Clinical effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc-lactate on oral halitosis. A dual-center, double-blind placebo-controlled study

J Clin Periodontol. 2003 Apr;30(4):300-6. doi: 10.1034/j.1600-051x.2003.00342.x.


Objectives: The aim of this double-blind, parallel study was to test the clinical efficacy of a newly developed mouthrinse in the treatment of oral halitosis in patients without periodontitis.

Material and methods: Forty volunteers, recruited in two centers, participated in this study. Patients were selected on the basis of (1) halitosis of oral origin, (2) full-mouth organoleptic score>1, using an arbitrary 0-5 scale, (3) level of volatile sulfur compounds (VSC)>170 parts per billion (ppb) and (4) Winkel tongue coating index (WTCI)>4 (0-12). Intervention included gargling with a mouthrinse containing chlorhexidine (0.05%), cetylpyridinium chloride (0.05%) and zinc-lactate (0.14%) or with a placebo mouthrinse without active ingredients. At days 0 and 14 clinical variables were assessed in order of performance: (1) organoleptic assessments, (2) levels of VSC, and (3) WTCI.

Results: Treatment with the active mouthrinse resulted in a significant mean reduction in the organoleptic score from 2.8 to 1.5 (p<0.005). In the placebo group, no significant reduction in the mean organoleptic score occurred. Consequently, this resulted, after 2 weeks, in a greater change of the organoleptic scores in the test group in comparison to the placebo group (p<0.005). The mean VSC scores were reduced from 292 to 172 ppb in the test group (p<0.005), whereas no reduction was observed in the placebo group. At the 2-week examination, the mean change of the VSC scores in the test group was significantly greater than the mean change in the placebo group (p<0.005). Neither in the test nor in the placebo group a significant reduction in tongue coating was observed.

Conclusions: In conclusion, the tested mouthrinse is effective in the treatment of oral halitosis.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Infective Agents, Local / administration & dosage
  • Anti-Infective Agents, Local / therapeutic use*
  • Cetylpyridinium / administration & dosage
  • Cetylpyridinium / therapeutic use*
  • Chlorhexidine / administration & dosage
  • Chlorhexidine / therapeutic use*
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Halitosis / drug therapy*
  • Halitosis / metabolism
  • Halitosis / pathology
  • Humans
  • Lactic Acid / administration & dosage
  • Lactic Acid / therapeutic use*
  • Male
  • Middle Aged
  • Mouthwashes / therapeutic use*
  • Placebos
  • Smell / physiology
  • Statistics, Nonparametric
  • Sulfur Compounds / analysis
  • Tongue / pathology
  • Tooth Discoloration / chemically induced
  • Treatment Outcome
  • Zinc / administration & dosage
  • Zinc / therapeutic use*


  • Anti-Infective Agents, Local
  • Mouthwashes
  • Placebos
  • Sulfur Compounds
  • Lactic Acid
  • Cetylpyridinium
  • Zinc
  • Chlorhexidine