van Steenberghe D, Avontroodt P, Peeters W, Pauwels M, Coucke W, Lijnen A, Quirynen M
Department of Periodontology, Oral Pathology and Maxillo-Facial Surgery, Faculty of Medicine, Catholic University of Leuven, Belgium.
J Periodontol. 2001 Sep;72(9):1183-91. doi: 10.1902/jop.2000.72.9.1183.
Morning breath odor is an often-encountered complaint. This double-blind, crossover, randomized study aimed to examine the bad breath-inhibiting effect of 3 commercially available mouthrinses on morning halitosis during an experimental period of 12 days without mechanical plaque control.
Twelve medical students with a healthy periodontium refrained from all means of mechanical plaque control during 3 experimental periods of 12 days (with intervening washout periods of at least 3 weeks). A professional oral cleaning preceded each period. During each experimental period, as the only oral hygiene measure allowed, the students rinsed twice a day with one of the following formulations in a randomized order: CHX-Alc (a 0.2% chlorhexidine [CHX] solution); CHX-NaF (CHX 0.12% plus sodium fluoride 0.05%); or CHX-CPC-Zn (CHX 0.05% plus cetylpyridinium chloride 0.05% plus zinc lactate 0.14%). After 12 days, morning breath was scored via volatile sulfur compound (VSC) level measurements of the mouth air and organoleptic ratings of the mouth air, the expired air, and a scraping of the tongue coating. At the 12-day visit, a questionnaire (subjective ratings) was completed and samples taken from both the tongue coating and the saliva for anaerobic and aerobic culturing and vitality staining. The de novo supragingival plaque formation was also recorded. All parameters were correlated with the baseline registrations.
Although oral hygiene during the 3 experimental periods was limited to oral rinses, bad breath parameters systematically improved, with the exception of a slight increase in VSC levels while using CHX-Alc, a finding which was associated with the direct influence of the CHX on the sulfide monitor. The oral microbial load after the use of CHX-NaF remained unchanged, while for the CHX-Alc and CHX-CPC-Zn, significant reductions in both aerobic and anaerobic colony forming units (CFU)/ml were noticed in comparison with baseline data for both tongue coating and saliva samples. The composition of microflora, on the other hand, did not reveal significant changes. The supragingival plaque formation was inhibited, in descending order, by CHX-Alc, CHX-CPC-Zn, and CHX-NaF. The subjective scores for the rinses indicated a higher appreciation for CHX-CPC-Alc and CHX-NaF because of a better taste and fewer side effects.
The results of this study demonstrate that morning halitosis can be successfully reduced via daily use of mouthrinses. CHX-Alc and CHX-CPC-Zn mouthrinses result in a significant reduction of the microbial load of tongue and saliva.
晨起口臭是一种常见的主诉。这项双盲、交叉、随机研究旨在在为期12天的实验期内，在不进行机械性菌斑控制的情况下，检验3种市售漱口水对晨起口臭的抑制效果。
12名牙周健康的医学生在3个为期12天的实验期内（中间间隔至少3周的洗脱期）不采取任何机械性菌斑控制手段。每个实验期开始前进行一次专业口腔清洁。在每个实验期内，作为唯一允许的口腔卫生措施，学生们按随机顺序每天用以下一种配方漱口水漱口两次：CHX-Alc（0.2%氯己定[CHX]溶液）；CHX-NaF（0.12%CHX加0.05%氟化钠）；或CHX-CPC-Zn（0.05%CHX加0.05%西吡氯铵加0.14%乳酸锌）。12天后，通过测量口腔空气中挥发性硫化物（VSC）水平以及对口腔空气、呼出气体和舌面刮片进行感官评分来评估晨起口臭情况。在第12天的访视时，完成一份问卷（主观评分），并从舌面和唾液中取样进行需氧和厌氧培养以及活力染色。还记录了龈上菌斑的新生形成情况。所有参数均与基线记录相关。
尽管在3个实验期内口腔卫生仅限于使用漱口水，但口臭参数有系统性改善，不过在使用CHX-Alc时VSC水平略有升高除外，这一发现与CHX对硫化物监测仪的直接影响有关。使用CHX-NaF后口腔微生物负荷保持不变，而与舌面和唾液样本的基线数据相比，使用CHX-Alc和CHX-CPC-Zn后需氧和厌氧菌落形成单位（CFU）/毫升均显著降低。另一方面，微生物群落组成未显示出显著变化。龈上菌斑形成受到抑制，按抑制程度从高到低依次为CHX-Alc、CHX-CPC-Zn和CHX-NaF。对漱口水的主观评分表明，由于口感更好且副作用更少，CHX-CPC-Alc和CHX-NaF更受青睐。
本研究结果表明，通过每日使用漱口水可成功减轻晨起口臭。CHX-Alc和CHX-CPC-Zn漱口水可显著降低舌面和唾液中的微生物负荷。
