{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T08:47:17Z","timestamp":1792572437134,"version":"4.5.0"},"reference-count":44,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J Int Soc Prev Community Dent"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>\n                    A\n                    <jats:sc>bstract<\/jats:sc>\n                  <\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>Halitosis, characterized by volatile sulfur compound (VSC) production, is a prevalent oral health concern affecting 31.8% of the global population. Conventional treatments such as chlorhexidine-based mouthwashes offer temporary relief, but probiotics have emerged as a promising biological therapy by modulating oral microbiota. We aimed to systematically evaluate the efficacy of probiotic monotherapy in reducing halitosis-related VSC levels and organoleptic test (OLT) scores in randomized controlled trials (RCTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A comprehensive database search (PubMed, Scopus, ClinicalTrials.gov, and gray literature) was conducted following PRISMA guidelines. The review protocol was prospectively registered with the Open Science Framework (OSF). Only RCTs comparing probiotics to placebo in systemically and periodontally healthy adults were included. Primary outcomes were changes in VSC levels and OLT scores, assessed using halimeters, Oral Chroma devices, or OLT evaluation. Risk of bias was assessed using the Cochrane RoB 2 tool.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Six RCTs (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 360 participants) met the inclusion criteria. Five studies demonstrated significant VSC reduction after probiotic intervention (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05). Three studies reported OLT score improvements, particularly with\n                      <jats:italic toggle=\"yes\">Streptococcus salivarius<\/jats:italic>\n                      K12 and\n                      <jats:italic toggle=\"yes\">Weissella cibaria<\/jats:italic>\n                      . Four studies confirmed microbiome alterations, with the effects of probiotics persisting post-treatment. No serious adverse effects were reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Probiotics significantly reduce VSC levels, improve OLT scores, and modulate the growth of oral microbiota. However, the heterogeneity of studies and limited long-term follow-up hinder clinical translation. Larger, standardized trials are essential for establishing the clinical efficacy. Probiotics present a safe adjunct therapy for halitosis management. Future research should focus on longitudinal studies, specific strain efficacy, and microbiome-targeted interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jispcd.jispcd_19_25","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T10:01:11Z","timestamp":1751882471000},"page":"301-312","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Effectiveness of Probiotics in Managing Oral Halitosis: A Systematic Review of Randomized Controlled Trials"],"prefix":"10.4103","volume":"15","author":[{"given":"Georgios","family":"Passadakis","sequence":"first","affiliation":[{"name":"Dentist, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chariklia","family":"Neophytou","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sotiria","family":"Davidopoulou","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Papadimitriou","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,7,5]]},"reference":[{"key":"CIT0001-20250902","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s00784-017-2164-5","article-title":"Estimated prevalence of halitosis: A systematic review and meta-regression analysis","volume":"22","author":"Silva","year":"2018","journal-title":"Clin Oral Investig"},{"key":"CIT0002-20250902","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1111\/j.1601-0825.2011.01890.x","article-title":"Halitology (breath odour: Aetiopathogenesis and management)","volume":"18","author":"Scully","year":"2012","journal-title":"Oral Dis"},{"key":"CIT0003-20250902","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":"Aydin","year":"2014","journal-title":"Br Dent J"},{"key":"CIT0004-20250902","doi-asserted-by":"crossref","first-page":"S303","DOI":"10.1111\/jcpe.12378","article-title":"Treatment of oral malodour. Medium-term efficacy of mechanical and\/or chemical agents: A systematic review","volume":"42","author":"Slot","year":"2015","journal-title":"J Clin Periodontol"},{"key":"CIT0005-20250902","first-page":"209","article-title":"The effect of mouthrinses on oral malodor: A systematic review","volume":"10","author":"Blom","year":"2012","journal-title":"Int J Dent Hyg 2012"},{"key":"CIT0006-20250902","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s12602-019-9521-4","article-title":"Probiotics as an Adjunct Therapy for the Treatment of Halitosis, Dental Caries and Periodontitis","volume":"12","author":"Bustamante","year":"2020","journal-title":"Probiotics Antimicrob Proteins"},{"key":"CIT0007-20250902","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1007\/s40496-017-0159-6","article-title":"Use of probiotics and oral health","volume":"4","author":"Allaker","year":"2017","journal-title":"Curr Oral Health Rep"},{"key":"CIT0008-20250902","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1111\/j.1365-2672.2006.02837.x","article-title":"A preliminary study of the effect of probiotic Streptococcus salivarius K12 on oral malodour parameters","volume":"100","author":"Burton","year":"2006","journal-title":"J Appl Microbiol"},{"key":"CIT0009-20250902","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1111\/j.1600-051X.2006.00893.x","article-title":"Inhibitory effect of Weissella cibaria isolates on the production of volatile sulphur compounds","volume":"33","author":"Kang","year":"2006","journal-title":"J Clin Periodontol"},{"key":"CIT0010-20250902","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.jclinepi.2009.06.006","article-title":"The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: Explanation and elaboration","volume":"62","author":"Liberati","year":"2009","journal-title":"J Clin Epidemiol"},{"key":"CIT0011-20250902","author":"Higgins","year":"2011"},{"key":"CIT0012-20250902","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"CIT0013-20250902","doi-asserted-by":"crossref","first-page":"8241681","DOI":"10.1155\/2016\/8241681","article-title":"Inhibitory effect of enterococcus faecium WB2000 on volatile sulfur compound production by porphyromonas gingivalis","volume":"2016","author":"Suzuki","year":"2016","journal-title":"Int J Dentistry"},{"key":"CIT0014-20250902","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1111\/j.1600-051X.2006.00893.x","article-title":"Inhibitory effect of Weissella cibaria isolates on the production of volatile sulphur compounds","volume":"33","author":"Kang","year":"2006","journal-title":"J Clin Periodontol"},{"key":"CIT0015-20250902","doi-asserted-by":"crossref","first-page":"e79","DOI":"10.1016\/j.adaj.2017.12.013","article-title":"Probiotics seem to decrease organoleptic scores in patients with halitosis, but there is uncertainty about their effect on volatile sulfur compounds","volume":"149","author":"Brignardello-Petersen","year":"2018","journal-title":"J Amer Dental Assoc"},{"key":"CIT0016-20250902","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1111\/j.1601-0825.2005.01084.x","article-title":"The rationale and potential for the reduction of oral malodour using streptococcus salivarius probiotics","volume":"11","author":"Burton","year":"2005","journal-title":"Oral Dis"},{"key":"CIT0017-20250902","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.tripleo.2010.03.032","article-title":"Effects of probiotic lactobacillus salivarius WB21 on halitosis and oral health: An open-label pilot trial","volume":"110","author":"Iwamoto","year":"2010","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"CIT0018-20250902","author":"Abati","year":"2015"},{"key":"CIT0019-20250902","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1002\/JPER.19-0089","article-title":"Are lactobacillus salivarius G60 and inulin more efficacious to treat patients with oral halitosis and tongue coating than the probiotic alone and placebo? 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