Effect of Triclosan Dentifrice and Tongue Cleaning on Oral Halitosis

Objectives: Oral halitosis is frequently associated with volatile sulfur compound-producing bacteria colonizing the dorsal surface of the tongue. This study examined the effect of a triclosan-containing dentifrice and a toothbrush with tongue cleaner on clinical measures of halitosis and on dorsal tongue surface bacteria. Methods: 21 subjects, defined as having halitosis based on both organoleptic scores ³ 3 (scale 0 – 5) as determined by a single examiner and mouth air sulfur levels of ³250 ppb as determined by portable sulfide detector, were included. At baseline and 28 days, each subject was examined for; (1) halitosis by organoleptic assessment and mouth air sulfur levels; (2) tongue coating score (scale 0 – 3); and, (3) dorsal tongue surface bacteria. Microbial samples were taken from an approximately 2 cm² area of the dorsal tongue surface by gentle scraping. The samples were examined in dot blot assays using digoxigenin labeled oligonucleotide probes specific for 21 bacterial species associated with halitosis i.e. a halitosis panel. After the baseline examination, subjects were instructed to perform oral hygiene twice a day with a triclosan-containing dentifrice as well as using a toothbrush with a tongue cleaner. Results: After 28 days, all subjects showed significant reductions (p<0.05) in organoleptic scores and mouth air sulfur levels compared to baseline. Clinical measures were all reduced to levels much below those used to define subjects as having halitosis as were tongue coating scores. Similarly, dot blot assays showed reductions in the numbers of dorsal tongue surface bacteria in the halitosis panel. Conclusions: All subjects enrolled in this clinical study and who initially presented with halitosis, demonstrated significant clinical and microbiological improvement resulting in the elimination of their halitosis following use of a triclosan-containing dentifrice and a toothbrush with a tongue cleaner.