The role of toothpastes in oral malodor management.

One out of four people suffers from persistent bad breath. In most of the cases, the cause can be found in the mouth, with the presence of tongue coating as the leading factor, followed by gingivitis and periodontitis, and it is referred to as oral malodor. Because oral malodor is the result of the degradation of organic substrates by anaerobic bacteria of the oral cavity, the management is mostly done by masking the odorous compounds or eliminating the cause (bacteria and their substrates) either mechanically or chemically. Toothpaste formulations have been modified to carry antimicrobial and oxidizing agents with an impact on the process of oral malodor formation. We performed extensive literature search regarding the effect of dedicated toothpastes in the management of oral malodor. The main characteristics of the in vitro and in vivo investigations and their most relevant findings are presented for discussion. Even though the amount of publications regarding this topic is far smaller than for others such as caries, plaque control and whitening, antibacterial ingredients such as triclosan and metal ions like stannous and zinc appear to be effective in the control of oral malodor. On the other hand, data supporting the use of hydrogen peroxide, baking soda, essential oils and flavors in the management of oral malodor are rather few and inconclusive.

Efficacy of different mouthrinse formulations in reducing oral malodour: a randomized clinical trial.

AIMS: The aim of this study was to assess the efficacy of mouthrinses formulations in oral malodour. MATERIAL & METHODS: This single-centre, double-blind, randomized, parallel group clinical trial compared the efficacy of Halita™ and meridol(®) with and without zinc lactate versus negative and positive control. Volunteers with confirmed oral malodour (18/group) rinsed with one mouthrinse during 7 days (15 ml, 2x/day for 1 min.). 15 min. after a first rinse (masking effect), and after 7 days (therapeutic effect) the change in organoleptic scores and level of sulphur compounds was recorded. RESULTS: All rinses showed a masking effect (OLS 1 to 2 values reduced), only the rinses with antimicrobial ingredients showed a therapeutic effect (OLS 1 to 1.5 value less). The addition of zinc resulted in a more pronounced masking effect. Halita™ and meridol(®) with zinc showed the best therapeutic effect. CONCLUSION: Although the masking effect of the rinses can be attributed partially to a dilution and the effect of aromas, the therapeutic effect should be linked to the anti-microbial action of active ingredients and counter action of zinc ions on VSC. A complete resolution of the unpleasant breath by additional mechanical intervention remains to be proven.