Chios Mastic Mouthwash and Halitosis and Oral Hygiene in Orthodontic Patients
Condition: Halitosis; Orthodontic Appliance Complication
MeSH terms: Halitosis
Study type: Interventional

Summary: 
      Halitosis is the third most common oral condition perceived by the patients as pathologic,
      after caries and periodontal diseases. Although it is difficult to estimate the prevalence of
      halitosis in the population due to the different assessment methods, the available
      descriptive epidemiologic studies estimate that 30-50% of the population experience oral
      malodor. Pathologic halitosis most commonly (85%) originates from the oral cavity and is a
      result of bacterial deposits that cover the tongue or are found in the inflamed oral mucosa,
      under poor-quality restorations, orthodontic mechanisms, carious lesions or mucosal ulcers.
      Odor usually results from the microbial degradation of organic substrates present in saliva.
      This interaction generates malodorous volatile sulfur compounds (VSCs), of which the three
      most common are: hydrogen sulfide (H2S), methyl-mercaptan (CH3SH) and dimethyl sulfide
      [(CH3)2S].

      Orthodontic patients with fixed appliances are more prone to halitosis, due to the increased
      plaque accumulation and the increased amounts of available nutrients for the supragingival
      and subgingival microbes .
    

Detailed description: 
      AIM: The aim of this study is to investigate the effect of Mastic mouthwash on halitosis
      (Volatile Sulfur Compounds' levels, VSCs) as well as plaque and gingival indexes in patients
      undergoing orthodontic treatment with fixed appliances PARTICIPANTS AND METHOD: The study is
      a double-blinded, placebo-controlled, parallel group, randomized clinical trial. Thirty
      patients with fixed orthodontic appliances were randomly allocated at a 1:1 ratio, to either
      the mastic-mouthwash or the placebo-mouthwash group. Eligibility criteria included ages
      between 13 and 18, active orthodontic treatment with fixed appliances, good general health
      and total initial VSCs levels above the baseline level of 150ppb. The primary outcomes will
      be: (a) their subjective perception of their own malodor via questionnaires, (b) their
      objective VSCs levels (hydrogen sulfide (H2S), methyl-mercaptan (CH3SH) and dimethyl sulfide
      ((CH3)2S) through the OralChromaTM device and (c) oral hygiene assessed with the use of the
      Modified Silness and Löe Plaque Index (PI-M) and the Silness and Löe Gingival Index (GI).
      Measurements were taken at baseline (T0) and after 2 weeks (T1).
    

Intervention name(s): Mastic mouthwash; Placebo mouthwash
Intervention type(s): Dietary Supplement; Dietary Supplement
Intervention description(s): All 30 patients will be randomly assigned to either the mastic mouthwash group A (Art of Nature Mastiha Mouthwash, Mastihashop, Greece) (n = 15) or the placebo mouthwash group B (from the same manufacturer) (n = 15) (Table 1). All patients will be asked to use the mouthwash twice a day (10 ml of mouthwash / 2 times a day for 30 sec for 14 days, every morning and every night after brushing) and to maintain their usual oral hygiene routine. The measurements will be done in the morning and at least three hours after brushing and without the use of the mouthwash by the participant on the day of the assessments.; All 30 patients will be randomly assigned to either the mastic mouthwash group A (Art of Nature Mastiha Mouthwash, Mastihashop, Greece) (n = 15) or the placebo mouthwash group B (from the same manufacturer) (n = 15) (Table 1). All patients will be asked to use the mouthwash twice a day (10 ml of mouthwash / 2 times a day for 30 sec for 14 days, every morning and every night after brushing) and to maintain their usual oral hygiene routine. The measurements will be done in the morning and at least three hours after brushing and without the use of the mouthwash by the participant on the day of the assessments.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This trial is designed as a prospective, randomized, placebo-controlled, double (investigator and patient) blinded, with two parallel groups and an equal allocation ratio in all groups. In this study, the intervention consists of delivery of mastic mouthwash or placebo lozenges.
Masking: Double (Participant, Investigator)
Primary purpose: Prevention
Keywords: Halitosis; Mastic; Orthodontic appliance