Halitosis: effect of periodontal treatment

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The prevalence of halitosis has been reported to range from 2.4 to 78% and periodontal disease is frequently accompanied by halitosis.  The bacteria associated with periodontal disease can produce volatile sulphur compounds (VSCs )  such as hydrogen sulphide (H2S) or and methyl mercaptan (CH3SH)  that are key components of oral malodour.

The aim of this review was to assess the effect of scaling and root planing (SRP) and professional tooth cleaning (PTC) together with oral hygiene instructions (OHI) had a beneficial effect on halitosis.


The PubMed/Medline, Cochrane CENTRAL and Google Scholar databases were searched. Randomised clinical trials (RCTs) or controlled clinical trials (CCTs) involving Professional tooth cleaning; along with oral hygiene instructions or non-surgical periodontal treatment; along with oral hygiene instruction and published in English were considered. The primary outcome was VSC concentrations (measured by sulphide monitor: Halimeter or gas chromatograph: OralChroma) with organoleptic scores as a secondary outcome. Two reviewers independently abstracted data and assessed study quality. Meta-analysis was not performed.


  • 8 studies were included
  • All trials or study arms included showed a positive effect on VSC levels or organoleptic scores after intervention.


The authors concluded: –

Based on best available evidence, professional tooth cleaning or non-surgical periodontal therapy (scaling and root planning) in combination with oral hygiene instructions reduced oral halitosis represented by VSC values and organoleptic scores in patients with periodontal disease, independently of tongue cleaning and use of mouthwashes.


While three databases have been searched studies were restricted to those published in English so other relevant studies could have been missed. The quality of the studies is limited as most of the included studies lack a classical control group. The authors also highlight concerns regarding accounting for confounders such as smoking habits, tongue cleaning and mouthwash use in the primary studies. Consequently thr findings of this review should be viewed cautiously.


Primary paper

Deutscher H, Derman S, Barbe AG, Seemann R, Noack MJ. The effect of professional tooth cleaning or non-surgical periodontal therapy on oral halitosis in patients with periodontal diseases. A systematic review. Int J Dent Hyg. 2017 Aug 24. doi: 10.1111/idh.12306. [Epub ahead of print] Review. PubMed PMID:28836329.

Other references

 Dental  Elf – 28th Aug 2017

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