Halitosis, or persistent bad breath, is one of the most common dental complaints. Managing the condition means controlling the balance of the oral microbiota and preventing the build-up of plaque. Using a mouthwash is often regarded as an accessible solution to tackle the problem, but this has its own side effects, like teeth staining. So what else can consumers do to keep bad breath away?
Some probiotics - Lactobacillus salivarius, Lactobacillus reuteri and Streptococcus salivarius - which are typically found in fermented foods like yogurt have been used to treat halitosis in the past. The treatment, called probiotic therapy, requires taking probiotic supplements for their potential to reduce odorous compound levels by preventing bacteria from decomposing amino acids and proteins in the mouth.
Previous studies however have proved inconclusive on whether this type of treatment really works. To determine if probiotic therapy can be used to banish bad breath, researchers from the West China Hospital of Stomatology at Sichuan University in China conducted a systematic review and meta-analysis on the most relevant published studies.
They found a total of 238 articles related to probiotics and halitosis, which were further whittled down to 7. These were all randomized controlled clinical trials involving a total of 278 people, where patients diagnosed with halitosis were given probiotic supplements, and their results were compared with those of a control group that received placebo.
The researchers compared the OLP scores – regarded as the gold standard for diagnosing halitosis – and the levels of VSC, or volatile sulphur compounds, which are the main contributor to bad breath. Tongue coating scores and plaque index were also included where available.
The meta-analysis confirmed the benefits of probiotic therapy on halitosis, showing that probiotics significantly reduced the levels of VSC in patients for up to 4 weeks, though results varied across the various studies included in the sample. OLP scores also fell significantly in patients that were taking probiotic supplements compared to those in the control group.
The treatment had no effect on the underlying causes of bad breath, however, with tongue coating scores and plaque index staying unchanged.
Concluding, the researchers wrote: “This systematic review and meta-analysis indicates that probiotics…may ease halitosis by reducing the VSC concentration levels in the short term, but there is no significant effect on the major cause of halitosis such as plaque and tongue coating.
“Considering the heterogeneity of the clinical trials included and the small sample size, more high-quality random clinical trials are required in the future to verify the results and to provide evidence for the efficacy of probiotics in the management of halitosis.”
Source:
Efficacy of probiotics in the management of halitosis: a systematic review and meta-analysis
Authors: Huang N, Li J, Qiao X, et al
Published: 20 December 2022, BMJ Open
