Comparison of different treatment modalities for oral halitosis

Acta Odontol Scand. 2012 May;70(3):224-33. doi: 10.3109/00016357.2011.635601. Epub 2011 Dec 12.


Objectives: To assess the effects on intra-oral halitosis by a mouth rinse containing zinc acetate (0.3%) and chlorhexidine diacetate (0.025%) with and without adjunct tongue scraping.

Materials and methods: Twenty-one subjects without a diagnosis of periodontitis were randomized in a cross-over clinical trial. Organoleptic scores (OLS) were assessed to define intra-oral halitosis by total volatile sulfur compound (T-VSC) measurements and by gas chromatography.

Results: Twenty-one subjects with a mean age of 45.7 years (SD: ±13.3, range: 21-66). The OLS were significantly lower following active rinse combined with tongue scraping (p < 0.001) at all time points. Immediately after, at 30 min, and at day 14, the T-VSC values were lower in the active rinse sequence than in the negative rinse sequence (p < 0.001, p < 0.001 and p < 0.05, respectively). At 30 min and at day 14, the hydrogen sulfide (H(2)S) and methyl mercaptan (MM) values were lower in the active rinse sequence compared to the inactive rinse sequence (p < 0.001). The inactive rinse sequence with tongue scraping reduced T-VSC at 30 min (p < 0.001) but not at 14 days. Similar reductions in T-VSC, H(2)S and MM were found in the active rinse sequence with or without tongue scraping.

Conclusion: The use of a tongue scraper did not provide additional benefits to the active mouth rinse, but reduced OLS and tongue coating index.

Publication types

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

MeSH terms

  • Adult
  • Analysis of Variance
  • Chlorhexidine / therapeutic use*
  • Cross-Over Studies
  • Dental Devices, Home Care*
  • Drug Combinations
  • Female
  • Halitosis / etiology
  • Halitosis / prevention & control*
  • Humans
  • Male
  • Middle Aged
  • Mouthwashes / therapeutic use*
  • Reference Values
  • Single-Blind Method
  • Statistics, Nonparametric
  • Sulfur Compounds / adverse effects
  • Sulfur Compounds / analysis
  • Tongue*
  • Young Adult
  • Zinc Acetate / therapeutic use*


  • Drug Combinations
  • Mouthwashes
  • Sulfur Compounds
  • chlorhexidine, zinc acetate drug combination
  • Zinc Acetate
  • Chlorhexidine