Print - 0974-2441 PTMDS 2017 | The 1 st Physics and Technologies in Medicine and Dentistry Symposium EFFICACY OF ORAL REFRESHER STRIP CONTAINING FIVE TYPES OF ESSENTIAL OILS ON ORAL MALODOR 1 Department of Dentistry, Faculty of Dentistry, Universitas Indonesia, Depok, Indonesia. 2 Department of Preventive and Public Health Dentistry Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia. 3 Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia. Email: antonrahardjo@gmail.com Received: 21 April 2017, Revised and Accepted: 13 July 2017 ABSTRACT Objective: The aim of this study was to determine the efficacy of an oral freshener strip containing five types of essential oils on oral malodor. Methods: This study was a clinical trial using cross-over, randomized-double-blind, and placebo-controlled trial design with 15 male participants. The measured parameters were tongue coating, organoleptic score, and volatile sulfur compounds (VSCs) score. Results: After the essential oil strip dissolved in the oral cavity, there was no significant reduction in tongue coating, but there was significant reduction (p<0.05) in the organoleptic score until 60 minutes after dissolved and VSCs until 30 minutes after dissolved. Conclusion: Essential oil strips are more effective than placebo strips in reducing oral malodor. Keywords: Oral freshener strips, Oral malodor, Essential oils, Volatile sulfur compounds. INTRODUCTION Oral malodor is the most complained about problem from patients visiting the dentist after dental caries and periodontal disease [1]. Oral malodor is an unpleasant or smelly breath emanating from the mouth that is caused by oral or non-oral factors. Oral malodor is generally related to an oral cause [2,3]. Physiological oral malodor is caused by a bacterial putrefactive process occurring within the oral cavity that converts protein into amino acid so that volatile sulfur compounds (VSCs) causing oral malodor are produced [4]. Anaerob Gram negative bacteria are most likely the main causes of oral malodor. They are Porphyromonas gingivalis, Fusobacterium nucleatum, Prevotella intermedia, and Treponema denticola [5]. These can be triggered by bad oral hygiene, reduced oral activity when sleeping, and xerostomia [6]. Approaches that can be taken to eliminate physiological oral malodor are conducting proper oral hygiene measures such as tooth brushing, interdental flossing, and scraping the dorsum of the tongue to clean the tongue coating [7,8]. Tongue coating is a white layer lying on the dorsum of the tongue where anaerobic bacteria that can produce VSCs are embedded [7,9]. Antibacterial mouthwash is widely used as an additional therapy to treat oral malodor. However, some mouthwashes have additional effects such as bitterness, burning sensation, and tooth staining [3]. Besides antibacterial mouthwash, nowadays, there is another therapy believed to overcome oral malodor - the oral refresher strip. This additional therapy is far more practical and can be used anytime and anywhere. One type of oral freshener strip contains antibacterial essential oils (EOS) such as thymol, eucalyptol, peppermint oil, menthol, and methyl salicylate. These EOS have antibacterial properties that break bacterial cell membrane, interfere with enzymatic processes, and disrupt bacterial lipopolysaccharide [10]. Many researchers who tested EOS in the form of mouthwash proved that these ingredients significantly reduce VSCs producing bacteria that cause oral malodor [10]. However, the efficacy of EOS in the form of oral refresher strips has not been tested. Therefore, this study aimed to compare the effectiveness of a placebo strip (PS) with an oral refresher strip containing five types of EOS: Thymol, eucalyptol, peppermint oil, menthol, and methyl salicylate in reducing physiological oral malodor parameters. METHODS This study was a clinical trial using a cross-over, randomized-double- blind, and placebo-controlled trial. All protocols used in this research have been reviewed and approved by the Research Ethics Committees of the Faculty of Dentistry at the University of Indonesia, number 180/Ethical Clearance/FKGUI/XI/2012. Researchers selected male participants to avoid the influence of the menstrual cycle on VSCs gas production [11]. Fifteen male volunteers were selected according to inclusion and exclusion criteria to participate in this study. Inclusion criteria Adult males (18-55-year-old) were selected with good general and oral health; non-smoking; had no respiratory problems, such as tonsillitis, bronchitis, bronchiectasis, pulmonary infection, or tumor; had no digestive problems, such as esophageal reflux and pyloric stenosis; had no systemic diseases, such as diabetes mellitus, kidney failure, hepatic disease, and trimethylaminuria; did not use orthodontic or prosthetic appliances; and were willing to participate in all research activities by signing the written informed consent. Exclusion criteria Exclusion criteria had abnormality within the oral cavity, such as active dental caries, periodontal disease, stomatitis aphtosa recurent were undergoing antibiotic therapy the preceding 4 weeks; had taken a xerostomia inducing drug, such as antihistamine, antidepressant, antihypertensive, narcotic were allergic to some of the tested materials. Each participant received two different treatments 2 weeks in a row. Participants consumed two types of oral refresher strip - A PS and a Research Article © 2017 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4. 0/) DOI: http://dx.doi.org/10.22159/ajpcr.2017.v10s5 .23091 Online - 2455-3891 Special Issue (October) FIESTA ELLYZHA 1 , ANTON RAHARDJO 2 *, SRY ANGKY SOEKANTO 3