title: The effect of water on morning bad breath: a randomized clinical trial.
abstract: OBJECTIVE
  To assess the effects of water on the parameters of 'morning bad breath' (MBB) and to evaluate whether there is a difference between rinsing with water and drinking a glass of water.
  
  
  METHODS
  A total of 50 participants were recruited and were randomly divided into two equal groups. One group rinsed with 15 ml of water for 30 s, and another group drank 200 ml of water within 30 s. Clinical assessments were carried out during one visit between 7:30 am and 12:00 pm. Pre- and post-intervention measures were assessed organoleptically as primary outcome parameters, and a secondary outcome parameter was assessed using both the Halimeter(®) and OralChroma(™) apparatuses to evaluate volatile sulphur compounds (VSCs), hydrogen sulphide (H2 S), methyl mercaptan (CH3 SH) and dimethyl sulphide ((CH3 )2 S). In addition, the presence of tongue coating (discoloration/thickness) and tongue fissures was assessed.
  
  
  RESULTS
  All 50 participants completed the study. In both groups, a significant reduction in the organoleptic score and the OralChroma(™) H2 S and CH3 SH readings was obtained after the intervention. Both regimens resulted in a CH3 SH reduction of approximately 60%, whereas the reduction in H2 S was between 30% and 50%. The acceptable change between pre- and post-assessments of the clinical parameters was not significantly different between the drinking and rinsing groups.
  
  
  CONCLUSIONS
  Rinsing with water or drinking a glass of water had a statistically significant effect on the MBB parameters. No significant difference was obtained between the two regimens.
authors.affiliation: Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Van der Sluijs
authors.affiliation: Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands.
authors.forename: D E
authors.initials: DE
authors.lastname: Slot
authors.affiliation: Master Degree Program Evidence Based Practice AMC-UvA, Amsterdam, The Netherlands.
authors.forename: E W P
authors.initials: EW
authors.lastname: Bakker
authors.affiliation: Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands.
authors.forename: G A
authors.initials: GA
authors.lastname: Van der Weijden
mesh_terms: D000328:Adult; D006209:Halitosis / Q000517:prevention & control*; D006801:Humans; D006862:Hydrogen Sulfide; D009067:Mouthwashes; D013457:Sulfur Compounds; D014059:Tongue; D014867:Water / Q000008:administration & dosage*
chemical_list: D009067:Mouthwashes; D013457:Sulfur Compounds; D014867:Water; D006862:Hydrogen Sulfide
keywords: Halimeter; OralChroma; drinking; morning bad breath; organoleptic score; rinsing; water