What do systematic reviews say?

Lactobacillus salivarius WB21 tablets vs placebo (3 tablets/4 times a day

• Interventions for managing halitosis 2019 · Cochrane All outcomes
  Suzuki 2014 (cross-over RCT) compared Lactobacillus salivarius WB21 tablets versus placebo tablets (OLT and VSC by gas chromatography). The trial did not give usable data and we could not extract data from the graph.
  1 study
  GRADE not reported

0.6% eucalyptus chewing gum vs 0.4% eucalyptus 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 0.4% eucalyptus chewing gum (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 4 weeks
  MD -0.1 [-0.37, 0.17]
  1 study · 64 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

  mean 2 weeks
  Patient-reported OLT score assessed with patient's perception: 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

Green tea mouthwash vs Placebo mouthwash

Green tea 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

  28 days
  MD -57.39 [-184.63, 69.85]
  1 study · 60 participants
  GRADE not reported

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
  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

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
  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

Toothbrushing + Turkish gall oral rinse vs Toothbrushing alone

Toothbrushing + Turkish gall oral rinse showed no clear difference in volatile sulphur compounds (VSC), halimeter compared with toothbrushing; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  2 weeks
  MD -211.47 [-503.58, 80.64]
  1 study · 66 participants
  GRADE not reported

Hyperbaric oxygen (following replantation) vs control

It is very uncertain whether hyperbaric oxygen (following replantation) changes tooth survival at 12 months compared with control (very low certainty).

• Interventions for treating traumatised permanent front teeth: avulsed (knocked out) and replanted 2019 · Cochrane All outcomes

  12 months
  RR 1.21 [1.07, 1.36]
  1 study · 69 participants
  Very low

0.6% eucalyptus chewing gum vs Placebo chewing gum

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

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  4 weeks
  MD 0.0 [-0.21, 0.21]
  1 study · 65 participants
  GRADE not reported

Miswak (Salvadora persica) stick vs Chlorhexidine mouthwash

Miswak (Salvadora persica) stick led to lower volatile sulphur compounds (VSC) compared with chlorhexidine mouthwash; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  1 week
  MD -0.77 [-1.19, -0.35]
  1 study · 24 participants
  GRADE not reported

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

It is very uncertain whether 0.3% triclosan + PVM/MA + sodium fluoride toothpaste changes dentist-reported breath odour (OLT) score (scale 1 to 9 hedonic) compared with sodium fluoride (control) toothpaste (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 1 week
  MD -3.48 [-3.77, -3.19]
  1 study · 81 participants
  Very low

Subgingival laser irradiation + povidone-iodine vs SRP

Subgingival laser irradiation + povidone-iodine led to higher volatile sulphur compounds (VSC) compared with SRP alone; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  4 weeks
  MD 70.0 [63.88, 76.12]
  1 study · 40 participants
  GRADE not reported

Dual zinc + arginine dentifrice vs Control (regular fluoride) dentifrice

It is very uncertain whether dual zinc + arginine dentifrice changes dentist-reported OLT hedonic rating (scale 1 to 9) compared with control (regular fluoride) dentifrice (very low certainty).

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 3 weeks
  MD -2.0 [-2.19, -1.81]
  1 study · 80 participants
  Very low

Lemongrass oil mouthwash vs Placebo mouthwash

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

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  8 days
  MD -26.66 [-43.39, -9.93]
  1 study · 20 participants
  GRADE not reported

Abrasive candy; abrasive candy + 2% propolis; abrasive candy + 0.5% zinc gluconate vs Abrasive candy + 1% propolis + 0.25% zinc

• Interventions for managing halitosis 2019 · Cochrane All outcomes
  Barak 2012 (5-arm RCT) compared abrasive candy, abrasive candy with propolis and abrasive candy with zinc gluconate versus abrasive candy with propolis and zinc; VSC measured by halimeter. We could not use the results…
  1 study
  GRADE not reported

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

Electric toothbrush (self, carer or carer-assisted brushing) showed no clear difference in plaque (medium term) compared with manual toothbrush (self, carer or carer-assisted brushing) (low certainty).

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Medium term (6 weeks to 12 months)
  SMD 0.29 [-0.07, 0.65]
  2 studies · 120 participants
  Low
• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Short term (<6 weeks)
  Assorted plaque indices scale 0-5, 1-4 weeks; 247 participants (4 RCTs); Very Low. Uncertain effect on plaque short term: 2 studies (69 participants) favoured the electric toothbrush; 2 studies (178 participants)…
  4 studies · 247 participants
  Very low

Hinokitiol gel vs Placebo gel

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

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  28 days
  MD -1.64 [-5.77, 2.49]
  1 study · 18 participants
  GRADE not reported

Triclosan dentifrice vs Negative control dentifrice

• Interventions for managing halitosis 2019 · Cochrane All outcomes
  Nogueira-Filho 2002 (5-arm trial) compared three commercial 0.3% triclosan dentifrices and an experimental formulation versus a negative control dentifrice; VSC by halimeter. We could not use the results in the…
  1 study
  GRADE not reported

Electric toothbrush (self, carer or carer-assisted brushing) vs Manual toothbrush

• Oral hygiene interventions for people with intellectual disabilities 2019 · Cochrane All outcomes

  Long term (>12 months)
  Comparison 2.8 (reported; not GRADE-rated). One NRS (Bratel 1991, 23 participants), self-efficacy at 16 months: 10/12 people with ID using the electric toothbrush reported a preference for it, finding it easier to use…
  1 study · 23 participants
  GRADE not reported

Toothbrushing + 0.075% cetylpyridinium chloride mouthwash vs Toothbrushing alone

Toothbrushing + 0.075% cetylpyridinium chloride mouthwash led to lower volatile sulphur compounds (VSC), halimeter compared with toothbrushing; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  3 weeks
  MD -8.04 [-15.87, -0.21]
  1 study · 70 participants
  GRADE not reported