An Unnecessary Evil – Arifa Sultana

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  Posted by: Dental Design      2nd December 2018

We all know how intrinsically systemic and oral health are linked. There is even sometimes a two-way relationship between poor dental hygiene and severity of general health conditions, meaning that neither can be optimised without the other. This can be challenging as some systemic diseases, or the medications used to manage them, can cause various side effects that influence the oral cavity, dental health standards and the sufferer’s confidence. One of these side effects is halitosis.

Origins of halitosis

While not a life-threatening complication, halitosis can have a huge impact on a patient’s quality of life. In fact, it has a negative effect on nearly every aspect of a sufferer’s life, including their friendships, dating experience, marriage, schooling and employment.[1] 

In nearly 85% of cases, the origin of halitosis is in the oral cavity[2]and one of the most common causes is the accumulation of food debris and plaque in the mouth.[3]Another major cause is xerostomia.

Patients with dry mouth have been shown to exhibit higher amounts of plaque on their teeth and tongue.[4]This is because saliva plays an important role in the remineralisation of the teeth, pH balance of the oral cavity, regulation of the microflora and primary digestion, among various other functions. Hypofunction of the salivary glands therefore has an inhibitory effect on all these areas[5]and dry mouth is associated with poorer dental health for this reason.

There are a number of systemic health conditions that can trigger decreased saliva secretion, or hyposialy. These include diabetes, depression and Sjogren’s syndrome.[6]

In diabetes, oral malodour can also be caused by diabetic ketoacidosis (DKA). This is the process by which the body burns fatty acids because there is insufficient insulin to allow enough glucose into the cells. It produces acidic ketone bodies that can be expelled through the mouth and result in an unusual smell on the breath.[7]

The support patients need

Regardless of what medical conditions a patient may be living with, they absolutely deserve to be relieved of the everyday symptoms wherever possible, enabling them to experience a better quality of life. The range of CB12 products provides one such solution for those suffering from halitosis.

Developed by dentists, the CB12 mouthwash has been formulated specifically to neutralise oral malodour and go on working all day. Unlike other mouthwashes that simply attempt to mask the unpleasant smell, CB12 targets the problem at the source.[8]Its patented formula contains low levels of zinc acetate and chlorhexidine diacetate. This combination has been clinically proven to be the most effective for converting the sulphur content of the volatile sulphur compounds (VSCs) known to cause oral malodour in the mouth into insoluble sulphides,[9]eliminating the smell completely. 

But the advantages don’t stop there. CB12 mouthwash is not only the ideal adjunct to daily tooth brushing and interdental cleaning, but it is also a long-lasting solution that will give your patients total confidence for up to 12 hours.[10]This is once again thanks to the product’s innovative formula that binds the liquid to the surfaces of the teeth for enduring protection. 

Giving you complete peace of mind that you are recommending the best product for your patients, CB12 mouthwash has been proven to work more effectively than 18 other leading European mouthwash brands.[11]The solutionalso contains 0.05 per cent sodium fluoride to help prevent decay and strengthen tooth enamel, and it’s available in mint/menthol and mild mint/menthol flavours to suit everyone’s taste buds.

Ensuring added convenience for busy patients, or those who appreciate the reassurance of an on-the-go solution, CB12 is available as a useful mouth spray. CB12 boost offers even more choice – it’s a sugar-free chewing gum that contains zinc acetate to target VSCs and oral malodour, as well as the popular sugar substitute xylitol, which has been shown to reduce cavities.[12]  

Added benefits

For any patients who come to you with halitosis, but especially for those who are simultaneously dealing with systemic health complications, anything you can do to alleviate their symptoms will be greatly appreciated by them. Exceeding their expectations by going the extra mile is likely to increase their satisfaction even further. So why not keep them smiling with CB12 White?

The latest product in the brand’s portfolio, CB12 White combines the power of unpleasant breath neutralisation with stain reduction, giving patients a beautiful, healthy and bright smile. Patients need only use it twice a day for two weeks to help remove even tough stains and protect their teeth from future discolouration. The alcohol-free mouthwash is available in soft mint/menthol flavour and, like the rest of the CB12 products, it can be used daily by anyone over 12-years-old.

Making the link

Patients are not always aware that their health conditions could affect their oral health, so it’s important to give them all the relevant information and guidance necessary. Halitosis can be a source of great anguish for some people, and whether it originates from a systemic disease, plaque accumulation, periodontitis,[13]or dentures,[14]there are proven solutions available to give patients back their confidence and their quality of life.



For more information about CB12 and how it could benefit your patients, please visit


[1]Azodo CC, Osazuwa-Peters N, Omili M. Psychological and social impacts of halitosis: a review. Journal of Social and Psychological Sciences. 2010 Jan;3(1) 74-91
[2]Bollen CML, Beikler T. Halitosis: the multidisciplinary approach. Int J Oral Sci. 2012 Jun; 4(2): 55–63. Published online 2012 Jun 22. doi: 10.1038/ijos.2012.39
[3]Porter SR, Scully C. Oral Malodour (halitosis). BMJ. 2006 Sep 23; 333(7569): 632–635. doi:  10.1136/bmj.38954.631968.AE
[4]Albuquerque DF, Tolentino EdS, Amado FM, Arakwa C, Chinellato LEM. Evaluation of halitosis and sialometry in patients submitted to head and neck radiotherapy. Oral Medicine Pathology, Oral Cir Bucal. 2010 Nov 1;15 (6):e850-4.doi:10.4317/medoral.15.e850
[5]Guobis Z, Kareiviene V, Baseciciene N, Paipaliene P, Niedzelskiene I, Sabalys G, Kubilius R, Gervickas A. Microflora of the oral cavity in patients with xerostomia. Medicina (Kaunas) 2011;47(12):646-51
[6]About halitosis. Dry mouth halitosis (xerostomia).[Accessed May 2018]
[7] Short term complications. Diabetic Ketoacidosis (DKA).[Accessed June 2018]
[8]Thrane et al (2009) A new mouthrinse combining zinc and chlorhexidine in low concentrations provides superior efficacy against halitosis compared to existing formulations: A double-blind clinical study’, The Journal of Clinical Dentistry, 18(3): 82-86. [Accessed May 2018]
[9]Erovic Ademovski Set al. The effect of different mouth rinse products on intra-oral halitosis. Int J Dent Hyg. 2016 May; 14(2):117-23. DOI
[10]Thane et al. Zn and CHX mouthwash effective against VSC responsible for halitosis for up to 12 hours. Journal of the British Society of Dental Hygiene and Therapy, Dental Health Vol 48 2009 No 3 of 6. [Accessed May 2018]
[11]Saad S et. al. Oral Diseases, Comparative effects of various commercially available mouth rinse formulations on oral malodour, (2011), 17:180-186
[12]Burt BA, The use of sorbitol- and xylitol-sweetened chewing gum in caries control. J Am Dent Assoc. 2006 Feb;137(2):190-6.
[13]Morita M, Wanf HL. Association between oral malodor and adult periodontitis: a review. J Clin Periodontol 2001; 28: 813–819
[14]Bosinceanu D, Forna DA, Bosinceanu DN, Forna N. Prevalence and clinical signs of xerostomia in denture wearers. Romanian Journal of Oral Rehabilitation
Vol. 7, Issue 4, October – December 2015

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