Abstract
Aim: To evaluate the effectiveness and sustainability of oral probiotics (Streptococcus salivarius K12), tongue brushing, and their combination in reducing halitosis.
Methods: The study was a prospective, randomized, placebo-controlled trial. A total of 80 participants were randomly allocated to four groups: control (n=20), oral probiotics (n=20), tongue brushing (n=20), and a combined group of tongue brushing and oral probiotics (n=20). Assessments were taken at three time points: at baseline; after a 4-week intervention; and at a 4-week intervention-free follow-up. The outcome measurements included volatile sulphur compound (VSC), self-reported halitosis, organoleptic score, and tongue coating index.
Results: After the 4-week intervention, VSC levels were significantly decreased in the oral probiotics, tongue brushing, and combined groups (all p < 0.05), with the greatest reduction observed in the combined group. At the 4-week intervention-free follow-up, the combined group VSC levels remained significantly lower than baseline, despite slight rebounds. Self-reported halitosis scores decreased after intervention and follow-up (p < 0.05). Organoleptic scores improved only in the combined group post-intervention (p < 0.01). Tongue coating scores decreased in both tongue brushing and combined groups, but not in the oral probiotics group.
Conclusions: Both tongue brushing and oral probiotics were effective in reducing halitosis, with the combined intervention producing the most significant and sustained improvements.