{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T17:24:42Z","timestamp":1789579482538,"version":"build-2803163510"},"reference-count":72,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T00:00:00Z","timestamp":1673481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011019","name":"National Research, Development and Innovation Office","doi-asserted-by":"publisher","award":["EFOP-3.6.2-16-2017-0006"],"award-info":[{"award-number":["EFOP-3.6.2-16-2017-0006"]}],"id":[{"id":"10.13039\/501100011019","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>We aimed to conduct a systematic review on published data in order to investigate the efficacy of mouthwash products containing chlorine dioxide in halitosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Study design<\/jats:title>\n<jats:p>Systematic review and meta-analysis<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Our search was conducted on 14th October 2021. We searched the following electronic databases: MEDLINE, Embase, Scopus, Web of Science, and CENTRAL. We analysed data on adults with halitosis, included only randomised controlled trials and excluded <jats:italic>in vitro<\/jats:italic> and animal studies. The interventional groups used chlorine dioxide, and the comparator groups used a placebo or other mouthwash. Our primary outcomes were changes in organoleptic test scores (OLS) and Volatile Sulfur Compound (VSC) levels from baseline to the last available follow-up.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>We found 325 articles in databases. After the selection process, ten articles were eligible for qualitative synthesis, and 7 RCTs with 234 patients were involved in the meta-analysis. Our findings showed a significant improvement in the parameters of the chlorine dioxide group compared to the placebo group in OLS one-day data (mean difference (MD): -0.82; 95% confidence intervals (95% CIs): [-1.04 \u2013-0.6]; heterogeneity: I<jats:sup>2<\/jats:sup> = 0%, p = 0.67); and one-week OLS data (MD: -0.24; 95% CIs: [-0.41 \u2013-0.07]; I<jats:sup>2<\/jats:sup> = 0%, p = 0.52); and also changes in H<jats:sub>2<\/jats:sub>S one-day data (standardised mean difference (SMD): -1.81; 95% CIs: [-2.52 \u2013-1.10]); I<jats:sup>2<\/jats:sup> = 73.4%, p = 0.02).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our data indicate that chlorine dioxide mouthwash may be a good supportive therapy in oral halitosis without known side effects.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0280377","type":"journal-article","created":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T18:47:34Z","timestamp":1673549254000},"page":"e0280377","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":19,"title":["Daily use of chlorine dioxide effectively treats halitosis: A meta-analysis of randomised controlled trials"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2276-7109","authenticated-orcid":true,"given":"Eszter","family":"Szalai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2204-0869","authenticated-orcid":true,"given":"P\u00e9ter","family":"Tajti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6354-3545","authenticated-orcid":true,"given":"Bence","family":"Szab\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P\u00e9ter","family":"Hegyi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5915-0383","authenticated-orcid":true,"given":"L\u00e1szl\u00f3 M\u00e1rk","family":"Czumbel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saghar","family":"Shojazadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e1bor","family":"Varga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orsolya","family":"N\u00e9meth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4000-9440","authenticated-orcid":true,"given":"Beata","family":"Keremi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,1,12]]},"reference":[{"issue":"5","key":"pone.0280377.ref001","first-page":"257","article-title":"Examination, classification, and treatment of halitosis; clinical perspectives","volume":"66","author":"K Yaegaki","year":"2000","journal-title":"J Can Dent Assoc"},{"issue":"1","key":"pone.0280377.ref002","first-page":"69","article-title":"Comparison of the Psychological Condition of Chinese Patients with or without Halitosis Complaints","volume":"21","author":"J Wang","year":"2018","journal-title":"Chin J Dent Res"},{"issue":"1","key":"pone.0280377.ref003","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.1038\/sj.bdj.2014.552","article-title":"Halitosis: a new definition and classification","volume":"217","author":"M Aydin","year":"2014","journal-title":"Br Dent J"},{"issue":"2","key":"pone.0280377.ref004","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1038\/ijos.2012.39","article-title":"Halitosis: the multidisciplinary approach","volume":"4","author":"CM Bollen","year":"2012","journal-title":"Int J Oral Sci"},{"issue":"1","key":"pone.0280377.ref005","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1902\/jop.1977.48.1.13","article-title":"Production and Origin of Oral Malodor: A Review of Mechanisms and Methods of Analysis","volume":"48","author":"J Tonzetich","year":"1977","journal-title":"Journal of Periodontology"},{"issue":"11","key":"pone.0280377.ref006","first-page":"1412","article-title":"Site-specific mouth rinsing can improve oral odor by altering bacterial counts. 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