Chewing gum on postoperative oral Malodor in patients undergoing general anesthesia: a randomized non-inferiority trial
Abstract Background We aimed to determine whether preoperative chewing gum is non-inferior to Chlorhexidine (CHX) mouthwash in reducing halitosis in patients undergoing elective general anesthesia with endotracheal intubation. Methods We conducted a randomized, single-blind, non-inferiority controll...
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2025-05-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-025-03134-7 |
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| author | Baohua Zhang Yang Han Huan He Li Jin Lidong Zhang |
| author_facet | Baohua Zhang Yang Han Huan He Li Jin Lidong Zhang |
| author_sort | Baohua Zhang |
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| description | Abstract Background We aimed to determine whether preoperative chewing gum is non-inferior to Chlorhexidine (CHX) mouthwash in reducing halitosis in patients undergoing elective general anesthesia with endotracheal intubation. Methods We conducted a randomized, single-blind, non-inferiority controlled trial involving patients undergoing surgery requiring endotracheal intubation for ≤ 3 h. Participants were randomly assigned to either the CHX mouthwash group (Group M) or the chewing gum group (Group N). Thirty minutes before general anesthesia, patients in Group M rinsed their mouths with 10 ml of CHX mouthwash, while those in Group N chewed Trident mint gum. The primary outcome was the incidence of halitosis in both groups, assessed before endotracheal intubation and at extubation. Results A total of 733 patients were included, with 365 patients in Group M and 368 patients in Group N. The incidence of halitosis in both groups was significantly reduced compared to baseline. Before extubation, the improvement in halitosis was greater in Group N than in Group M (P < 0.05). After extubation, the improvement in halitosis in Group N was non-inferior to that in Group M (Z = 1.96, 95% CI: -0.0898 to 0.0944, p = 0.0023). Conclusions In patients undergoing elective general anesthesia with endotracheal intubation, chewing gum was found to be non-inferior to CHX mouthwash in improving postoperative halitosis. Trial registration Chictr.org.cn ChiCTR2400082035 (date of registration: 19/03/2024). |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-05-01 |
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| spelling | doaj-art-9e36b829871a4e2cbf0651e1a93b12142025-08-20T03:48:18ZengBMCBMC Anesthesiology1471-22532025-05-012511810.1186/s12871-025-03134-7Chewing gum on postoperative oral Malodor in patients undergoing general anesthesia: a randomized non-inferiority trialBaohua Zhang0Yang Han1Huan He2Li Jin3Lidong Zhang4Department of Anesthesiology, Jinling Hospital, Affiliated with the Medical School of Nanjing UniversityDepartment of Anesthesiology, Jinling Hospital, Affiliated with the Medical School of Nanjing UniversityDepartment of Anesthesiology, General Hospital of the Southern Theater Command of PLADepartment of Anesthesiology, Jinling Hospital, Affiliated with the Medical School of Nanjing UniversityDepartment of Anesthesiology, Jinling Hospital, Affiliated with the Medical School of Nanjing UniversityAbstract Background We aimed to determine whether preoperative chewing gum is non-inferior to Chlorhexidine (CHX) mouthwash in reducing halitosis in patients undergoing elective general anesthesia with endotracheal intubation. Methods We conducted a randomized, single-blind, non-inferiority controlled trial involving patients undergoing surgery requiring endotracheal intubation for ≤ 3 h. Participants were randomly assigned to either the CHX mouthwash group (Group M) or the chewing gum group (Group N). Thirty minutes before general anesthesia, patients in Group M rinsed their mouths with 10 ml of CHX mouthwash, while those in Group N chewed Trident mint gum. The primary outcome was the incidence of halitosis in both groups, assessed before endotracheal intubation and at extubation. Results A total of 733 patients were included, with 365 patients in Group M and 368 patients in Group N. The incidence of halitosis in both groups was significantly reduced compared to baseline. Before extubation, the improvement in halitosis was greater in Group N than in Group M (P < 0.05). After extubation, the improvement in halitosis in Group N was non-inferior to that in Group M (Z = 1.96, 95% CI: -0.0898 to 0.0944, p = 0.0023). Conclusions In patients undergoing elective general anesthesia with endotracheal intubation, chewing gum was found to be non-inferior to CHX mouthwash in improving postoperative halitosis. Trial registration Chictr.org.cn ChiCTR2400082035 (date of registration: 19/03/2024).https://doi.org/10.1186/s12871-025-03134-7HalitosisChewing gumCHX mouthwashEndotracheal intubation |
| spellingShingle | Baohua Zhang Yang Han Huan He Li Jin Lidong Zhang Chewing gum on postoperative oral Malodor in patients undergoing general anesthesia: a randomized non-inferiority trial BMC Anesthesiology Halitosis Chewing gum CHX mouthwash Endotracheal intubation |
| title | Chewing gum on postoperative oral Malodor in patients undergoing general anesthesia: a randomized non-inferiority trial |
| title_full | Chewing gum on postoperative oral Malodor in patients undergoing general anesthesia: a randomized non-inferiority trial |
| title_fullStr | Chewing gum on postoperative oral Malodor in patients undergoing general anesthesia: a randomized non-inferiority trial |
| title_full_unstemmed | Chewing gum on postoperative oral Malodor in patients undergoing general anesthesia: a randomized non-inferiority trial |
| title_short | Chewing gum on postoperative oral Malodor in patients undergoing general anesthesia: a randomized non-inferiority trial |
| title_sort | chewing gum on postoperative oral malodor in patients undergoing general anesthesia a randomized non inferiority trial |
| topic | Halitosis Chewing gum CHX mouthwash Endotracheal intubation |
| url | https://doi.org/10.1186/s12871-025-03134-7 |
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