Halitosis Reduction and Oral Hygiene Improvement: A Study of Chlorhexidine, Oil Pulling, and Saline in Orthodontic Patients with Braces

Abstract

Introduction: Orthodontic treatment with fixed braces promotes plaque accumulation, leading to increased microbial count and deterioration of periodontal status. Volatile sulfur-producing organisms also increase, contributing to halitosis. This study aimed to investigate the effectiveness of oil pulling, regular brushing, normal saline mouthrinse, and chlorhexidine (CHX) in treating halitosis and its impact on pathogenic microorganisms in orthodontic patients. Materials and methods: Forty patients aged 14–20 years were randomly divided into four groups: CHX, oil pulling, normal saline, and regular brushing. Halitosis and oral hygiene were evaluated using five parameters: anaerobic bacteria count in culture, organoleptic technique, breath analyzer, gingival index (GI), and plaque index (PI). Data were gathered at baseline, 10, and 20 days after the initiation of treatment. The ANOVA and the Kruskal–Wallis tests were used for the statistical analysis, with p < 0.05 serving as the significance level. Results: Both GI and PI showed statistically significant improvement in CHX and oil pulling groups at the end of the intervention, with p < 0.05. The organoleptic and breath analyzer scores demonstrated significant differences across all groups between the intervention periods. The CHX group showed a significant reduction in anaerobic bacterial count at 10 days, but at 20 days, oil pulling was more effective in reducing anaerobic bacterial count. Conclusion: Oil pulling and regular saline can be used as viable substitutes for CHX in order to improve oral hygiene and lessen halitosis in individuals receiving fixed orthodontic treatment.