Chlorine Dioxide
Place in Therapy
There have been few publications on chlorine dioxide from 1960 to 2010.1 Amongst the studies reviewed, most found a significant reduction in organoleptic profiles while using chlorine dioxide mouthrinse as compared to placebo. However, the clinical significance of these results is unknown, as the patients’ malodour still remained in the unpleasant/stale category of the 7 point scale in some of the studies.2-5 The other study showed no significant reduction in organoleptic profiles when using chlorine dioxide mouthrinse, whereas patients in the placebo group demonstrated a significant increase compared to baseline.6 After subjecting the results to critical appraisal, it was determined that chlorine dioxide mouthrinse demonstrates a statistically significant benefit in reducing malodour when compared to water or non-therapeutic rinses, however the increment of improvement clinically remains to be validated in future studies. A concern exists in that many products containing chlorine dioxide are being heavily marketed for being able to control oral malodour, but this seems to be based more so on the testimonies of dentists and patients. As a result, chlorine dioxide may be given an “Accept, maybe recommend” for both stand-alone treatment or as adjunctive therapy for the treatment of oral malodour.
Chlorine dioxide mouthrinses are not currently commercially available in Canada. Although the limited trials have shown promise in reducing organoleptic profiles of patients with malodour in the limited studies available, we could not recommend it as a first line option due to its limited availability to consumers of the Canadian market.
References
1. Roldán S, Herrera D, Sanz M. Biofilms and the tongue: therapeutical approaches for the control of halitosis. 2003. Clin Oral Invest 7: 189-197.
2. Shinada et al. Effects of a mouthwash with chlorine dioxide on oral malodour and salivary bacteria: a randomized placebo-controlled 7-day trial. 2010. Trials 11(14): 1-11.
3. Frascella J, Gilbert R, Fernandez P. Odour reduction potential of a chlorine dioxide mouthrinse. J Clin Dent. 1998. 9(2):39-42.
4. Frascella J, Gilbert RD, Fernandez P, Hendler J. Efficacy of chlorine dioxide-containing mouthrinse in oral malodour. Compend Contin Educ Dent. 2000. 21(3):241-4.
5. Peruzzo DC, Jandiroba PFCB, Noguiera Filho GR. Use of 0.1% chlorine dioxie to inhibit the formation of morning volatile sulphur compounds (VSC). 2007. Braz Oral Res 21(1): 70-4.
6. Cortelli JR, Barbosa MDS, Westphal MA. Halitosis: a review of associated factors and therapeutic approach. 2008. Braz Oral Res 22(Spec Iss 1):44-54.
7. van den Broek AWMT, Feenstra L, de Baat C. A review of the current literature on management of halitosis. 2008. Oral Diseases14:30-39.
8. Loesche WK, Kazor C. Microbiology and treatment of halitosis. 2002. Periodontology 28: 256-279.
9. Silwood CJL, Grootveld MC, Lynch E. A multifactorial investigation of the ability of oral health care products (OHCPs) to alleviate oral malodour. 2001. J Clin Periodontol 28:034-041.
Chlorine dioxide mouthrinses are not currently commercially available in Canada. Although the limited trials have shown promise in reducing organoleptic profiles of patients with malodour in the limited studies available, we could not recommend it as a first line option due to its limited availability to consumers of the Canadian market.
References
1. Roldán S, Herrera D, Sanz M. Biofilms and the tongue: therapeutical approaches for the control of halitosis. 2003. Clin Oral Invest 7: 189-197.
2. Shinada et al. Effects of a mouthwash with chlorine dioxide on oral malodour and salivary bacteria: a randomized placebo-controlled 7-day trial. 2010. Trials 11(14): 1-11.
3. Frascella J, Gilbert R, Fernandez P. Odour reduction potential of a chlorine dioxide mouthrinse. J Clin Dent. 1998. 9(2):39-42.
4. Frascella J, Gilbert RD, Fernandez P, Hendler J. Efficacy of chlorine dioxide-containing mouthrinse in oral malodour. Compend Contin Educ Dent. 2000. 21(3):241-4.
5. Peruzzo DC, Jandiroba PFCB, Noguiera Filho GR. Use of 0.1% chlorine dioxie to inhibit the formation of morning volatile sulphur compounds (VSC). 2007. Braz Oral Res 21(1): 70-4.
6. Cortelli JR, Barbosa MDS, Westphal MA. Halitosis: a review of associated factors and therapeutic approach. 2008. Braz Oral Res 22(Spec Iss 1):44-54.
7. van den Broek AWMT, Feenstra L, de Baat C. A review of the current literature on management of halitosis. 2008. Oral Diseases14:30-39.
8. Loesche WK, Kazor C. Microbiology and treatment of halitosis. 2002. Periodontology 28: 256-279.
9. Silwood CJL, Grootveld MC, Lynch E. A multifactorial investigation of the ability of oral health care products (OHCPs) to alleviate oral malodour. 2001. J Clin Periodontol 28:034-041.