{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:07:42Z","timestamp":1787501262263,"version":"build-2736575974"},"reference-count":35,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy, Timisoara"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Background and Objectives: Halitosis is a common condition with substantial psychosocial impact, frequently driven by intra-oral biofilm, tongue coating, and reduced salivary clearance. This study compared the short-term effectiveness of standardized counseling alone, probiotic lozenges containing Streptococcus salivarius K12, and a zinc-containing mouthrinse in adults with persistent intra-oral halitosis. Materials and Methods: In this 4-week, parallel-group, randomized pragmatic trial, 117 adults with bothersome halitosis for at least 3 months and baseline organoleptic score \u2265 2 were allocated 1:1:1 to standard care, probiotic lozenges, or zinc mouthrinse. All participants received standardized counseling and tongue cleaning instructions. The primary endpoint was change in volatile sulfur compounds (VSCs) measured by portable sulfide monitoring. Secondary outcomes included organoleptic score, Halitosis Associated Life-Quality Test (HALT), Oral Health Impact Profile-14 (OHIP-14), tongue coating, plaque, and salivary Solobacterium moorei quantified by qPCR. Results: Baseline demographic, clinical, and biochemical characteristics were comparable across groups. All interventions improved outcomes over 4 weeks, but improvements followed a consistent gradient favoring zinc mouthrinse, followed by probiotic lozenges, then standard care. Mean VSC reduction was \u221212.7 \u00b1 33.9 ppb with standard care, \u221247.3 \u00b1 42.2 ppb with probiotics, and \u221278.5 \u00b1 36.3 ppb with zinc mouthrinse (p &lt; 0.001). Organoleptic scores improved by \u22120.2 \u00b1 0.7, \u22120.8 \u00b1 0.8, and \u22121.2 \u00b1 0.8, respectively (p &lt; 0.001). HALT and OHIP-14 scores showed parallel reductions, and moderate\/severe halitosis at week 4 remained most frequent in the standard care group (58.9%) and least frequent in the zinc group (20.5%; p = 0.004). Conclusions: Both active adjunctive strategies improved intra-oral halitosis beyond standardized counseling alone, but the zinc-containing mouthrinse produced the greatest short-term benefits across objective, clinician-rated, and patient-reported outcomes. These findings support zinc-based rinses as a practical short-term adjunct for managing persistent intra-oral halitosis in outpatient dental care. Durability after discontinuation and potential relapse beyond 4 weeks were not assessed in this trial.<\/jats:p>","DOI":"10.3390\/microorganisms14050990","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T08:46:26Z","timestamp":1777538786000},"page":"990","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical and Microbiological Effects of Streptococcus salivarius K12 Lozenges and Zinc Mouthrinse on Persistent Intra-Oral Halitosis"],"prefix":"10.3390","volume":"14","author":[{"given":"Adrian","family":"Bolos","sequence":"first","affiliation":[{"name":"Department of Oral Rehabilitation, Faculty of Dental Medicine, Specialization of Dental Technology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otilia Cornelia","family":"Bolos","sequence":"additional","affiliation":[{"name":"Department of Dental Aesthetics, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edida","family":"Maghet","sequence":"additional","affiliation":[{"name":"Department of Dental Aesthetics, Faculty of Dental Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9118-9133","authenticated-orcid":false,"given":"Alexandra Ioana","family":"Danila","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Embryology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca","family":"Briceag","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, Ovidius University of Constanta, 7 Ilarie Voronca Street, 900684 Constanta, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan Andrei","family":"Bumbu","sequence":"additional","affiliation":[{"name":"Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"14","DOI":"10.4103\/0976-9668.107255","article-title":"Halitosis: From diagnosis to management","volume":"4","author":"Colak","year":"2013","journal-title":"J. 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