Intraoral Halitosis Management in Children and Adolescents: A Systematic Review

Objectives: Due to the high prevalence of halitosis in children and adolescents and the personal and social problems that it entails, it is necessary to apply effective therapeutic alternatives to reduce this condition. This systematic review aimed to assess the efficacy of different therapies compared to placebo or control group on intraoral halitosis in children and adolescents.
Methods: A systematic search was conducted on the following databases: PubMed, Epistemonikos, Cochrane Central Register of Controlled Trials and LILACS. We included human controlled trials with an age range between 5 to 18 years old with a diagnosis of intraoral halitosis at the beginning of the study. The search included trials that involved any type of interventions for intraoral halitosis management. Risk bias tool from Cochrane was used for risk assessment.
Results: Six articles fulfilled the selection criteria. No meta-analysis could be done due to the differences between the reported treatments. The risk of bias was moderate across the articles. Five articles showed improvement in the halitosis management comparing the intervention group (chlorhexidine, tongue cleaner, scaling, photodynamic therapy, and /or probiotics) vs the control group (conventional oral hygiene). One article did not find any difference in the intervention group that included: scaling, tooth brushing and tongue cleaning compared to scaling and tooth brushing alone.
Conclusions: There is moderate quality evidence suggesting that tongue cleaning combined with other hygiene method is needed to improve bad breath in children and adolescents. We suggest carrying out well-designed studies to evaluate the use of the different oral hygiene methods to control bad breath of oral origin.