O7 
The treatment of oral malodor

Objective  Because the increase in the bacterial load on the tongue is paramount in the etiology of malodor, we sought to reduce this load by debriding the tongue in combination with short‐term usage of antimicrobial mouthrinses.Methods  Subjects with oral malodor had an OR score >2, had whole mouth volatile sulfur (VSCs) levels ≥200 ppb (Halimeter®), and had a positive tongue BANA test. The subjects were given a tongue scraper and a 16 oz bottle of mouthrinse (Listerine® or Ther‐a‐sol®, single blind design). They were instructed to debride their dorsal tongue surface, to brush and floss the teeth, to rinse with 1 oz of the mouthrinse for 1 min, instructed not to eat or drink for 2–3 h thereafter, and to repeat the protocol in the morning and evening for 7 days. After 1 week all malodor measurements were repeated. The patients were then given a zinc containing tongue gel and instructed to debride the tongue surface, repeating this procedure twice a day.Results and discussion  Thirty‐two subjects entered this program, 31 returned 1 week later, and 20 returned for a follow‐up examination (average of 37 weeks). The OR score decreased from 2.8 to 0.9 after 1 week of treatment, and to 0.6 for those who returned for the follow‐up. The VSCs decreased from 339 ppb prior to treatment to 120 ppb after 1 week and to 53 ppb 37 weeks later. Eighty‐one percent of the tongues were BANA positive prior to treatment, 16% after 1 week and 0% after 37 weeks. The microbial flora changed from one dominated by asaccharolytic species to one dominated by saccharolytic species such as S. salivarius.Conclusions  This report describes a long‐term beneficial effect of treatment on oral malodor.