Efficacy of Melaleuca alternifolia and chlorhexidine mouth rinses in reducing oral malodor and Solobacterium moorei levels. A 1 week, randomized, double-blind, parallel study.

2022
Indian journal of pharmacology 54(2)
- K Prabhu Srikumar
- B N Bhagyashree
- Sridharan Srirangarajan
- Rao J Ravi
- Rudresh Vinaya

PubMed: 35546457
DOI: 10.4103/ijp.ijp_772_20

Study Design

Type: Randomized Controlled Trial (RCT)
Sample size: n = 160
Population: 160 individuals with halitosis
Methods: placebo-controlled parallel study, double-blind, randomized, with two test mouth rinses (Melaleuca alternifolia and Chlorhexidine) and placebo, evaluated before and after 1 week treatment
Blinding: Double-blind
Duration: 1 week

Large Human Trial

Objectives

The objective is to evaluate the association of Solobacterium moorei (S. moorei) to halitosis and to also check for the effects of two different mouth rinses on levels of S. moorei in saliva and tongue coating and its impact on oral halitosis.

Materials and methods

This was a placebo-controlled parallel study of 160 individuals who were randomized and the study was performed using double-blinded protocol. Enrolled individuals filled a structured questionnaire regarding demographic data, oral hygiene habits, and dietary habits. Full mouth organoleptic odor scores (OLR), volatile sulfur compounds levels, Miyazaki's tongue coating index, and Plaque scores were recorded before intervention (baseline) and after 1-week post treatment. Microbiological samples obtained from the tongue and saliva was investigated for S. moorei levels using real time polymerase chain reaction. Participants were randomly assigned for two test mouth rinses (Melaleuca alternifolia and Chlorhexidine) and placebo groups.

Results

All salivary and tongue coating samples were tested positive for S. moorei in the halitosis group. One week post-treatment S. moorei counts in saliva and tongue coating samples of test group showed a significant reduction at P < 0.001. Paired t-test results showed that Melaleuca alternifolia was comparable with chlorhexidine in reduction of OLR, and VSC scores (P < 0.001). Salivary levels of S. moorei in Melaleuca alternifolia group showed a higher reduction (5.67 log¹⁰ copies/mL) than chlorhexidine group (5.1log¹⁰ copies/mL).

Conclusion

S. moorei showed a positive correlation with oral halitosis scores. Both Melaleuca alternifolia and chlorhexidine were equally effective in reducing S. moorei levels and halitosis score.

Research Insights

Tea Tree→Reduced Oral Malodor
Paired t-test results showed that Melaleuca alternifolia was comparable with chlorhexidine in reduction of OLR, and VSC scores (P < 0.001).
Effect
Beneficial
Effect size
Moderate
Tea Tree→Reduced Solobacterium moorei Level
Salivary levels of S. moorei in Melaleuca alternifolia group showed a higher reduction (5.67 log10 copies/mL) than chlorhexidine group (5.1log10 copies/mL).
Effect
Beneficial
Effect size
Large