. Although strontium (Sr) is included in some products for reducing dental hypersensitivity, it may also have anti-halitosis properties. This randomized, double-blind, cross-over clinical study compared the anti-VSC effect of brushing with commercial toothpastes and rinses containing Zn and Sr. The volunteers (n = 30) either brushed/rinsed with/without tongue brushing using Zn-containing toothpaste/rinse, Sr-containing toothpaste/rinse, or placebo (control). Volatile sulphur compounds [hydrogen sulphide (H2 S) and methyl mercaptan (CH3 SH)] were measured, in morning breath, using gas chromatography. The anti-VSC effects of the test toothpastes and test rinses were significantly better than the anti-VSC effects of the respective controls. Toothbrushing with test toothpastes gave median reductions, compared with the control, of 70% for H2 S and 55-57% for CH3 SH. Rinsing with the Sr- and Zn-containing solutions had the same anti-VSC effect as toothbrushing and tooth- and tongue brushing with the Sr- and Zn-containing toothpastes. Zinc-containing rinse resulted in a significantly higher median salivary level of Zn compared with brushing with Zn-containing toothpaste, although this effect did not correlate with the anti-VSC effect. It can be concluded that the Sr- and Zn-containing toothpastes and the Zn- and Sr-containing rinses, when used in the evening, are equally effective in reducing morning-breath VSCs the following day. © 2015 Eur J Oral Sci.
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