title: Use of a novel group of oral malodor measurements to evaluate an anti-oral malodor mouthrinse (TriOralTM) in humans.
abstract: OBJECTIVE
  This study compared the ability of a test mouthwash containing zinc chloride and sodium chlorite (TriOral) to reduce intrinsic oral malodor, to that of two other mouthrinses, one with zinc chloride only and the other with no zinc chloride/no sodium chlorite, using a novel group of oral malodor parameter measurements.
  
  
  METHODS
  Forty-eight subjects completed the study; 16 in the test group, 17 in the zinc only group, and 15 in the no zinc chloride/ no sodium chlorite group. At baseline and after two and four weeks, parameters assessed were 1) malodorants in the headspace of and in solution in resting whole saliva determined organoleptically, 2) breath volatile sulfur compounds (VSC) measured with a sulfide monitor (Halimeter), 3) fresh and incubated saliva oxidation-reduction potential (E(h)) measured with a platinum electrode, and 4) level of saliva indolic compounds (IC), indole and skatole, determined colorimetrically with Kovac's reagent. The VSC, E(h), and IC data for the three mouthrinses were analyzed statistically by repeated measures ANOVA between groups, and by 2-way ANOVA within groups. Corresponding organoleptic data were analyzed by Kruskal-Wallis and Friedman non-parametric tests.
  
  
  RESULTS
  Organoleptic, VSC, and E(h) evaluations clearly showed the zinc chloride/sodium chlorite test mouthrinse to be more effective than the other two rinses. In all cases, the level of significance was p < 0.001 between the test mouthrinse and its no zinc chloride/no sodium chlorite control; between test mouthrinse and the zinc chloride only product, significance was p < 0.05, < 0.001 and < 0.01 for the organoleptic, VSC, and E(h) tests, respectively. Noteworthy was the observation that the mean organoleptic saliva headspace score with the test mouthrinse was reduced to zero, and VSC levels fell below 50 ppb S by the end of the study, a level where the breath is usually non-odorous. The test mouthwash also appeared more effective in reducing the salivary IC levels, but the results did not reach significance at p < 0.05 unless IC levels were amplified in the saliva by incubation overnight at 37 degrees C. Correlations between the various procedures were highly significant, achieving in almost all cases a probability level of p < 0.001.
  
  
  CONCLUSIONS
  The results supported the conclusion that the zinc chloride plus sodium chlorite mouthrinse (TriOral) is more effective in reducing oral malodor than a zinc chloride alone mouthrinse, and even more effective than its no zinc chloride/no sodium chlorite mouthrinse control. The methods used in this study were consistent with one another, and highly effective in measuring various parameters that characterize oral malodor.
authors.affiliation: Department of Oral Biology and Pathology, State University of New York Stony Brook, NY, USA.
authors.forename: Don P
authors.initials: DP
authors.lastname: Codipilly
authors.forename: Hershel W
authors.initials: HW
authors.lastname: Kaufman
authors.forename: Israel
authors.initials: I
authors.lastname: Kleinberg
mesh_terms: D000328:Adult; D000368:Aged; D002712:Chlorides / Q000627:therapeutic use*; D003124:Colorimetry; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006209:Halitosis / Q000378:metabolism / Q000517:prevention & control*; D006801:Humans; D007211:Indoles / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use*; D009812:Odorants / Q000032:analysis; D010084:Oxidation-Reduction; D012463:Saliva / Q000737:chemistry; D012862:Skatole / Q000032:analysis; D013457:Sulfur Compounds / Q000032:analysis; D017967:Zinc Compounds / Q000627:therapeutic use*
chemical_list: D002712:Chlorides; D004338:Drug Combinations; D007211:Indoles; D009067:Mouthwashes; D013457:Sulfur Compounds; C500052:TriOral; D017967:Zinc Compounds; C016837:zinc chloride; C030374:indole; D012862:Skatole; C001599:chlorite