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References supporting Cetylpyridinium Chloride (CPC) kills bacteria that lead to bad breath:
Effect of different mouth rinses on morning breath. J Periodontal. 2001 Sep BACKGROUND: Morning breath odor is an often-encountered complaint. This double-blind, crossover, randomized study aimed to examine the bad breath-inhibiting effect of 3 commercially available mouth rinses on morning halitosis during an experimental period of 12 days without mechanical plaque control. METHODS: Twelve medical students with a healthy periodontium refrained from all means of mechanical plaque control during 3 experimental periods of 12 days (with intervening washout periods of at least 3 weeks). A professional oral cleaning preceded each period. During each experimental period, as the only oral hygiene measure allowed, the students rinsed twice a day with one of the following formulations in a randomized order: CHX-Alc (a 0.2% chlorhexidine [CHX] solution); CHX-NaF (CHX 0.12% plus sodium fluoride 0.05%); or CHX-CPC-Zn (CHX 0.05% plus cetylpyridinium chloride 0.05% plus zinc lactate 0.14%). After 12 days, morning breath was scored via volatile sulfur compound (YSC) level measurements of the mouth air and organoleptic ratings of the mouth air, the expired air, and a scraping of the tongue coating. At the 12-day visit, a questionnaire (subjective ratings) was completed and samples taken from both the tongue coating and the saliva for anaerobic and aerobic culturing and vitality staining. The de novo supragingival plaque formation was also recorded. All parameters were correlated with the baseline registrations. RESULTS: Although oral hygiene during the 3 experimental periods was limited to oral rinses, bad breath parameters systematically improved, with the exception of a slight increase in YSC levels while using CHX-AIc, a finding which was associated with the direct influence of the CHX on the sulfide monitor. The oral microbial load after the use of CHX-NaF remained unchanged, while for the CHX-Alc and CHX-CPC-Zn, significant reductions in both aerobic and anaerobic colony forming units (CFU)/ml were noticed in comparison with baseline data for both tongue coating and saliva samples. The composition of micro flora, on the other hand, did not reveal significant changes. The supragingival plaque formation was inhibited, in descending order, by CHX-AIc, CHX-CPC-Zn, and CHX-NaF. The subjective scores for the rinses indicated a higher appreciation for CHX-CPC-Alc and CHX-NaF because of a better taste and fewer side effects. CONCLUSIONS: The results of this study demonstrate that morning halitosis can be successfully reduced via daily use of mouth rinses. CHX-Alc and CHX-CPC-Zn mouth rinses result in a significant reduction of the microbial load of tongue and saliva. The efficacy of amine fluoride/stannous fluoride in the suppression of morning breath odor. Periodontal. 2002 Oct; 29. BACKGROUND: Breath odor is a complaint encountered worldwide, often linked to microbial overload in the oral cavity. This double blind, crossover, randomized study assessed the efficacy of several antiseptic mouth rinses or slurry vs. a control solution in the prevention of morning bad breath during an experimental period of 7 days without mechanical plaque control. Methods: Sixteen dental students with a healthy periodontium abolished, after a thorough professional cleaning, all means of mechanical plaque control during five experimental periods of 7 days, interleaved by washout periods of at least 3 weeks. During each experimental period, as the only oral hygiene measure, the students rinsed twice a day with one of the following formulations (in a randomized order): a 0.2% chlorhexidine-a1cohol mouth rinse (CHX-A1c), a 0.05% CHX + 0.05% cetylpyridinium chloride + 0.14% zinc lactate mouth rinse (CHX-CPC-Zn), an amine fluoride/stannous fluoride (125 ppm F-/125 ppm F-) containing mouth rinse (AmF/SnF2Mr), a slurry of a tooth paste (AmF/SnF2SI) containing amine fluoride (350 ppm F-) and stannous fluoride (1050 ppm F-) and a placebo solution (placebo). At days 0, 3 and 7, morning breath was scored via VSC level measurements of the mouth air, and organoleptic ratings of the mouth air and tongue coating. At the same visits both the degree of gingival inflammation and the de novo plaque fonnation were rated. At the end of each period a questionnaire for subjective ratings was completed and microbiological samples were taken from the tongue dorsum, the saliva and the supragingival plaque for anaerobic and aerobic culturing. Results: Although oral hygiene during the experimental periods was limited to rinsing, bad breath parameters systematically improved (P < 0.00 I) with the three mouth rinses (CHX-AIc, CHX-CPC-Zn, AmF/SnF2Mr), with a superiority of the CHX-CPC-Zn solution when only VSC values were considered (P < 0.003). The AmF/SnF2 slurry and the placebo solution showed only minor changes with time. The three mouth rinses reduced significantly (P < 0.001) the bacterial load (aerobic & anaerobic) in the saliva (>or= 0.5 log reduction with a superiority (P < 0.005) for the CHX-Alc when compared to the two others). Changes in the bacterial load on the tongue dorsum could only be detected for the CHX-Alc solution (0.5 log). The antibacterial effect of the placebo solution and the slurry were negligible. The composition of micro flora on the other hand did not reveal significant changes. The de novo supragingival plaque fonnation was significantly (P < 0.05) inhibited by the three mouth rinses with a slight superiority for the CHX-Alc solution. The degree of gingival inflammation at day 7 remained low " 0.16) for all products. The CHX-Alc solution scored significantly worse for the subjective evaluation (questionnaires) concerning taste and sensitivity of tongue). CONCLUSIONS: The results of this study demonstrate that morning breath odor can be successfully reduced by the sole twice daily use of CHX-A1c, CHX-CPC-Zn or AmF/SnF2Mr mouth rinses, which all significantly reduced the bacterial load in the saliva and retarded the de novo plaque fonnation. Abstract The Antimicrobial Efficacy of a New CPC/Zn acetate Breath Freshening Mouth Rinse A new mouth rinse containing cetylpyridinium chloride and zinc acetate (CPC/Zn) significantly reduced mouth odor scores in clinical studies versus a control rinse. Objectives: This investigation examined the antimicrobial effects of these rinses in laboratory and clinical studies. Methods: Laboratory tests with oral bacteria were performed with alamar blue, a redox dye that rapidly detects bacterial viability. Results: Treatment of A. viscosus, S. mutans, and S. sanguis by CPC/Zn resulted in a 25, 35 and 16% decrease in bacterial viability respectively versus control and were statistically significant (p < 0.05). A randomized, double blind clinical study with 37 subjects was conducted to confirm these laboratory results. After a washout phase, subjects abstained from oral hygiene and provided a saliva sample for determining the numbers of total and oral odorigenic producing bacteria on enriched and indicator plates. Mouth rinses were used once and subjects sampled at 90 and 180 minutes post treatment for total and oral odorigenic bacteria. In comparison to control, the decrease of total bacteria following CPC/Zn use at 90 and 180 minutes were 59.9% and 32.1% respectively. The use of CPC/Zn resulted in a 61. 7% and 72.5% decrease of odorigenic bacteria at 90 and 180 minutes respectively versus control rinse. The decrease in bacteria with the CPC/Zn rinse were significantly higher than the control rinse at all post-use time points (p<0.05). Conclusions: These results demonstrate the efficacy of a mouth rinse with CPC/Zn on oral bacteria in laboratory and clinical tests. Additionally, the CPC/Zn rinse resulted in a higher reduction of oral odorigenic bacteria than the control rinse. |
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