Abstract
The objective of this clinical investigation was to test the effectiveness on breath odor of a newly designed sonic tongue brush (TongueCare+, TC). It consists of a soft silicone brush optimally designed based on the tongue’s anatomy to remove bacterial biofilm from the tongue’s complex surface, and it is coupled with a sonic power toothbrush handle. TC was used in combination with an antibacterial tongue spray (BreathRx, BRx) containing 0.09% cetylpyridinium chloride and 0.7% zinc gluconate. A total of 21 participants with oral malodor exceeding the threshold for recognition took part in this cross-over clinical investigation, which consisted of a single use of four treatment arms with one week washout period in between. The treatments consisted of: (1) TC + BRx, (2) TC + water, (3) BRx and (4) water. Malodor levels and bacterial density were monitored up to 6 h by organoleptic scoring and selective plating, respectively. The organoleptic score and bacterial density were significantly lower after using TC + BRx compared to all alternative treatments at all time points. A significant decrease in both parameters was detected after a single use of TC + BRx, from levels characteristic of high oral malodor, to barely noticeable levels after treatment and this was maintained up to 6 h. Moreover, we identified a significant positive correlation between bacterial density and organoleptic score, confirming that bacterial tongue biofilm is the root cause of oral malodor in these subjects. The results of this clinical investigation demonstrated that the combined treatment of a sonic tongue brush with the antibacterial tongue spray is able to deliver more than 6 h of fresh breath following a single use. The clinical investigation was registered at the ISRCTN registry under study identification number ISRCTN38199132.
Highlights
Oral malodor is a widespread problem affecting up to 30% of the global population and 74% consider it as an issue [1]
In the present clinical investigation we evaluated the efficacy of a combined mechanical and chemical intervention to reduce oral malodor
The primary objective was to determine if this combined approach could deliver a greater reduction in oral malodor and in bacterial density compared to the individual treatments
Summary
Oral malodor is a widespread problem affecting up to 30% of the global population and 74% consider it as an issue [1]. Numerous products are available for the control of oral malodor, generally categorized into chemical and mechanical methods Chemical methods such as mouthrinses typically contain a combination of antimicrobial compounds (chlorhexidine or cetylpyridinium chloride) and metal ions (Zn2+), which are very effective in reducing VSC [8,9,10,11,12]. Malodor levels increase rapidly after a single usage [13], suggesting that those treatments cannot deliver a full day of fresh breath Mechanical treatments such as tongue scrapers and brushes physically remove bacterial biofilms from the tongue surface. Mechanical interventions only provide transient protection that can last for as little as 30 min [14] This is presumably due to the limited biofilm removal from the tongue’s complex surface. The objective of this study was to test if a combined approach using a newly designed sonic tongue brush in combination with an antimicrobial spray could decrease oral malodor over a prolonged period of at least 6 h
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