Effect of a Mouthwash Containing Chlorhexidine and Chlorine Dioxide on Halitosis

A Randomized Double-Blind Crossover Clinical Trial Evaluating the Efficacy of a Mouthwash Containing Chlorhexidine and Chlorine Dioxide in Patients With Oral Malodor

Halitosis significantly impacts the quality of a patient's life. This randomized, double-blind crossover trial evaluates a mouthwash containing chlorhexidine (0.01%) and chlorine dioxide (0.05%) compared with placebo. Forty participants rinsed twice daily for 2 weeks, followed by a 2-week washout and crossover. The primary outcomes were volatile sulfur compounds (H₂S, CH₃SH), measured by OralChroma. Secondary outcomes included plaque index, gingival index, bleeding on probing, tongue coating, and salivary bacterial counts (Aa, Pg, Fn, Pi, and Ec).

Inclusion Criteria:

• ≥20 natural teeth
• H₂S >1.5 ng/10ml or CH₃SH >0.5 ng/10ml
• Signed informed consent

Exclusion Criteria:

• Systemic disease
• Smoking
• Pregnancy or lactation
• Periodontal pockets ≥4 mm
• Recent antibiotic use (<1 month)
• Orthodontic appliances or dentures
• Allergy to CHX or C