The Effect of Chlorine Dioxide (ClO₂) on Oral Malodor

Different products are today found on the market in order to reduce the level of volatile sulphide compounds (VSC) in the mouth and thereby malodor. Objectives: The aim of the present investigation was to evaluate the effect of a new stabilized form of chlorine dioxide (ClO₂) in this context. Methods: Nineteen adult subjects (13 smokers and 6 non-smokers), aged 32-74 yrs, were included in the study. They participated in a 14-day randomized trial during which they rinsed 4 times daily with 2x10 ml of either: 1) 40 ppm ClO₂ (XINIX^®, XINIX AB, Stockholm, Sweden), 2) 0.02% zinc chloride (ZC) or 3) distilled water (DW). The level of VSC was measured at baseline, day 7 and day 14 with a portable sulphide monitor (Halimeter^®). Measurements were carried out before and after a mouthrinse with the test solution in order to evaluate both the long- and short-term effect. Patient satisfaction was evaluted day 7 and day 14 by use of a visual analogue scale (VAS). Results: Only ClO₂ resulted in a long-term reduction of VSC from day 0 to day 14 for all individuals and smokers (p<0.05). The strongest short-term reduction of VSC was found for ZC (42-44%), followed by ClO₂ (24-29%) and DW (9-14%); ZC and ClO₂ differed significantly from DW (p<0.01) and ZC from ClO₂ (p<0.05). The mean VAS was 36% for ClO₂, 21% for ZC and 22% for DW (NS). Conclusions: The main conclusion from this study is that the new stabilized form of chlorine dioxide, both from an objective and subjective point of view, is able to reduce the level of oral malodor. However, the long-term effect seem to be in favour for chlorine dioxide compared to zinc chloride. This study was supported by Patentmedelsfonden för Odontologisk Profylaxforskning and XINIX AB, Sweden.