Efficacy of Probiotic Tablets in the Reduction of Halitosis: A Randomised, Single Blind, Controlled Clinical Trial.

Objective: To evaluate the effect of a fresh-breath mild effervescent tablet on halitosis as an alternative to mouthwash.

Methods: Halitosis is the unpleasant and offensive odour emanating from the oral cavity (bad breath), which is linked to the presence of volatile sulphur compounds (VSCs). A randomised, single-blind, controlled clinical trial was conducted with 102 volunteers who had oral complaints (range 18-60 years). Breath samples were taken and analysed for the level of hydrogen sulphide (H2S), methyl mercaptan (CH3SH) and dimethyl sulphide (CH3SCH3). Sixty-one volunteers who met the halitosis criteria were enrolled and completed the clinical trial. Two groups were formed according to the test employed: the Immediate Effect Test (IET) (n = 31) and the Effective Duration Test (EDT) (n = 30). In the IET, subjects were divided into three subgroups: fresh-breath mild effervescent tablet (MT, n = 11), the fresh-breath lozenge tablet (LT, n = 10), and fresh-breath mouthwash (MW, n = 10). Halitosis was measured immediately after completely consuming the test tablet or gargling. In the EDT, subjects were also divided into three subgroups: fresh-breath mild effervescent tablet (MT, n = 10), probiotic powder (PP, n = 10) and probiotic tablet (PT, n = 10). Halitosis was measured at 0 h, 1 h, and 2 h after consuming the test substances.

Results: In the IET group, a statistically significant reduction in VSCs was obtained in all three subgroups compared with baseline (VSCs of MT group, p 0.01, VSCs of LT subgroup, p 0.05, VSCs of MT group, p 0.01). The fresh-breath mild effervescent tablet subgroup showed a statistically significantly greater reduction in VSCs compared to the fresh-breath lozenge subgroup (p 0.01). No statistically significant differences in VSC reduction were found between the fresh-breath mild effervescent tablet subgroup and the mouthwash group (p = 0.38). In the EDT group, the VSC level of the fresh-breath mild effervescent tablet group was still statistically significantly lower than the baseline 2 h after consumption (p 0.01). The two control groups which used commercial fresh-breath probiotic products did not show any statistically significant difference compared to baseline. The VSC level of these two groups gradually returned to the baseline level 2 h after consumption.

Conclusions: Fresh-breath mild effervescent tablets have shown promising potential as an alternative, effective, and potentially safe choice for fresh breath in comparison to mouthwash.