Background/Objectives: This study evaluated the effectiveness of Cotinus coggygria (Smoke Tree) Flower Water mouthwash in reducing halitosis and improving oral hygiene parameters among adolescents undergoing fixed orthodontic treatment. Methods: A double-blind, randomized, placebo-controlled, parallel-group clinical trial was conducted with 30 individuals undergoing treatment with fixed orthodontic appliances. Participants were allocated (1:1) into two groups: Group A received the Cotinus coggygria mouthwash, while Group B received the placebo mouthwash. Hydrogen sulfide (H2S) concentration in breath, measured by the OralChroma[TM] II device, was the primary outcome. Secondary outcomes included dimethyl sulfide [(CH3)2S] and methyl mercaptan (CH3SH) levels, assessed with the same device, and oral hygiene status evaluated using the Modified Silness & Löe Plaque (PI-M) as well as the Silness & Löe Gingival (GI) indices. Normality of the data distribution was assessed using the Shapiro-Wilk test. Statistical analyses were conducted using the Mann-Whitney U test and Student's t-test. Results: A statistically significant reduction in H2S levels was observed in the C. coggygria group compared to placebo (p = 0.014). Median H2S levels decreased from 147.00 ppb at baseline (T0) to 35.00 ppb at follow-up (T1) after 2 weeks. A statistically significant reduction in total VSC levels was also observed in the C. coggygria group compared to placebo (p < 0.001). Median total VSC levels decreased from 254.00 ppb at baseline (T0) to 105.00 ppb at follow-up (T1) after 2 weeks. No significant differences were found between groups for the other volatile sulfur compounds. A Significant improvements were noted in periodontal parameters in favor of the C. coggygria group. The Gingival Index decreased from 2.0 to 1.3 (p < 0.001; 95% CI: -0.7 to -0.2), and the Plaque Index (PI-M) decreased from 1.6 to 1.0 (p = 0.001; 95% CI: -0.7 to -0.3). Conclusions: Cotinus coggygria mouthwash appeared to be an effective adjunct for managing halitosis and improving oral hygiene parameters in adolescents undergoing fixed orthodontic treatment. No adverse effects were reported.

Background/Objectives: Oral manifestations are recognized extra-intestinal features of inflammatory bowel disease (IBD); however, their prevalence and clinical relevance remain controversial. This study aims to quantify the prevalence of individual oral outcomes in IBD patients and to evaluate their association with the disease compared with healthy controls. Methods: A systematic review was conducted in accordance with PRISMA guidelines. Eligible studies were identified through searches of PubMed/MEDLINE, Cochrane Library, Scopus, Ovid MEDLINE, and EMBASE. Studies reporting oral signs and symptoms in IBD patients were included. A single-arm meta-analysis was performed for oral ulcerations, dry mouth, halitosis, tongue alterations, oral aphthae, stomatitis, and taste changes. Risk of bias was assessed using the Newcastle-Ottawa Scale. Results: Twenty-one studies including 7791 participants (5914 IBD patients and 1877 controls) were analyzed. The pooled prevalence of oral ulcerations was 20% (95%CI11-33), dry mouth 32% (95%CI14-59), halitosis 22% (95%CI7-51), and tongue alterations 11% (95%CI4-24). Comparative analyses showed no statistically significant differences between IBD patients and controls for these outcomes. Conclusions: Although oral manifestations are frequently reported in IBD patients, their prevalence does not significantly differ from that of the general population. Standardized, multicenter studies are required to clarify disease-specific associations.

This single-blind, randomized clinical trial evaluated the impact of a strict oral hygiene (OH) phase on self-reported halitosis and quality of life (QoL) in patients with periodontitis. This study reports a secondary analysis of a single-blind randomized controlled trial (parallel, 1:1), registered at RBR-5jmx32v. The study included 24 individuals diagnosed with periodontitis who were randomly assigned to the intervention group (IG; n = 12) and the no-intervention group (NIG; n = 12). After receiving personalized OH instructions, the IG participants followed a rigorous OH phase for 45 days, whereas the NIG participants received no guidance during this period. The halitosis-associated QoL test (HALT) was administered at baseline and after 45 days. Data were analyzed using t-tests, chi-square tests, and multilevel linear regression, with significance set at p < 0.05. The average age of the study participants was 47.2 years, with a balanced sex distribution and no differences in income or education. Self-reported halitosis decreased from 100% to 50% in the IG after 45 days, whereas it remained at 91.6% in the NIG (p = 0.034). The IG also showed a mean HALT score reduction of 11.9 points (-11.88; 95% CI: -19.40 to -4.36), with significant improvements in social impact and self-esteem (p < 0.05). Clinically, BOP (p < 0.001) and VPI (p = 0.03) improved significantly in the IG, with no significant changes in NIG. This exploratory trial demonstrates that implementing a strict OH phase in patients with periodontitis may help reduce self-reported halitosis, improve HALT scores, and improve clinical outcomes, supporting its role as an adjunctive strategy in periodontal care.