RCT Evaluating Combined Oral Hygiene Effects on Overnight Volatile Sulfur

Objectives: This clinical study was conducted to evaluate the combination use of a therapeutic dentifrice and rinse plus power brush on overnight volatile sulfur production. Methods: A two-treatment, 4-period crossover clinical study was conducted to assess overnight breath effects of two regimens. Subjects were randomly assigned to a combination regimen with 0.454% stannous fluoride sodium hexametaphosphate dentifrice (Crest® Pro-Health™ Night), a rotating-oscillating powered brush (Oral-B® Vitality™ Precision Clean), and 0.07% cetylpyridinium chloride rinse Crest® Pro-Health™ Night) or a regular brush + paste control. Subjects used the assigned test products twice unsupervised on one day, with breath effects assessed instrumentally at baseline and overnight using a Halimeter to measure volatile sulfur compounds (VSC) in ppb. Treatments were compared on a natural logarithm scale using ANCOVA with baseline VSC as a covariate. Results: 25 adults (mean age of 42 years, 60% female) were evaluated. Groups were balanced (p=0.25) at baseline, with back transformed VSC adjusted means of 287 and 262 in the combination regimen and control groups, respectively. Only the combination group exhibited significant (p<0.0001) improvement from baseline. The overnight adjusted VSC means were 172 for the combination regimen and 262 for the control. Treatments differed significantly (p<0.0001) in overnight VSC. Conclusion: One day use of a combination involving an antimicrobial paste, powered brush and antimicrobial rinse yielded a 34% reduction in overnight volatile sulfur compounds compared to regular brushing.