INTRODUCTION:

Bad breath medically referred to as halitosis is an embarrassing health condition that affects approximately 30% of people around the world.^[1]

Halitosis is caused by a group of anaerobic sulphur producing bacteria that breeds underneath the tongue and often in the throat and tonsillar area.

Bad breath lowers self esteem and affects every day life. It also has great impact on relationships. People with halitosis tend to have low self confidence.

Halitosis can be controlled by practicing proper oral hygiene, brushing twice a day and using dental aids like mouthwash or floss will help to almost completely eliminate the problem.

This research aims at finding out which substance is most efficient in controlling or ameliorating halitosis.

Received on 15.04.2015 Modified on 10.06.2015

Research J. Pharm. and Tech. 8(8): August, 2015; Page 1132-1134

DOI: 10.5958/0974-360X.2015.00200.0

MATERIALS AND METHODS:

25 people were randomly selected for this study. They were asked to rate their bad breath on a scale of 0 to 10, where 0 meant no halitosis and 10 meant chronic bad breath.

Four substances were selected – mouthwash, polo, orbit and hot water with salt.

The selected people were asked to use each substance for a period of one week, at the end of each week they were asked to reevaluate their halitosis on the same scale.

All these scores were tabulated. Statistics were done to determine which of the four substances has the most efficacy in controlling halitosis.

RESULTS:

MOUTHWASH

BEFORE MOUTHWASH

Valid	Frequency	Percent	Valid percent	Cumulative percent
2	5	20.0	20.0	20.0
3	8	32.0	32.0	52.0
4	9	36.0	36.0	88.0
5	3	12.0	12.0	100.0
TOTAL	25	100.0	100.0

AFTER MOUTHWASH

Valid	Frequency	Percent	Valid percent	Cumulative percent
0	4	16.0	16.0	16.0
1	12	48.0	48.0	64.0
2	6	24.0	24.0	88.0
3	3	12.0	12.0	100.0
TOTAL	25	100.0	100.0

20% of people rated their bad breath as 2, 32% as 3, 36% as 4 and 12% of people as 5 before using mouthwash. After using mouthwash 16% of people rated their bad breath as 0, 48% as 1, 24% as 2 and 12% as 3.

So there is significant decrease in halitosis after the use of mouth wash for a week, according to statistical data.

POLO

BEFORE POLO

Valid	Frequency	Percent	Valid percent	Cumulative percent
2	5	20.0	20.0	20.0
3	8	32.0	32.0	52.0
4	9	36.0	36.0	88.0
5	3	12.0	12.0	100.0
TOTAL	25	100.0	100.0

AFTER POLO

Valid	Frequency	Percent	Valid percent	Cumulative percent
1	1	4.0	4.0	1
2	3	12.0	12.0	2
3	10	40.0	40.0	3
4	6	24.0	24.0	4
5	3	12.0	12.0	5
6	2	8.0	8.0	6

Before using polo, 20% of people rated their bad breath as 2, 32% as 3, 36% as 4 and 12% as 5. After using polo for one week, 4% of people rated their bad breath as 1, 12% as 2, 40% as 3, 24% as 4, 12% as 5 and 8% as 6.

There is no significant decrease in halitosis due to the usage of polo.

ORBIT

BEFORE ORBIT

Valid	Frequency	Percent	Valid percent	Cumulative percent
2	5	20.0	20.0	20.0
3	8	32.0	32.0	52.0
4	9	36.0	36.0	88.0
5	3	12.0	12.0	100.0
TOTAL	25	100.0	100.0

AFTER ORBIT

Valid	Frequency	Percent	Valid percent	Cumulative percent
1	1	4.0	4.0	4.0
2	5	20.0	20.0	24.0
3	9	36.0	36.0	60.0
4	9	36.0	36.0	96.0
5	1	4.0	4.0	100.0
TOTAL	25	100.0	100.0

20% of people rated their bad breath as 2, 32% as 3, 36% as 4 and 12% as 5. After using orbit for a period of one week, 4% people rated their bad breath as 1, 20% as 2, 36% as 3, 36% as 4 and 4% as 5.

There is no significant decrease in halitosis due to the usage of orbit.

HOT WATER WITH SALT

BEFORE HOT WATER WITH SALT

Valid	Frequency	Percent	Valid percent	Cumulative percent
2	5	20.0	20.0	20.0
3	8	32.0	32.0	52.0
4	9	36.0	36.0	88.0
5	3	12.0	12.0	100.0
TOTAL	25	100.0	100.0

AFTER HOT WATER WITH SALT

Valid	Frequency	Percent	Valid percent	Cumulative percent
3	8	32.0	32.0	32.0
4	10	40.0	40.0	72.0
5	6	24.0	24.0	96.0
6	1	4.0	4.0	100.0
TOTAL	25	100.0	100.0

Before gargling with hot water and salt, 20% of people rated their bad breath as 2, 32% as 3, 36% as 4 and 12% as 5.

After gargling with hot water and salt for a period of one week, 32% of people rated their bad breath as 3, 40% as 4, 24% as 5 and 4 % of people as 6.

According to statistical data, there is a significant increase in halitosis.

NON PARAMETRIC TEST

WILCOXON SIGNED RANKS TEST

	After mothwash -before mouthwash	After polo –before polo	After orbit –before orbit	After hot water with salt– before hot water with salt
Z	4.338 (p< 0.001 )	0.607 (NS)	0.790 (NS)	2.839 (p < 0.01 )

KRUSKAL - WALLIS TEST (TO ASSESS THE EFFECTIVENESS OF TREATMENTS –TO SEE WHICH TREATMENT IS MOST EFFECTIVE)

	TREATMENT	N	MEAN RANK
BEFORE	MOUTH WASH	25	50.50
	POLO	25	50.50
	ORBIT	25	50.50
	HOT WATER WITH SALT	25	50.50
	TOTAL	100
AFTER	MOUTH WASH	25	17.74
	POLO	25	59.54
	ORBIT	25	53.36
	HOT WATER WITH SALT	25	71.36
	TOTAL	100

TEST STATISTICS (a,b)

BEFORE

AFTER

KRUSKAL – WALLIS

CHI SQUARE

0.000 (NS)

49.925 ( p < 0.001 )

Hence from the statistical data, it can be concluded that mouthwash has the most efficiency in controlling halitosis.

DISCUSSION:

Most adults and many children suffer from halitosis occasionally, chronically and regularly.^[2]but they do not always go in for treatment as they are embarrassed about their problem.

The most common substance used for the treatment of halitosis is mouth wash. Most mouth washes contain fluoride, which helps to fight cavities and prevent periodontal disease.^[3]

Some mouth wash solutions contain alcohol. The major drawback of using alcohol based is irritation and burning of the oral mucosa and dry mouth.^[3]

Prolonged or overuse of alcohol based mouth rinses causes oral cancer. A 2009 Australian study found that alcohol containing mouth wash solutions allow carcinogens to penetrate into mouth lining increasing oral cancer risk.^[4]

The other substances that are used for controlling bad breath are breath mints and chewing gum.

Polo is basically a breath mint. Breath mints primarily freshen a person’s breath by masking offensive odour. They also stimulate the flow of saliva which helps in removing food and bacterial debris, thus preventing plaque formation.^[5]

Eating too much mint will cause irritation of the mucous membrane.^[6]

Chewing gum is good for oral health and also for teeth as it increase the flow of saliva, that helps to flush out sugars and food debris. It also neutralizes decay causing acids in our mouth. Chewing gum prevents buildup of plaque. They also whiten our teeth and prevent staining.^[7]

Chewing gum contains sugar as one of the core component. So chewing gum essentially equates to bating our teeth in sugar. This causes tooth decay.^[8]If the chewing gum is sugar free, it may contain acidic flavoring that will lead to dental erosion with prolonged usage.^[8]

A natural remedy used for treating halitosis is hot water and salt. This rinse is an excellent short term solution, especially when there are wounds in the oral cavity.

The reason these salt water rinses are so good is because salt hastens the healing process and acts as a natural disinfectant.^[9]

But long term use of mouth rinses are not recommended because it could cause erosion of the teeth. The acidity of salt water softens enamel and makes teeth more susceptible to chipping and cavities.^[9]

CONCLUSION:

Therefore halitosis can be controlled by maintaining proper oral hygiene, visiting the dentist regularly and using mouth wash or any other dental aids. If studies are conducted with other substances, a better alternative for control of halitosis may be found.

REFERENCES:

[1] www.therabreath.com

[2] Jon.L. Richter,: Diagnosis and Treatment of Halitosis

[3] www.wisegeek.com

[4] McCullough. M.J, Farah. C.S : The role of alcohol in oral carcinogenesis with particular reference to alcohol containing mouth washes

[5] Wikipedia

[6] www.buzzle.com

[7] www.chewinggumfacts.com

[8] articles.mercola.com

[9] www.todaysdentistry.com.au