title: Treatment of oral malodour. Medium-term efficacy of mechanical and/or chemical agents: a systematic review.
abstract: OBJECTIVE
  What is the effect of a dentifrice (DF), a mouthwash (MW), tongue cleaning (TC), or any combination of these as adjunct to toothbrushing on intra-oral malodour and tongue coating as compared to toothbrushing alone in systemically healthy patients, when used for a minimum follow-up period of 2 weeks?
  
  
  METHODS
  The MEDLINE-PubMed, Cochrane-CENTRAL and EMBASE databases were searched up to August 2014. Measurements of Volatile Sulphur Compounds and organoleptic scores of oral malodour were selected as outcome variables. Data were extracted and a descriptive analysis was performed.
  
  
  RESULTS
  Independent screening of 1054 unique papers resulted in 12 eligible clinical trials with a medium-term (≥2 weeks) duration. The majority of studies provided a significant reduction in oral malodour when evaluating products with an active ingredient (incorporated into a DF or a MW) used adjunctively to toothbrushing. The added value of tongue cleaning over a MW was evaluated in one study.
  
  
  CONCLUSIONS
  Due to very limited evidence, the potential effect of a specifically formulated dentifrice, a mouthwash or a tongue scraper for treating oral malodour is, in general, unclear. For mouthwashes containing the active ingredients chlorhexidine + cetylpyridinium chloride + zinc (CHX + CPC + Zn) and zinc chloride + cetylpyridinium chloride (ZnCl + CPC) most evidence was available. The strength of a recommendation to use these products was graded to be 'weak'.
authors: Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
authors: Dagmar E
authors: DE
authors: Slot
authors: Sophie
authors: S
authors: De Geest
authors: Fridus A
authors: FA
authors: van der Weijden
authors: Marc
authors: M
authors: Quirynen
mesh_terms: D003742:Dental Devices, Home Care; D003802:Dentifrices / Q000627:therapeutic use; D005500:Follow-Up Studies; D006209:Halitosis / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D009067:Mouthwashes / Q000627:therapeutic use; D014059:Tongue / Q000473:pathology; D014099:Toothbrushing / Q000379:methods; D016896:Treatment Outcome
chemical_list: D003802:Dentifrices; D009067:Mouthwashes
keywords: bad breath; dentifrice; halitosis; intra-oral malodour; mouthrinse; mouthwash; oral malodour; review; tongue cleaning; toothpaste