{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T11:00:23Z","timestamp":1767351623248,"version":"3.48.0"},"reference-count":30,"publisher":"MJS Publishing, Medical Journals Sweden AB","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BIiD"],"abstract":"<jats:p>Objective: This study evaluated the antibacterial efficacy of chlorhexidine-chlorine dioxide (CHX-CDO) mouthwash formulations against major halitosis-related pathogens: Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa), Fusobacterium nucleatum (Fn), Prevotella intermedia (Pi), and Eikenella corrodens (Ec).\nMaterials and methods: Five bacterial strains were cultured anaerobically. Experimental mouthwashes with varying concentrations of CHX (0.01\u20130.2%) and CDO (0.05\u20130.1%), labeled solution A\u2013J, were tested. Agar diffusion assays measured inhibition zones. MICs were determined by broth microdilution with 24 h anaerobic incubation and OD600 measurement. The time-kill test quantified CFUs from serial dilutions at time points (0, 1, 3, 6, 12, and 24 h).\nResults: All CHX-CDO mouthwash combinations inhibited bacterial growth, with A (0.05% CHX + 0.05% CDO), C (0.2% CHX + 0.05% CDO), F (0.2% CHX + 0.1% CDO), and J (CHX 0.02\/CDO 0.1) showing the largest inhibition zones and G (CHX 0.01\/CDO 0.05) and H (CHX 0.02\/CDO 0.05) exhibiting the most favorable MIC values. Time-kill assays confirmed sustained bactericidal effects for low concentration-CHX\/0.05% CDO formulations. Significant differences in antibacterial activity were observed among the formulations (p &lt; 0.05).\nConclusion: Low-dose CHX combined with 0.05% CDO mouthwash maintains antibacterial efficacy against halitosis-associated pathogens, suggesting a promising CHX dose reduction while preserving effectiveness.<\/jats:p>","DOI":"10.2340\/biid.v13.45222","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T10:57:00Z","timestamp":1767351420000},"source":"Crossref","is-referenced-by-count":0,"title":["In vitro effect of mouthwash containing chlorhexidine and chlorine dioxide against halitosis pathogens"],"prefix":"10.2340","volume":"13","author":[{"given":"Thao Thi Phuong","family":"Tran","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thuy Anh Vu","family":"Pham","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1183","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"137419","doi-asserted-by":"crossref","unstructured":"Degif R, Abaynew Y. Knowledge, attitudes, and practices toward halitosis among dental patients at Zewditu Memorial Hospital, Addis Ababa, Ethiopia. Front Oral Health. 2025;6:1522682. https:\/\/doi.org\/10.3389\/froh.2025.1522682","DOI":"10.3389\/froh.2025.1522682"},{"key":"137420","unstructured":"Akaji EA, Folaranmi N, Ashiwaju O. Halitosis: a review of the literature on its prevalence, impact and control. Oral Health Prev Dent. 2014;12:297\u2013304. https:\/\/doi.org\/10.3290\/j.ohpd.a33135"},{"key":"137421","doi-asserted-by":"crossref","unstructured":"Izidoro C, Botelho J, Machado V, Reis AM, Proen\u00e7a L, Alves RC, et al. Revisiting standard and novel therapeutic approaches in halitosis: a review. Int J Environ Res Public Health. 2022;19:11303. https:\/\/doi.org\/10.3390\/ijerph191811303","DOI":"10.3390\/ijerph191811303"},{"key":"137422","doi-asserted-by":"crossref","unstructured":"Kapoor U, Sharma G, Juneja M, Nagpal A. Halitosis: current concepts on etiology, diagnosis and management. Eur J Dent. 2016;10:292\u2013300. https:\/\/doi.org\/10.4103\/1305-7456.178294","DOI":"10.4103\/1305-7456.178294"},{"key":"137423","doi-asserted-by":"crossref","unstructured":"Tangerman A, Winkel EG. Intra- and extra-oral halitosis: finding of a new form of extra-oral blood-borne halitosis caused by dimethyl sul-phide. J Clin Periodontol. 2007;34(9):748\u201355. https:\/\/doi.org\/10.1111\/j.1600-051X.2007.01116.x","DOI":"10.1111\/j.1600-051X.2007.01116.x"},{"key":"137424","doi-asserted-by":"crossref","unstructured":"Poppolo Deus F, Ouanounou A. Chlorhexidine in dentistry: pharmacology, uses, and adverse effects. Int Dent J. 2022;72:269\u201377. https:\/\/doi.org\/10.1016\/j.identj.2022.01.005","DOI":"10.1016\/j.identj.2022.01.005"},{"key":"137425","doi-asserted-by":"crossref","unstructured":"Szalai E, Tajti P, Szab\u00f3 B, Hegyi P, Czumbel LM, Shojazadeh S, et al. Daily use of chlorine dioxide effectively treats halitosis: a meta-analysis of randomised controlled trials. PLoS One. 2023;18:e0280377. https:\/\/doi.org\/10.1371\/journal.pone.0280377","DOI":"10.1371\/journal.pone.0280377"},{"key":"137426","doi-asserted-by":"crossref","unstructured":"Anna H, Barnab\u00e1s P, Zsolt L, Rom\u00e1na Z. Tracking of the degradation process of ethylenediaminetetraacetic acid and chlorhexidine diglu-conate in the presence of hyper-pure chlorine dioxide in endodontic disinfection. J Pharm Biomed Anal. 2019;164:360\u20134. https:\/\/doi.org\/10.1016\/j.jpba.2018.11.005","DOI":"10.1016\/j.jpba.2018.11.005"},{"key":"137427","doi-asserted-by":"crossref","unstructured":"Buyukozer Ozkan H, Terlemez A, Orhan EO. Proton nuclear magnetic resonance spectroscopy analysis of mixtures of chlorhexidine with different oxidizing agents activated by photon-induced photoacoustic streaming for root canal irrigation. Photobiomodul Photomed Laser Surg. 2020;38:374\u20139. https:\/\/doi.org\/10.1089\/photob.2019.4734","DOI":"10.1089\/photob.2019.4734"},{"key":"137428","unstructured":"Thao TTP, Ngan LTM, Thuy PAV. Isolation and identification of porphyromonas gingivalis from sub-gingival plaque samples of patients with periodontitis. Ho Chi Minh City J Med. 2018;22(5):178."},{"key":"137429","doi-asserted-by":"crossref","unstructured":"Thao TTP, Ngan LTM, Van NTT, Thuy PAV. Isolation and storage Aggregatibacter actinomicetemcomitans from the subgingival plaque of patients with periodontitis. Sci Tech Dev J Health Sci. 2021;2(2):185\u201393. https:\/\/doi.org\/10.32508\/stdjhs.v2i2.467","DOI":"10.32508\/stdjhs.v2i2.467"},{"key":"137430","unstructured":"Thao TTP, Tham DT, Hung TT. Isolation and storage of Fusobacterium nucleatum from the subgingival plaque of patients with periodontitis. HIUJS. 2022;19:31\u201340."},{"key":"137431","doi-asserted-by":"crossref","unstructured":"Brookes ZLS, Bescos R, Belfield LA, Ali K, Roberts A. Current uses of chlorhexidine for management of oral disease: a narrative review. J Dent. 2020;103:103497. https:\/\/doi.org\/10.1016\/j.jdent.2020.103497","DOI":"10.1016\/j.jdent.2020.103497"},{"key":"137432","doi-asserted-by":"crossref","unstructured":"Mej\u00eda K, Rodr\u00edguez-Hern\u00e1ndez AP, Mart\u00ednez-Hern\u00e1ndez M. Insights into the mechanism of action of chlorhexidine on Porphyromonas gingi-valis. Int J Dent. 2025;2025:1492069. https:\/\/doi.org\/10.1155\/ijod\/1492069","DOI":"10.1155\/ijod\/1492069"},{"key":"137433","doi-asserted-by":"crossref","unstructured":"Jefri UHNM, Khan A, Lim YC, Lee KS, Liew KB, Kassab YW, et al. A systematic review on chlorine dioxide as a disinfectant. J Med Life. 2022;15:313\u20138. https:\/\/doi.org\/10.25122\/jml-2021-0180","DOI":"10.25122\/jml-2021-0180"},{"key":"137434","unstructured":"Deka A, Anil TA, Barua P, Paul R. An ex vivo comparative study determining the bactericidal activity of 3 different irrigants against Entero-coccus faecalis. Int J Oral Health Dent. 2017;3:85\u20138. https:\/\/doi.org\/10.18231\/2395-499X.2017.0020"},{"key":"137435","doi-asserted-by":"crossref","unstructured":"Noszticzius Z, Wittmann M, K\u00e1ly-Kullai K, Beregv\u00e1ri Z, Kiss I, Rosivall L, et al. Chlorine dioxide is a size-selective antimicrobial agent. PLoS One. 2013;8:e79157. https:\/\/doi.org\/10.1371\/journal.pone.0079157","DOI":"10.1371\/journal.pone.0079157"},{"key":"137436","doi-asserted-by":"crossref","unstructured":"Ogata N. Denaturation of protein by chlorine dioxide: oxidative modification of tryptophan and tyrosine residues. Biochemistry. 2007;46:4898\u2013911. https:\/\/doi.org\/10.1021\/bi061827u","DOI":"10.1021\/bi061827u"},{"key":"137437","doi-asserted-by":"crossref","unstructured":"Medir M, Giralt F. Stability of chlorine dioxide in aqueous solution. Water Res. 1982;16:1379\u201382. https:\/\/doi.org\/10.1902\/jop.2008.070630","DOI":"10.1016\/0043-1354(82)90221-4"},{"key":"137438","doi-asserted-by":"crossref","unstructured":"Andr\u00e9s CMC, Lastra JMP, Andr\u00e9s Juan C, Plou FJ, P\u00e9rez-Lebe\u00f1a E. Chlorine dioxide: friend or foe for cell biomolecules? A chemical approach. Int J Mol Sci. 2022;23:15660. https:\/\/doi.org\/10.1016\/0043-1354(82)90221-4","DOI":"10.3390\/ijms232415660"},{"key":"137439","doi-asserted-by":"crossref","unstructured":"Paraskevas S, Rosema NA, Versteeg P, Van der Velden U, Van der Weijden GA. Chlorine dioxide and chlorhexidine mouthrinses compared in a 3-day plaque accumulation model. J Periodontol. 2008;79(8):1395\u2013400. https:\/\/doi.org\/10.3390\/ijms232415660","DOI":"10.1902\/jop.2008.070630"},{"key":"137440","doi-asserted-by":"crossref","unstructured":"Alvarado Rodr\u00edguez PY, Rodr\u00edguez Zaragoza DE, Ruiz-Reyes H. Comparison of the antimicrobial effect of chlorine dioxide, sodium hypo-chlorite, and chlorhexidine on bacteria isolated from the root canal. J Dent Oral Sci. 2022;4:1\u201312. https:\/\/doi.org\/10.37191\/Mapsci-2582-3736-4(4)-141","DOI":"10.37191\/Mapsci-2582-3736-4(4)-141"},{"key":"137441","doi-asserted-by":"crossref","unstructured":"Nagy E, Boyanova L, Justesen US. How to isolate, identify, and deter- mine antimicrobial susceptibility of anaerobic bacteria in routine laboratories. Clin Microbiol Infect. 2018;24:1139\u201348. https:\/\/doi.org\/10.3389\/fmicb.2021.741863","DOI":"10.1016\/j.cmi.2018.02.008"},{"key":"137442","doi-asserted-by":"crossref","unstructured":"Abbood HM, Hijazi K, Gould IM. 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An in vitro comparative study determining bactericidal activity of stabilized chlorine dioxide and other oral rinses. J Clin Dent. 2011;22:1\u20135."},{"key":"137446","doi-asserted-by":"crossref","unstructured":"Carda-Di\u00e9guez M, Rosier BT, Lloret S, Llena C, Mira A. The tongue biofilm metatranscriptome identifies metabolic pathways associated with the presence or absence of halitosis. NPJ Biofilms Microbiomes. 2022;8(1):100. https:\/\/doi.org\/10.1038\/s41522-022-00364-2","DOI":"10.1038\/s41522-022-00364-2"},{"key":"137447","doi-asserted-by":"crossref","unstructured":"Kulis E, Cvitkovic I, Pavlovic N, Kumric M, Rusic D, Bozic J. A comprehensive review of antibiotic resistance in the oral microbiota: mecha-nisms, drivers, and emerging therapeutic strategies. Antibiotics (Basel). 2025;14:828. https:\/\/doi.org\/10.3390\/antibiotics14080828","DOI":"10.3390\/antibiotics14080828"},{"key":"137448","doi-asserted-by":"crossref","unstructured":"Brookes Z, Teoh L, Cieplik F, Kumar P. Mouthwash effects on the oral microbiome: are they good, bad, or balanced? Int Dent J. 2023;73(Suppl 2):S74\u201381. https:\/\/doi.org\/10.1016\/j.identj.2023.08.010","DOI":"10.1016\/j.identj.2023.08.010"}],"container-title":["Biomaterial Investigations in Dentistry"],"original-title":[],"link":[{"URL":"https:\/\/medicaljournalssweden.se\/biid\/article\/download\/45222\/52454","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicaljournalssweden.se\/biid\/article\/download\/45222\/52454","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T10:57:05Z","timestamp":1767351425000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicaljournalssweden.se\/biid\/article\/view\/45222"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,2]]},"references-count":30,"URL":"https:\/\/doi.org\/10.2340\/biid.v13.45222","relation":{},"ISSN":["2641-5275"],"issn-type":[{"value":"2641-5275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,2]]}}}