What do systematic reviews say?

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

Salvadora persica (miswak) mouthrinse vs Chlorhexidine mouthwash

Miswak (Salvadora persica) mouthwash showed no clear difference in volatile sulphur compounds (VSC) compared with chlorhexidine mouthwash; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  1 week
  MD -0.2 [-1.03, 0.63]
  1 study · 21 participants
  GRADE not reported

SRP plus subgingival laser irradiation vs SRP

SRP plus subgingival laser irradiation showed no clear difference in volatile sulphur compounds (VSC) compared with SRP alone; GRADE not reported.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  4 weeks
  MD -3.3 [-9.38, 2.78]
  1 study · 40 participants
  GRADE not reported

Chlorhexidine + zinc acetate mouthwash vs Placebo mouthwash

The review found no eligible studies for this question.

• Interventions for managing halitosis 2019 · Cochrane All outcomes

  mean 3 months
  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

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

It is very uncertain whether halita mouthwash (chlorhexidine 0.05% + cetylpyridinium chloride… 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 -1.0 [-1.65, -0.35]
  1 study · 40 participants
  Very low

Active rinse (zinc acetate + chlorhexidine + sodium fluoride), with or without tongue scraping vs Negative control rinse, with or without tongue scraping

• Interventions for managing halitosis 2019 · Cochrane All outcomes
  Ademovski 2012 (4-arm cross-over trial) compared an active rinse (with/without tongue scraping) versus a negative control rinse (with/without tongue scraping); OLT and VSC. The authors did not report the correlation…
  1 study
  GRADE not reported