What do systematic reviews say?

Two-phase oil-water mouthrinse (0.05% cetylpyridinium chloride) vs Control mouthwash

Oil water two-phase mouthwash (with cetylpyridinium chloride) showed no clear difference in volatile sulphur compounds (VSC), sulphide monitor compared with control mouthwash; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  1 week
  MD -11.0 [-25.26, 3.26]
  1 study · 50 participants
  GRADE not reported

Triclosan mouthwash (with and without alcohol); zinc lactate + chlorhexidine + cetylpyridinium mouthwash vs Placebo mouthwash

• Interventions for managing halitosis 2019 · Cochrane All outcomes
  Lopez Jornet 2003 (4-arm RCT) compared triclosan mouthwash with and without alcohol and a zinc lactate + chlorhexidine + cetylpyridinium mouthwash versus placebo mouthwash (VSC by halimeter and OLT). We could not…
  1 study
  GRADE not reported

1000 mg champignon extract vs placebo

The review found no eligible studies for this question.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 2 weeks
  Dentist-reported OLT score: listed in the Summary of findings table but no data reported. No data were reported for dentist-reported OLT score.
  0 studies
  No studies found

Toothbrushing + 0.075% cetylpyridinium chloride mouthwash vs Toothbrushing alone

Toothbrushing + 0.075% cetylpyridinium chloride mouthwash may leads to lower dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with toothbrushing (low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 3 weeks
  MD -0.48 [-0.72, -0.24]
  1 study · 70 participants
  Low

0.6% eucalyptus chewing gum vs Placebo chewing gum

It is very uncertain whether 0.6% eucalyptus chewing gum changes dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with placebo chewing gum (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 4 weeks
  MD -0.1 [-0.31, 0.11]
  1 study · 65 participants
  Very low

Salvadora persica (miswak) mouthrinse vs Chlorhexidine mouthwash

It is very uncertain whether miswak (Salvadora persica) mouthwash changes dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with chlorhexidine mouthwash (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 1 week
  MD 0.01 [-0.95, 0.97]
  1 study · 21 participants
  Very low

0.2% zinc sulphate toothpaste vs Placebo toothpaste (without zinc)

0.2% zinc sulphate toothpaste led to lower volatile sulphur compounds (VSC) compared with placebo toothpaste (without zinc); GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  4 weeks
  MD -11.3 [-20.45, -2.15]
  1 study · 188 participants
  GRADE not reported

Salvadora persica (miswak) mouthrinse vs Chlorhexidine mouthwash

It is very uncertain whether miswak (Salvadora persica) mouthwash changes patient self-assessment VAS (scale 0 to 10) compared with chlorhexidine mouthwash (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 1 week
  MD -0.18 [-1.59, 1.23]
  1 study · 21 participants
  Very low

0.6% eucalyptus chewing gum vs 0.4% eucalyptus chewing gum

0.6% eucalyptus chewing gum showed no clear difference in volatile sulphur compounds (VSC) compared with 0.4% eucalyptus chewing gum; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  4 weeks
  MD 0.0 [-0.21, 0.21]
  1 study · 64 participants
  GRADE not reported

Toothbrushing + 0.075% cetylpyridinium chloride mouthwash vs Toothbrushing alone

The review found no eligible studies for this question.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 3 weeks
  Patient-reported OLT score: listed in the Summary of findings table but no data reported. No data were reported for patient-reported OLT score.
  0 studies
  No studies found

Pycnogenol chewing gum vs Placebo chewing gum

Pycnogenol chewing gum led to lower VSC: hydrogen sulphide compared with placebo chewing gum; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  4 weeks
  MD -114.9 [-206.59, -23.21]
  1 study · 21 participants
  GRADE not reported

Zinc chloride + sodium fluoride dentifrice vs Sodium fluoride (control) toothpaste

• Interventions for managing halitosis 2019 · Cochrane All outcomes
  Payne 2011 reported 19 non-oral and 12 oral adverse effects. The oral effects were tingling sensation in lips, dry mouth or sore gums.
  1 study
  GRADE not reported

Miswak (Salvadora persica) stick vs Chlorhexidine mouthwash

It is very uncertain whether miswak (Salvadora persica) stick changes patient self-assessment VAS (scale 0 to 10) compared with chlorhexidine mouthwash (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 1 week
  MD -0.26 [-1.16, 0.64]
  1 study · 24 participants
  Very low

Chlorine dioxide mouthrinse (with tongue scraping) vs Chlorhexidine mouthwash (with tongue scraping)

Chlorine dioxide mouthrinse (with tongue scraping) showed no clear difference in VSC: hydrogen sulphide compared with chlorhexidine mouthwash (with tongue scraping); GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  1 week
  MD -11.0 [-31.61, 9.61]
  1 study · 22 participants
  GRADE not reported

Protease cysteine + actinidine tablets vs placebo (3 tablets/4 times a day

Protease cysteine + actinidine tablets showed no clear difference in volatile sulphur compounds (VSC), OralChroma compared with placebo tablets; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  1 week
  MD -45.8 [-258.38, 166.78]
  1 study · 14 participants
  GRADE not reported

Triclosan/copolymer-containing fluoride toothpaste vs Non-fluoride (0 ppm F) placebo toothpaste

• Interventions for managing halitosis 2019 · Cochrane All outcomes
  Niles 1999 (cross-over trial) compared 0.3% triclosan + 2.0% PVM/MA + 0.243% NaF toothpaste versus placebo toothpaste; VSC by gas chromatograph. We could not use the results in the meta-analysis as there was no…
  1 study
  GRADE not reported

Cetylpyridinium chloride mouthwash vs Placebo mouthwash

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  2 weeks
  Adverse events reported by Borden 2002 were not related to the interventions.
  1 study · 47 participants
  GRADE not reported

Chlorine dioxide mouthrinse (with tongue scraping) vs Chlorhexidine mouthwash (with tongue scraping)

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  1 week
  Wirthlin 2011 reported altered taste sensation as the adverse event. OLT scores could not be included in the analysis as the group-wise data were not given.
  1 study · 22 participants
  GRADE not reported

Mouthwash (amine/stannous fluoride; or chlorhexidine + cetylpyridinium + zinc) vs Chlorhexidine mouthwash or tap water

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  7 days
  Wigger-Alberti 2010 mouthwash data (ASF; CHX + CPC + Zn; CHX; tap water) were calculated from a graph (Additional Table 1) but not included, as the report did not give details of sample size per group.
  1 study
  GRADE not reported

Pycnogenol chewing gum vs Placebo chewing gum

Pycnogenol chewing gum showed no clear difference in VSC: methyl mercaptan compared with placebo chewing gum; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  4 weeks
  MD -8.4 [-24.95, 8.15]
  1 study · 21 participants
  GRADE not reported