What do systematic reviews say?

Chlorhexidine + zinc acetate mouthwash vs Placebo mouthwash

It is very uncertain whether chlorhexidine + zinc acetate mouthwash changes dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with placebo mouthwash (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 3 months
  MD -0.2 [-0.58, 0.18]
  1 study · 44 participants
  Very low

Pycnogenol chewing gum vs Placebo chewing gum

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

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  4 weeks
  MD -4.7 [-27.01, 17.61]
  1 study · 21 participants
  GRADE not reported

Mechanical tongue cleaning (tongue scraper) vs No tongue cleaning

It is very uncertain whether mechanical tongue cleaning (tongue scraper) changes dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with no tongue cleaning (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 2 weeks
  MD -0.2 [-0.34, -0.07]
  2 studies · 46 participants
  Very low

0.6% eucalyptus chewing gum vs Placebo chewing gum

The review found no eligible studies for this question.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 4 weeks
  Adverse events: listed in the Summary of findings table but no data reported. No data were reported for adverse events.
  0 studies
  No studies found

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

It is very uncertain whether 0.2% zinc sulphate toothpaste changes dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with placebo toothpaste (without zinc) (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 4 weeks
  MD -1.31 [-1.39, -1.23]
  1 study · 187 participants
  Very low

Sodium bicarbonate toothpaste vs Control toothpaste (without sodium bicarbonate)

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  6 weeks
  Adverse events reported by Lomax 2017 were not related to the interventions.
  1 study · 148 participants
  GRADE not reported

Subgingival laser irradiation + povidone-iodine vs SRP

It is very uncertain whether subgingival laser irradiation + povidone-iodine changes dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with SRP alone (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 4 weeks
  MD 0.49 [0.3, 0.68]
  1 study · 40 participants
  Very low

Miswak (Salvadora persica) stick vs Chlorhexidine mouthwash

It is very uncertain whether miswak (Salvadora persica) stick 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 -0.55 [-1.33, 0.23]
  1 study · 24 participants
  Very low

Benzethonium chloride mouthwash vs Placebo mouthwash

Benzethonium chloride mouthwash showed no clear difference in VSC: hydrogen sulphide compared with placebo mouthwash; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  9 days
  MD -125.1 [-286.32, 36.12]
  1 study · 20 participants
  GRADE not reported

Benzethonium chloride mouthwash vs Placebo mouthwash

Benzethonium chloride mouthwash showed no clear difference in VSC: dimethyl sulphide compared with placebo mouthwash; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  9 days
  MD -0.03 [-0.63, 0.57]
  1 study · 20 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
  Adverse events: listed in the Summary of findings table but no data reported. No data were reported for adverse events.
  0 studies
  No studies found

Cetylpyridinium chloride mouthwash vs Chlorhexidine + zinc mouthwash

It is very uncertain whether cetylpyridinium chloride mouthwash changes dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with chlorhexidine + zinc mouthwash (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 2 weeks
  MD -0.33 [-0.72, 0.06]
  1 study · 44 participants
  Very low

Mechanical tongue cleaning (tongue scraper) vs No tongue cleaning

Mechanical tongue cleaning (tongue scraper) showed no clear difference in volatile sulphur compounds (VSC) compared with no tongue cleaning; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  1 week
  MD -7.69 [-47.08, 31.69]
  2 studies · 46 participants
  GRADE not reported

Toothbrushing + Turkish gall oral rinse vs Toothbrushing alone

Toothbrushing + Turkish gall oral rinse showed no clear difference in dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with toothbrushing; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  2 weeks
  MD -0.1 [-0.5, 0.3]
  1 study · 66 participants
  GRADE not reported

Essential oil 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 · 45 participants
  GRADE not reported

Lactobacillus beta lactoperoxidase (LPO) tablets vs placebo (3 tablets/4 times a day

• Interventions for managing halitosis 2019 · Cochrane All outcomes
  Nakano 2017 (2-arm trial) compared Lactobacillus beta LPO tablets versus placebo tablets (VSC by OralChroma). The trial did not report any usable data and hence could not be included in the analysis.
  1 study
  GRADE not reported

Triphala and Ela decoction mouthwash vs Chlorhexidine mouthwash

It is very uncertain whether triphala and Ela decoction 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 2 weeks
  MD 0.2 [0.09, 0.31]
  1 study · 60 participants
  Very low

Triclosan/copolymer-containing fluoride toothpaste vs Sodium fluoride (control) toothpaste

The review found no eligible studies for this question.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 1 week
  Adverse events: listed in the Summary of findings table but no data reported. No data were reported for adverse events.
  0 studies
  No studies found

Hinokitiol gel vs Placebo gel

Hinokitiol gel showed no clear difference in VSC: hydrogen sulphide compared with placebo gel; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  28 days
  MD -2.13 [-5.33, 1.08]
  1 study · 18 participants
  GRADE not reported

Cetylpyridinium chloride mouthwash vs Chlorhexidine + zinc mouthwash

Cetylpyridinium chloride mouthwash showed no clear difference in volatile sulphur compounds (VSC) compared with chlorhexidine + zinc mouthwash; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  2 weeks
  MD 0.49 [-8.68, 9.66]
  1 study · 44 participants
  GRADE not reported