The effects of antimicrobial mouthrinses on oral malodor and their status relative to US Food and Drug Administration regulations.

This study was undertaken to review the rationale behind the usage of antibacterial mouthrinses to control oral malodor and to evaluate the claims made for antibacterial mouthrinses against the statements of US Food and Drug Administration regulations. The literature from 1960 to August 1997, found in a MEDLINE search on oral malodor, halitosis, and tongue microbiology, was examined. Clinical trials that were double blind and had selected subjects who exhibited a detectable level of oral malodor were evaluated. Individuals who experience oral malodor resulting from the overgrowth of proteolytic, anaerobic bacteria on their tongue surfaces can be successfully treated by a regimen that includes tongue brushing and toothbrushing, often in combination with use of a mouthrinse containing an antibacterial agent. Several candidate mouthrinses containing essential oils, zinc chloride, or an oil-water-cetylpyridinium chloride mouthrinse have reduced the organoleptic scores of individuals with moderate levels of oral malodor in the absence of tongue brushing. Very little long-term data beyond 6 weeks of usage are available. These mouthrinses should be marketed as oral deodorants that are analogous in purpose to the usage of deodorant soaps to control and/or eliminate body malodors.