What do systematic reviews say?

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

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