Abstract
Halitosis or oral malodor is a condition caused by the putrefaction of sulfur-containing amino acids. It affects 30–50% of the population and causes social rejection, reducing quality of life, and self-esteem. Probiotics, especially Lactobacillus species, have been proposed for the treatment of genuine halitosis, due to their ability to reduce bacterial colonization. Our objective was to evaluate their use for the treatment of oral halitosis. Applying the PRISMA statement guidelines, we searched PubMed, EMBASE, and Web of Science databases for scientific articles from the last 15 years, up to July 2021. The keywords used were “Probiotics”; “Halitosis”; “Mouth diseases”; “Oral health”; “Humans”; “Randomized Clinical Trials” according to the question, “Are probiotics effective for the reduction or elimination of oral halitosis?” Fourteen studies were identified, although only four met the inclusion criteria. We evaluated 283 participants treated with two different probiotics, with a follow-up of at least 2 weeks. Risk of bias was assessed using the Cochrane Collaboration tool. A fixed-effects meta-analysis was performed. No statistical significance was found (p = 0.53). Despite the limitations of this meta-analysis, we believe that some probiotics have a beneficial effect on halitosis, although more clinical trials are needed to establish real evidence on this aspect.Systematic Review Registration: https://doi.org/10.37766/inplasy2021.9.0009, identifier: INPLASY20211900.
Highlights
Halitosis, or bad breath, is a term referring to an unpleasant or annoying odor that emanates from the oral cavity of an individual and affects between 30 and 50% of the population [1]
The International Society for Breath Odor Research (ISBOR) classifies halitosis according to its origin into three categories: genuine halitosis, pseudohalitosis, and halitophobia
Probiotic therapy following oral disinfection with chlorhexidine may reduce the severity of halitosis over longer periods
Summary
Bad breath, is a term referring to an unpleasant or annoying odor that emanates from the oral cavity of an individual and affects between 30 and 50% of the population [1]. Genuine halitosis can occur under certain pathological conditions, or in a physiological form, in which the malodor originates in the oral cavity and is not associated with a specific pathological condition or disease. This type of halitosis exhibits a bad breath odor that exceeds the socially acceptable level, produced by putrefaction processes in the oral cavity, without the existence of a specific disease or pathological condition that causes it, being its main origin, the plaque (biofilm) accumulated in the interdental spaces, the dorsoposterior region of the tongue, under the prosthesis or in the orthodontic appliances [5, 6]
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