A multifactorial investigation of the ability of oral health care products (OHCPs) to alleviate oral malodour.
AIM, BACKGROUND: Oral malodour (halitosis) is generally ascribable to oral microbial putrefaction generating malodorous volatile sulphur compounds which predominantly comprise dihydrogen sulphide and methyl mercaptan. This study assesses the relative effectiveness of 6 oral health care products in reducing oral cavity volatile sulphur compound concentrations.


METHODS
A mixed model 3-factor factorial experimental design involving 6 volunteers, 7 treatment regimens (products I-VI* and water placebo) and 5 time-points (0.00-5.29 h) was undertaken. Electron-donating volatile sulphur compound levels were determined in triplicate using a sulphide monitor (Interscan model 1170) both prior to (0.00 h) and following oral rinsing (20 ml of 5 of the products) or chewing (2 capsules of the remaining product) episodes with each product examined (0.29, 1.29, 2.29 and 5.29 h post-administration).


RESULTS
Results were recorded as peak and steady-state volatile sulphur compound equivalents (ppb). With the exception of one of the products, each oral health care product tested was found to reproducibly reduce volatile sulphur compound concentrations within 20 min of treatment; the mean % decreases in peak (and corresponding steady-state) levels ranging from 3.6 (0.0) to 16.8 (16.4)%. Subsequently, volatile sulphur compound concentrations returned to their zero-control (baseline) values within 5 h, the rate of this regression being in the reverse of the order observed for the magnitude of the primary 20 min reduction for both peak and steady-state measurements. As expected, the water placebo exerted no influence on oral cavity volatile sulphur compound levels. The most effective oral health care products contained admixtures of chlorite anion and chlorine dioxide (both of these agents have the ability to directly oxidise volatile sulphur compounds to non-malodorous products and the latter is also powerfully cidal towards odourigenic micro-organisms).


CONCLUSIONS
We therefore conclude that oral health care products containing such oxohalogen oxidants may provide a useful therapeutic strategy for the treatment of oral malodour.
Silwood
C J
CJ
Room AW518, Medical Unit, 5th Floor, Alexandra Wing, Royal London Hospital, London E1 1BB, UK.
Grootveld
M C
MC
Lynch
E
E
D000328:Adult; D000704:Analysis of Variance; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D001419:Bacteria / Q000378:metabolism; D002214:Capsules; D002594:Cetylpyridinium / Q000627:therapeutic use; D002712:Chlorides / Q000627:therapeutic use; D002713:Chlorine / Q000627:therapeutic use; D017606:Chlorine Compounds / Q000627:therapeutic use; D016001:Confidence Intervals; D004338:Drug Combinations; D005163:Factor Analysis, Statistical; D006209:Halitosis / Q000382:microbiology / Q000517:prevention & control*; D006801:Humans; D006862:Hydrogen Sulfide / Q000032:analysis / Q000037:antagonists & inhibitors; D008297:Male; D008409:Mastication; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use*; D016877:Oxidants / Q000627:therapeutic use; D010084:Oxidation-Reduction; D010087:Oxides / Q000627:therapeutic use; D010919:Placebos; D000644:Quaternary Ammonium Compounds / Q000627:therapeutic use; D015203:Reproducibility of Results; D012459:Salicylates / Q000627:therapeutic use; D013438:Sulfhydryl Compounds / Q000032:analysis / Q000037:antagonists & inhibitors; D013457:Sulfur Compounds / Q000032:analysis / Q000037:antagonists & inhibitors; D013729:Terpenes / Q000627:therapeutic use; D013997:Time Factors; D014867:Water
D000891:Anti-Infective Agents, Local; D002214:Capsules; D002712:Chlorides; D017606:Chlorine Compounds; D004338:Drug Combinations; D009067:Mouthwashes; D016877:Oxidants; D010087:Oxides; D010919:Placebos; D000644:Quaternary Ammonium Compounds; C091018:RetarDEX oral rinse; D012459:Salicylates; C094642:Scope mouthwash; D013438:Sulfhydryl Compounds; D013457:Sulfur Compounds; D013729:Terpenes; D014867:Water; C005231:methylmercaptan; D002713:Chlorine; C057473:Listerine; C025109:chlorine dioxide; D002594:Cetylpyridinium; D006862:Hydrogen Sulfide; C001599:chlorite