Types Of Rinses For Bad Breath
Contributed by: Jimi Stein
Here are few of oral rinses used to battle against bad breath. Read about them to get more info on which one to choose. I do not guarantee they are 100 % cure, sometimes they will not even help you, it depends on how strong the bad breath is and what is the cause. Talking about the cause, the doctors are still figuring it out (please help us before year 3000).
Clinical trials conclude that zinc mouth rinses are effective for reducing oral malodor in people with good oral health. Zinc rinses (in chloride, citrate or acetate form) have been found to reduce oral volatile sulfur compound (VSC) concentrations for greater than three hours. The zinc ion may counteract the toxicity of the VSC's and it functions as an odor inhibitor by preventing disulfide group reduction to thiols and by reaction with the thiols groups in VSC's. It has been reported a zinc-based rinse was more effective as compared to chlorinedioxide based rinse when both rinses were used twice a day for 60 seconds over a 6-week period. Zinc containing chewing gum has been shown to reduce oral malodor.
Chlorhexidine digluconate is useful in decreasing gingivitis and plaque buildup. It is one of two active ingredients in mouth rinses that has been shown to reduce gingivitis in long-term clinical trials and appears to be the most effective anti-plaque and anti-gingivitis agent known today. The efficacy of chlorhexidine as a mouthrinse to control oral malodor has not been studied extensively. The primary side effect of chlorhexidine is the discoloration of the teeth and tongue. In addition, an important consideration for long-term use is its potential to disrupt the oral microbial balance, causing some resistant strains to flourish, such as Streptococcus viridans. The effect of 1-stage full mouth disinfection in periodontitis patients (Scaling and root planing of all pockets within 24 hrs together with the application of Chlorhexidine to all intra-oral niches followed by chlorhexidine rinsing for 2 months) resulted in a significant improvement in oral malodor when compared to a fractional periodontal therapy (consecutive root planings per quadrant, at a 1 to 2 week interval). While Chlorhexidine appears to be clinically effective from these open-design clinical studies, it is not an agent that should be used routinely, or for long periods of time, in the control of oral malodor, because of its side effects. Mouth rinse containing Chlorhexidine, Cetylpyridium chloride and Zinc lactate was evaluated in a clinical study for two weeks. Eight subjects participated in this pilot study and this formulation showed improvement in organoleptic scores and a trend to reduce tongue and saliva microflora. Antimalodor properties of chlorhexidine spray 0.2% chlorhexidine mouth rinse 0.2% and sanguarine-zinc mouth rinse were evaluated on morning breath. Oral malodor parameters were assessed before breakfast and four hours later after lunch. Results indicated that a sanguarine-zinc solution had a short effect as compared to chlorhexidine that lasted longer.
Chlorine Dioxide Rinses:
Chlorine Dioxide (ClO2) is a strong oxidizing agent that has a high redox capacity with compounds containing sulfur. Chlorine dioxide is also used in water disinfection and in food processing equipment sanitation and functions best at a neutral pH. Commercially available mouth rinses are a solution of sodium chlorite since chlorine dioxide readily loses its activity. Further independent clinical investigations are needed to substantiate the effectiveness of sodium chlorite containing rinses for the control of oral malodor. In fact, chlorine dioxide, the agent most widely touted on the Internet, has no published clinical studies (as of December, 1999) to substantiate the claims to reduce oral malodor. Benzalkonium chloride in conjunction with sodium chlorate has been shown to be effective in reducing oral malodor. In this pilot study subjects with mild to severe periodontitis were instructed to use the mouthwash twice a day for a period of six weeks and periodontal and oral malodor parameters were assessed.
Triclosan (2,4,4'-trichloro-2'-hydroxydiphenylether) is a broad spectrum nonionic antimicrobial agent. This lipid soluble substance has been found to be effective against most types of oral cavity bacteria. A combined zinc and triclosan mouth rinse system has been shown to have a cumulative effect, with the reduction of malodor increasing with the duration of the product use.
Two-phase oil-water mouth rinses have been tested for their ability to control halitosis. A clinical trial reported significant long-term reductions in oral malodor from the whole mouth and the tongue dorsum posterior. The rinse is thought to reduce odor-producing microbes on the tongue because there is a polar attraction between the oil droplets and the bacterial cells. The two-phase rinse has been shown to significantly decrease the level of volatile sulfur compounds eight to ten hours after use, although not as effectively as a 0.2% chlorhexidine rinse. Positive controls such as Chlorhexidine and Listerine® that had previously shown to reduce organoleptic scores were used in these clinical studies.
The potential of hydrogen peroxide to reduce levels of salivary thiol precursors of oral malodor has been investigated. Using analytical procedures, percent reduction in salivary thiols levels post treatment compared to baseline was found to be 59%.
Topical Antimicrobial Agents:
Azulene ointment with a small dose of Clindamycin was used topically in eight patients with maxillary cancer to inhibit oral malodor that originates from a gauze tamponade applied to the postoperative maxillary bone defect. The malodor was markedly decreased or eliminated in all cases. Anaerobic bacteria such as Porphyromonas and Peptostreptococcus involved in generation of malodor also became undetectable.
Some of the natural controls for oral malodor include gum containing tea extract. Also recommended are natural deodorants such as copper chlorophyll and sodium chlorophyllin. Alternative dental health services suggest the use of chlorophyll oral rinses in addition to spirulina and algae products. Conclusions About Mouth rinses/Mouthwashes: Many of the mouth rinses available today are being used for the prevention and or treatment of oral malodor. Much more research is required to develop an efficacious mouth rinse for the alleviation of oral malodor. The treatment of oral malodor is relatively a new field in dentistry and many of the treatments thus far have involved a trial and error approach, but the knowledge and experience gained so far will hopefully facilitate clinical investigations in this field and eventually lead to improved diagnostic techniques and treatment products.