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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.

Oral malodor is mainly caused by the presence of volatile sulfur-containing compounds (VSC) produced by proteolytic periodontopathic bacteria in the oral cavity. Different solutions have been used as mouthrinses, trying to reduce malodor, and a large number is on the market. The aim of this study was to compare the effect of three commercially available mouthrinses with a simple inexpensive solution of zinc (zinc acetate 0.1%) on the production of VSC in vivo. Two of the solutions contained triclosan, one of them with fluoride and the other with sodium bicarbonate, and the third one contained herbal components. Seven healthy subjects rinsed with cysteine to induce production of VSC at baseline. After halitosis induction and VSC measurements, the subjects rinsed with the test solution, and mouth airVSC analyses were then performed by means of gas chromatography subsequent to repeated cysteine rinses after 30, 60, and 120 min. The data were calculated as percentage reduction of VSC from baseline. The percentage reduction of VSC decreased over time for all experimental groups. Zinc acetate had clearly the highest percentage reduction, starting from 95.68% at 30 min and with 69.27% after 2 h. The three other mouthrinses produced a VSC reduction of 23.92% 49.86% after 30 min, decreasing to 13.06%-37.09% after 2 h. One-way ANOVA (P = 0.05) was applied, and comparisons showed no differences between the commercially available solutions, but zinc acetate was significantly better than these. It may be concluded that some commercial mouthrinses are markedly less effective than a simple and cheap solution of zinc acetate.

Volatile sulfur-containing compounds (VSC) are known to constitute the major component of halitosis. Aqueous solutions of zinc salts have been shown to reduce the levels of VSC produced orally. The aim of the present study was to examine whether zinc could be made available in the oral cavity and inhibit VSC production when delivered by a chewing gum. VSC measurements were carried out on the 'morning breath' of 11 test subjects and re-examined after the use of test solutions containing 0.02% zinc chloride, 0.2% chlorhexidine, or water or the use of chewing gums containing 2 mg, 0.5 mg, or 0 mg zinc acetate. The results showed that similar amounts of zinc in mouthrinses or chewing gum had the same effect, with a reduction of the oral VSC of 45%. Chewing gum thus seems to be a viable alternative for delivering zinc to reduce VSC levels in the oral cavity.