Impact of mouthrinses on morning bad breath in healthy subjects

J Clin Periodontol. 2004 Feb;31(2):85-90. doi: 10.1111/j.0303-6979.2004.00452.x.


Background: During sleep, a proliferation of oral bacteria is responsible for the release of offending gases in morning breath even in healthy people. Thus, the aim of this study was to evaluate the bad breath-inhibiting effect of four commercially available mouthrinses (0.03% triclosan, 0.12% chlorhexidine gluconate, 0.05% cetylpyridinium chloride and essential oils) on morning breath when compared with a positive and a negative control.

Method: A six-step double-blind, crossover, randomised study was conducted in 12 dental students with healthy periodontium, who refrained from mechanical plaque control during a 4-day period. The subjects were instructed to rinse twice daily with the assigned product during each period. Fifteen-day washout intervals were used. Before professional plaque and tongue coating removal (baseline), the morning breath was scored through volatile sulphur compounds (VSCs) level measured by a sulphide monitor. After 4 days, VSCs and plaque index (PI) were recorded.

Results: Even in the absence of mechanical plaque control, there was a decrease in VSC level with the use of all mouthrinses, with the exception of an increase with the use of the negative control. The VSC formation was inhibited in descending order, by positive control (0.2% chlorhexidine), 0.12% chlorhexidine, triclosan and essential oils and cetylpyridinium chloride. Plaque formation was inhibited by chlorhexidine mouthrinses and essential oils.

Conclusions: These findings suggest that mouthrinses can reduce morning bad breath, and that such a reduction is not attributable only to the reduction of supragingival plaque formation.

Publication types

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

MeSH terms

  • Adult
  • Anti-Infective Agents, Local / therapeutic use*
  • Cetylpyridinium / therapeutic use
  • Chlorhexidine / analogs & derivatives*
  • Chlorhexidine / therapeutic use
  • Cross-Over Studies
  • Dental Plaque / prevention & control
  • Dental Plaque Index
  • Double-Blind Method
  • Female
  • Halitosis / metabolism
  • Halitosis / prevention & control*
  • Humans
  • Male
  • Mouthwashes / therapeutic use*
  • Oils, Volatile / therapeutic use
  • Sulfides / analysis
  • Sulfur Compounds / analysis
  • Triclosan / therapeutic use


  • Anti-Infective Agents, Local
  • Mouthwashes
  • Oils, Volatile
  • Sulfides
  • Sulfur Compounds
  • Triclosan
  • Cetylpyridinium
  • chlorhexidine gluconate
  • Chlorhexidine