Effect of antimicrobial photodynamic therapy and laser alone as adjunct to mechanical debridement in the management of halitosis: A systematic review

Objective: The aim of the present study was to assess the efficacy of laser therapy (LT) and antimicrobial photodynamic therapy (aPDT) as adjunct to mechanical debridement (MD) on the management of halitosis. Data Sources: In order to address the focused question "Is MD with adjunct LT and/or aPDT more effective in the management of halitosis compared with MD alone?" an electronic search without time or language restrictions was conducted up to January 2017 in indexed data-bases using the combination of different key words including photochemotherapy, lasers, light, photodynamic therapy, halitosis, and bad breath. The exclusion criteria included qualitative and/or quantitative reviews, case reports, case series, commentaries, letters to the editor, interviews, and updates. Results: Six randomized control trials were included and processed for data extraction. Results from all studies reported that MD with adjunct LT or aPDT is more effective in reducing halitosis and/or volatile sulfur compounds concentration associated with oral conditions compared with MD alone. One study reported a significant reduction in bacterial colony forming units on the dorsum of the tongue among patients with coated tongue receiving MD with aPDT compared with MD alone. Conclusion: The efficacy of aPDT and/or LT on halitosis management remains unclear. Further well-designed randomized clinical trials assessing the efficacy of mechanical debridement with LT or aPDT on the halitosis treatment are needed.