This study aimed to determine the effect of green tea mouthwash on oral malodor, plaque, and gingival inflammation. Gingivitis subjects who had over 80 parts per billion of volatile sulfur compounds (VSC) in the morning breath were randomly assigned into green tea or placebo mouthwash group. At baseline, VSC, Plaque Index (PI) and Papillary Bleeding Index (PBI) were recorded. Participants were rinsed with the assigned mouthwash, and VSC level was remeasured at 30 minutes and 3 hours postrinsing. For the following 4 weeks, participants were asked to rinse with the assigned mouthwash twice daily. VSC, PI and PBI were remeasured at day 28. It was found that, at 30 minutes and 3 hours postrinsing, VSC was reduced by 36.76% and 33.18% in the green tea group and 19.83% and 9.17% in the placebo group, respectively. At day 28, VSC was reduced by 38.61% in the green tea group and 10.86% in the placebo group. VSC level in the green tea group was significantly different when compared to the placebo. PI and PBI were significantly reduced in both groups. However, no significant difference was found between groups. In conclusion, green tea mouthwash could significantly reduce VSC level in gingivitis subjects after rinsing for 4 weeks. 1. Introduction Oral malodor is defined as an unpleasant breath odor whose causes originate from the mouth. This condition is caused mainly by the emanation of volatile sulfur compounds (VSC) especially hydrogen sulfide, methyl mercaptan, and dimethyl sulfide through the mouth air. These foul-smelling compounds are produced through the degradation of sulfur-containing amino acids by anaerobic Gram-negative bacteria. Other odoriferous compounds, for example, indole and cadaverine are also reported to cause oral malodor [1]. Oral malodor was found to correlate with periodontal disease. Quirynen et al. [2] found that 11% of 2,000 patients who suffered from bad breath had periodontal health problem. Takeuchi et al. [3] reported a positive association between periodontal parameters and the severity of oral malodor. The increase in oral malodor in subjects with periodontal disease is attributed to a higher number of Gram-negative, periodontal bacteria within the oral cavity. These bacteria including Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Tannerella forsythia, and Eubacterium species and spirochetes are known to produce significant amount of VSC [4]. In addition, desquamated cells or blood elements from the inflamed gingival tissue can provide sources for microbial putrefaction. In contrast, oral malodor was
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