title: Breath malodor reduction with use of a stannous-containing sodium fluoride dentifrice: a meta-analysis of four randomized and controlled clinical trials.
abstract: OBJECTIVE
  To determine the effectiveness of a novel stannous-containing sodium fluoride dentifrice in reducing malodor-causing volatile sulfur compound (VSC) levels versus a standard marketed fluoride (negative control) anti-caries dentifrice using pooled data from independent clinical trials.
  
  
  METHODS
  Four randomized and controlled, evaluator-blinded, 3- or 4-period, 2-treatment crossover clinical studies were conducted at four separate centers in Asia and the United States in subjects with a baseline VSC score of > 100 ppb. Following a week-long acclimation period, subjects were randomly assigned to a treatment sequence specifying the order of use of a stannous-containing sodium fluoride dentifrice and a negative control dentifrice (Crest Cavity Protection). VSC levels were assessed at four time points using a Halimeter during each treatment period: (1) baseline prior to treatment; (2) 3-4 hours after baseline and a single brushing; (3) 24 hours post-baseline and after two total brushings ("overnight"/"morning breath"); and (4) 27-28 hours post-baseline following three total product uses. Brushing instructions were standardized and required two minutes of timed toothbrushing with the assigned dentifrice. Washout periods of at least 2 days separated the treatment periods.
  
  
  RESULTS
  A total of 100 subjects were included in the meta-analysis. The stannous-containing dentifrice showed statistically significantly greater breath benefits via VSC reduction compared to the negative control dentifrice (P < 0.047) at all three time points. The stannous-containing dentifrice provided increasingly greater superior relative breath protection benefits of 7.7% at Hour 3-4 post-baseline, 10.6% after 24 hours ("overnight"/"morning breath"), and 24.5% at Hour 27-28. Similar malodor reduction benefits in favor of the stannous-containing dentifrice relative to the negative control were observed for each individual study.
authors.affiliation: Department of Preventive and Pediatric Dentistry, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Basic Research Academic Discipline, China.
authors.forename: Xiping
authors.initials: X
authors.lastname: Feng
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.forename: Richard
authors.initials: R
authors.lastname: Cheng
authors.forename: Lily
authors.initials: L
authors.lastname: Sun
authors.forename: Yuqing
authors.initials: Y
authors.lastname: Zhang
authors.forename: Tao
authors.initials: T
authors.lastname: He
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001944:Breath Tests; D002327:Cariostatic Agents / Q000627:therapeutic use; D018592:Cross-Over Studies; D003802:Dentifrices / Q000737:chemistry / Q000627:therapeutic use*; D005260:Female; D006209:Halitosis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000737:chemistry / Q000627:therapeutic use*; D012824:Silicic Acid / Q000737:chemistry / Q000627:therapeutic use; D016037:Single-Blind Method; D012969:Sodium Fluoride / Q000627:therapeutic use; D013457:Sulfur Compounds / Q000009:adverse effects; D017971:Tin Compounds / Q000627:therapeutic use; D014002:Tin Fluorides / Q000737:chemistry / Q000627:therapeutic use*; D014100:Toothpastes / Q000737:chemistry / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D002327:Cariostatic Agents; C510825:Crest Pro-Health Dentifrice; D003802:Dentifrices; D010710:Phosphates; D013457:Sulfur Compounds; D017971:Tin Compounds; D014002:Tin Fluorides; D014100:Toothpastes; C546060:hydrated silica gel-based toothpaste; D012824:Silicic Acid; C023599:stannous chloride; D012969:Sodium Fluoride