How to use adjunct products in fighting bad breath. - Breath mints / Lozenges / Sprays / Drops / Toothpaste / Chewing gum / Probiotics

- How they work. | What level of results can you expect? | What ingredients are important to look for?

The role of products other than mouthwash in treating halitosis.

Other than just oral rinses, other types of products (breath mints, lozenges, toothpaste, sprays, drops, chewing gum) can be used to deliver the kinds of compounds that have been shown to be effective in combating halitosis.

And in fact, their use may deliver the therapeutic agent over a longer time span, or more often, than what's common with just rinsing alone, thus allowing it a greater exposure in your mouth.

In a slightly different vein, the use of probiotics offers an avenue of treatment unlike other approaches.

These products should just be considered adjuncts.

Despite what you may interpret from advertising, we think it's important to state that the types of products discussed on this page are best utilized only as additions to the other efforts you're using to cure your halitosis.

  • On their own, any type of product that solely relies on a chemical approach is unlikely to provide a complete solution.

    That's because mechanical cleansing (brushing, flossing, tongue cleaning) is also needed to fully disrupt existing colonies of odor-causing bacteria.

  • In the case of probiotics, this treatment method is simply still unproven.

What types of products might you consider?

The various options you have include probiotics (as their own category), and then various products that simply serve as an alternative delivery system for the same types of compounds typically found in mouthwashes. This includes mints, lozenges, drops, sprays, chewing gum and toothpaste.

What compounds should they contain?

Research has shown that there are a number of agents that are effective against either the bacteria that cause bad breath (antibacterials) or else the smelly volatile sulfur compounds (VSC's) that they create. (VSC's are the smelly compounds responsible for breath odors.)

We discuss these compounds on their own page but they generally include chlorhexidine (a prescription-only drug), chlorine dioxide (sodium chlorite), zinc compounds, cetylpyridinium, triclosan and essential oils/antiseptic concoctions.

Combination products. | Using more than one product.

Studies suggest that when it comes to controlling bad breath a combination approach is typically beneficial.

For example, Using an OTC cetylpyridinium chloride or essential oils mouthwash, in combination with a toothpaste formulated with zinc or stannous fluoride, can be expected to create a greater effect than using either product alone.

a) Breath mints, lozenges, drops, sprays, etc...

Each of these kinds of products has been utilized as a delivery system for agents shown to be effective in combating bad breath.

Possible benefits.

Probably the most advantageous aspect of using one of these types of products is that their use is frequently more convenient than rinsing.

  • Many compounds provide their greatest benefit for relatively short durations. So the convenience of using a spray, drops, mint or lozenge may provide a way of applying the remedy more frequently than just using an oral rinse would allow.
  • Additionally, products that dissolve in your mouth (mints, lozenges) have the added benefit that they can provide a way of creating a more prolonged exposure of the compound in your mouth.
  • When objects (like mints or lozenges) are consumed, they tend to stimulate the flow of saliva. This increased oral moisture, in turn, creates an enhanced washing-away and diluting effect of both oral bacteria and the smelly VSC byproducts they create.

What to watch out for when selecting a product.

You need to specifically look for the kinds of ingredients that our pages discuss as being effective in treating halitosis because not all breath-oriented products do.

Don't be fooled.

Products that don't contain proven compounds usually just create a temporary masking effect of breath odors via perfumes and flavorings.

If so, their use has very limited value. Beyond their short term benefit (however effective that is), they offer nothing that actually addresses the underlying fundamental causes of halitosis.

Choose a sugar-free product.

In all cases, and especially those where the type of product you choose will be utilized multiple times per day and/or will remain in your mouth for an extended period of time, it's vital that you choose a product that's sugar-free.

Failing to do so can place you at increased risk for tooth decay, possibly substantially so. When looking for a product, look for those sweetened with the compounds sorbitol and/or xylitol.

b) Chewing gum.

A big benefit of chewing gum.

As mentioned above, just the act of having something in your mouth, like chewing gum, can help to decrease halitosis. That's because as you chew, your body tends to produce more saliva. And an increase in salivary flow helps to dilute and wash away the smelly volatile sulfur compounds that cause bad breath.

Admittedly however, this is just a temporary effect and offers nothing toward addressing the fundamental causes of a person's halitosis.

Zinc chewing gum.

As a way of improving the benefits/effectiveness of their products, some manufacturers have incorporated zinc compounds into the formulation of their products.

Effectiveness.

Rosing evaluated VSC levels after test subjects chewed gum , both a regular one and a sugar-free product that also contained zinc.

  • The use of both gums produced a reduction in VSC levels, even out to 60 minutes after chewing. (60 minutes was the point where no further testing was performed.)

The authors of the paper concluded that the lack of difference between the effect of the two products suggested that the act of chewing, and the increase in saliva production it produced, was a more significant factor than the actual compounds found in the gum.

Another study.

Research by De Luca-Monasterios confirms the point that just the act of chewing something, and the associated increase in saliva it creates, helps to lower VSC levels.

Test subject VSC levels were measured both before and then after their having chewed gum for 15 minutes. This short activity resulted in a decrease of VSC levels on the order of 17%.

Section references - Rosing, De Luca-Monasterios

Considerations.

The findings of these studies show that the use of chewing gum can provide an effective short-term remedy. But that any additional cost associated with a product that contains additional active ingredients, like zinc, may be hard to justify.

It's very important to note that in regard to tooth decay prevention (a separate issue that should always be kept in mind) that the product that's chosen should be a "sugarless" one. (Sorbitol and xylitol are common alternative sweeteners used for these types of products.)

c) Toothpaste.

Toothpaste formulations can include compounds that are effective in helping to control bad breath.

1) Stannous fluoride.

Toothpaste formulations frequently contain fluoride. And those that utilize its stannous fluoride form have the added benefit that this compound has antibacterial properties that can have an effect on the types of bacteria that cause halitosis.

Currently, two prominent multi-care toothpastes (Crest Pro-Health, Colgate Total) are formulated with stannous fluoride, and have earned the American Dental Association's Seal of Acceptance for the category of "Bad Breath Control."

 

2) Zinc compounds.

A study by Navada found that the use of toothpaste formulated with zinc (zinc sulfate) was effective in reducing oral malodor. (As measured by test subject VSC levels, which showed reductions ranging from 16% to 46% vs. the control group.)

  • Initially, the effect was found to last for 2 hours following brushing.
  • After 4 weeks of continued use, the reduction in VSC's lasted 12 hours. (Long-term usage provided a greater benefit.)

Section references - Navada

d) Probiotics

Since it's oral bacteria that produce the smelly compounds (VSC's) that cause bad breath, a proposed approach for curing a person's halitosis is via the use of probiotics.

The plan.

The idea associated with this approach is one of creating a population shift in the types of microorganisms that live in the person's mouth. In this case, the presence of halitosis-causing bacteria is supplanted by non odiferous ones (typically Lactobacillus strains).

  • The person first cleans their mouth (brushing, flossing, tongue cleaning), with special regard to those areas most associated with harboring halitosis-associated bacteria.
  • Afterward, the non-offensive bacteria are introduced via lozenge or chewed/dissolved pill, in hopes that they'll end up competing for those living areas preferred by the just removed halitosis-causing bacteria.

If so, with fewer offending bacteria present, fewer VSC's will be produced in the person's mouth. As a result, the quality of their breath will improve.

Does the idea of using probiotics to treat halitosis work?

It's debatable. For example, the findings of a literature review of this subject performed by Yoo were conflicting.

  • It was determined that the research articles evaluated had shown that the use of competing organisms lowered subject organoleptic scores. (Meaning that "smell" testing determined that the subject's breath was less offensive.)
  • But testing for VSC levels (via the use of scientific equipment) showed no improvement.

(The conundrum here is that the testers felt that the subjects' breath had improved but the gases usually considered responsible for bad breath remained at the same levels, pre and post probiotics.)

Further comments.

The fact of the matter is that out of 153 studies initially identified as possible candidates for this review, only three met the inclusion criteria. (A failure to qualify usually has to do with inherent shortcomings in a study's design, such as lack of objectivity.)

And related to this lack of information, the review's author simply stated that further study will be needed to "prove or refute the effect of probiotics on halitosis."

Section references - Yoo, Bartold


If you haven't been there already, don't overlook our page that describes how the various compounds that fight halitosis work.

Or our page that discusses what research shows is the most effective type of mouthwash for bad breath.

 
Feedback