What do systematic reviews say?

Cetylpyridinium chloride mouthwash vs Chlorhexidine + zinc 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 · 44 participants
  GRADE not reported

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

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

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  1 week
  MD 7.63 [-1.7, 16.96]
  1 study · 22 participants
  GRADE not reported

Sodium bicarbonate toothpaste vs Control toothpaste (without sodium bicarbonate)

Sodium bicarbonate toothpaste showed no clear difference in volatile sulphur compounds (VSC) compared with control toothpaste (without sodium bicarbonate); GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  6 weeks
  MD 105.8 [-16.2, 227.8]
  1 study · 148 participants
  GRADE not reported

Scaling and root planing (SRP) plus glycine powder air polishing vs Scaling/root planing alone

Scaling and root planing (SRP) plus glycine powder air polishing showed no clear difference in volatile sulphur compounds (VSC), halimeter compared with scaling and root planing (SRP) alone; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  30 days
  MD -3.87 [-17.93, 10.19]
  1 study · 60 participants
  GRADE not reported

Essential oil mouthwash vs Placebo mouthwash

Essential oil mouthwash showed no clear difference in volatile sulphur compounds (VSC), halimeter compared with placebo mouthwash; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  2 weeks
  MD -5.13 [-32.94, 22.68]
  1 study · 45 participants
  GRADE not reported
• Interventions for managing halitosis 2019 · Cochrane All outcomes
  Garcia 2014 (2-arm RCT) compared essential oil mouthwash versus placebo mouthwash (VSC by halimeter). We could not include the results in the meta-analysis because of the missing SD and P value.
  1 study
  GRADE not reported

Cetylpyridinium chloride mouthwash vs Placebo mouthwash

Cetylpyridinium chloride mouthwash led to lower volatile sulphur compounds (VSC), halimeter compared with placebo mouthwash; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  2 weeks
  MD -20.04 [-37.71, -2.37]
  1 study · 47 participants
  GRADE not reported

Hinokitiol gel vs Placebo gel

It is very uncertain whether hinokitiol gel changes dentist-reported organoleptic test (OLT) score (scale 0 to 5) compared with placebo gel (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 4 weeks
  MD -0.27 [-1.26, 0.72]
  1 study · 18 participants
  Very low

1000 mg champignon extract vs placebo

1000 mg champignon extract showed no clear difference in patient's family member-reported VAS score (scale 0 to 100) compared with placebo; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  2 weeks
  MD -1.74 [-15.52, 12.04]
  1 study · 40 participants
  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
  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

Chlorine dioxide + zinc mouthwash vs Placebo mouthwash

It is very uncertain whether chlorine dioxide + zinc 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 2 weeks
  MD -0.17 [-0.59, 0.25]
  1 study · 41 participants
  Very low

Benzethonium chloride mouthwash vs Placebo mouthwash

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

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  9 days
  MD 7.2 [-24.92, 39.32]
  1 study · 20 participants
  GRADE not reported

0.05% chlorhexidine + 0.05% cetylpyridinium chloride + 0.14% zinc lactate mouthrinse vs Placebo mouthwash

Halita mouthwash (chlorhexidine 0.05% + cetylpyridinium chloride… led to lower volatile sulphur compounds (VSC), halimeter compared with placebo mouthwash; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  2 weeks
  MD -188.0 [-308.29, -67.71]
  1 study · 40 participants
  GRADE not reported

0.05% chlorhexidine + 0.05% cetylpyridinium chloride + 0.14% zinc lactate mouthrinse vs Placebo mouthwash

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 2 weeks
  Adverse events (Table 6). Risk with placebo mouthwash: None reported. Risk with halita mouthwash: tongue staining was seen in patients who gargled, rather than rinsed. 40 participants (1 RCT). Certainty: VERY LOW.
  1 study · 40 participants
  Very low

Mechanical tongue cleaning (tongue scraper) vs No tongue cleaning

The review found no eligible studies for this question.

• Interventions for managing halitosis 2019 · Cochrane All outcomes
  Quality of life was a prespecified secondary outcome. None of the 44 included studies in the review (across all comparisons) reported quality-of-life data (review-wide evidence gap).
  0 studies
  No studies found

Chlorine dioxide + zinc 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 · 41 participants
  GRADE not reported

Toothbrushing + chlorine dioxide mouthwash vs Toothbrushing + tongue cleaning

Toothbrushing + chlorine dioxide mouthwash led to lower volatile sulphur compounds (VSC), sulphide monitor compared with toothbrushing + tongue cleaning; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  4 weeks
  MD -81.87 [-140.12, -23.62]
  1 study · 30 participants
  GRADE not reported

Halita mouthrinse vs Perio-plus mouthrinse

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 8 days
  Adverse events (Table 12). Risk with Perio-plus mouthrinse: 1 patient reported unpleasant feeling after the use of the product; there were no severe adverse events reported. Risk with halita mouthrinse: 1 patient…
  1 study · 36 participants
  Very low

Hinokitiol gel vs Placebo gel

The review found no eligible studies for this question.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 4 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

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

• Interventions for managing halitosis 2019 · Cochrane All outcomes
  Payne 2011 (cross-over RCT) compared ZnCl + NaF dentifrice versus control NaF dentifrice; VSC by gas chromatography. The trial reported the adjusted mean VSC scores in a graph and hence we could not use the data in the…
  1 study
  GRADE not reported

Topical G32 (ayurvedic preparation) vs Chlorhexidine, 0.2% to 2% (solution or gel)

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  1 week
  Patil 2017 reported burning mucosa and drying of mouth in a few subjects using the control drug (chlorhexidine) and no adverse effects were reported in the intervention group (G32 tablets).
  1 study · 40 participants
  GRADE not reported