← Product Code LFD · K171542

# TheraBreath Dry Mouth Oral Rinse, TheraBreath Dry Mouth Lozenges (K171542)

_Dr. Harold Katz, LLC (Dba Therabreath · LFD · Mar 16, 2018 · DE · SESE_

**Canonical URL:** https://fda.innolitics.com/device/K171542

## Device Facts

- **Applicant:** Dr. Harold Katz, LLC (Dba Therabreath
- **Product Code:** LFD
- **Decision Date:** Mar 16, 2018
- **Decision:** SESE
- **Submission Type:** Traditional
- **Device Class:** Class U
- **Review Panel:** DE
- **Attributes:** Therapeutic

## Indications for Use

TheraBreath Dry Mouth Oral Rinse is intended for relief of dry mouth symptoms and is indicated for use to refresh, moisturize, lubricate and soothe the oral cavity, and alleviate discomfort due to dry mouth. TheraBreath Dry Mouth Lozenges are intended for relief of dry mouth symptoms, and are indicated for use to refresh, moisturize, lubricated, and soothe the oral cavity, and alleviate discomfort due to dry mouth.

## Device Story

TheraBreath Dry Mouth Oral Rinse and Lozenges are artificial saliva substitutes formulated with moisturizers, humectants, and salivary enzymes. The rinse is a liquid solution; the lozenges are solid oral units. Both products are sugar-free, alcohol-free, and gluten-free. They are intended for over-the-counter use by patients experiencing xerostomia. Patients apply the rinse or lozenges as needed to the oral cavity to provide temporary lubrication, moisture, and relief from oral discomfort. The products are part of a three-step oral care program involving brushing, rinsing, and lozenge use. By mimicking natural saliva properties, the devices help maintain oral comfort and refresh breath, potentially improving quality of life for patients suffering from dry mouth symptoms.

## Clinical Evidence

Bench testing only. No clinical data. Testing included product composition analysis, conformity with specifications (pH, specific gravity, appearance), and biocompatibility (ISO 10993-5 cytotoxicity, ISO 10993-10 mucosal sensitization and irritation). Accelerated and real-time aging studies established shelf-life. Comparative laboratory testing confirmed physical properties similar to reference devices.

## Technological Characteristics

Artificial saliva agents containing moisturizers, humectants, and salivary enzymes. Non-sterile. Formulations are sugar-free, alcohol-free, and gluten-free. Biocompatibility per ISO 10993-5 and ISO 10993-10. Rinse is liquid; lozenges are solid. Contains xylitol and Spilanthes extract.

## Predicate Devices

- MedActive Oral Relief Spray and MedActive Oral Relief Gel ([K152201](/device/K152201.md))

## Reference Devices

- Dr. Fresh Orazyme Dry Mouth Mouthwash ([K111250](/device/K111250.md))
- SST 100 Lozenges ([K023046](/device/K023046.md))

## Submission Summary (Full Text)

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March 16, 2018

Dr. Harold Katz, LLC (dba TheraBreath) % Barbara Fant President Clinical Research Consultants, Inc. 3308 Jefferson Avenue, Upper Level Cincinnati. Ohio 45220

Re: K171542

Trade/Device Name: TheraBreath Dry Mouth Oral Rinse, TheraBreath Dry Mouth Lozenges Regulatory Class: Unclassified Product Code: LFD Dated: February 7, 2018 Received: February 9, 2018

Dear Barbara Fant:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

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Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part 801); medical device reporting of medical device-related adverse events) (21 CFR 803); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820); and if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to http://www.fda.gov/MedicalDevices/Safety/ReportaProblem/default.htm for the CDRH's Office of Surveillance and Biometrics/Division of Postmarket Surveillance.

For comprehensive regulatory information about mediation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/) and CDRH Learn (http://www.fda.gov/Training/CDRHLearn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (http://www.fda.gov/DICE) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely.

Andrew I. Steen -S

for Tina Kiang, Ph.D. Acting Director Division of Anesthesiology, General Hospital, Respiratory, Infection Control, and Dental Devices Office of Device Evaluation Center for Devices and Radiological Health

Enclosure

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## 4. Indications for Use Statement

510(k) Number (if known): To Be Assigned K171542

Device Name:

TheraBreath Dry Mouth Oral Rinse TheraBreath Dry Mouth Lozenges

#### Indications for Use:

TheraBreath Dry Mouth Oral Rinse is intended for relief of dry mouth symptoms and is indicated for use to refresh, moisturize, lubricate and soothe the oral cavity, and alleviate discomfort due to dry mouth.

TheraBreath Dry Mouth Lozenges are intended for relief of dry mouth symptoms, and are indicated for use to refresh, moisturize, lubricated, and soothe the oral cavity, and alleviate discomfort due to dry mouth.

Type of Use (Select one or both, as applicable)

□ Prescription Use (Part 21 CFR 801 Subpart D) X Over-The-Counter Use (21 CFR 801 Subpart C)

PLEASE DO NOT WRITE BELOW THIS LINE – CONTINUE ON A SEPARATE PAGE IF NEEDED.

#### FOR FDA USE ONLY

Concurrence of Center for Devices and Radiological Health (CDRH) (Signature)

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# 5. 510(k) Summary

## 510(k) Submission, Traditional; as required by (21CFR§807.92(c))

| 510(k) Owner:        | Dr. Harold Katz, LLC (dba TheraBreath)<br>5802 Willoughby Avenue<br>Los Angeles, California 90038<br>Telephone: 323-762-8518<br>Facsimile: 323-993-8327<br>E-Mail: harold@drkatz.com                                            |
|----------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Contact Person:      | Barbara S. Fant, Pharm.D.<br>Clinical Research Consultants, Inc.<br>3308 Jefferson Avenue, Upper Level<br>Cincinnati, Ohio 45220<br>Telephone: (513) 961-8200<br>Facsimile: (513) 961-2858<br>E-Mail: bsfant@crc-regulatory.com |
| Date:                | March 15, 2018                                                                                                                                                                                                                  |
| Trade Name:          | TheraBreath Dry Mouth Oral Rinse<br>TheraBreath Dry Mouth Lozenges                                                                                                                                                              |
| Common name:         | Dry mouth oral rinse<br>Dry mouth mouthwash<br>Dry mouth lozenges                                                                                                                                                               |
| Classification Name: | Saliva, Artificial; Unclassified                                                                                                                                                                                                |
| Product Code:        | LFD                                                                                                                                                                                                                             |

### Identification of a Legally Marketed Predicate Device

TheraBreath Dry Mouth Oral Rinse and TheraBreath Dry Mouth Lozenges are substantially equivalent to the legally marketed predicate device: MedActive Oral Relief Spray and MedActive Oral Relief Gel, marketed by Medactive Oral Pharmaceuticals, LLC, Premarket Notification Number: K152201, FDA Product Code LFD (Saliva, Artificial; Unclassified); and 

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to the reference devices: Dr. Fresh Orazyme Dry Mouth Mouthwash marketed by Dr. Fresh, LLC, 510(k) Premarket Notification Number: K111250, FDA Product Code LFD (Saliva, Artificial; Unclassified); and, SST 100 Lozenges marketed by Hexim Pharmaceuticals, 510(k) Premarket Notification Number: K023046, FDA Product Code LFD (Saliva, Artificial; Unclassified).

# General Description

TheraBreath Dry Mouth Oral Rinse and TheraBreath Dry Mouth Lozenges are specifically formulated as an artificial saliva substitute with moisturizers, humectants and salivary enzymes with lubricating, moisturizing and soothing properties to relieve the symptoms of dry mouth. In addition. TheraBreath Dry Mouth Lozenges continuously moisten the mouth to relieve the symptoms of Dry Mouth and to refresh breath. TheraBreath Dry Mouth Oral Rinse and TheraBreath Dry Mouth Lozenges are sugar-free, alcohol-free, and gluten-free.

TheraBreath Dry Mouth Oral Rinse is packaged in 16 ounce size bottles and is Tingling Mint flavored. TheraBreath Dry Mouth Lozenges are Mandarin Mint flavored and are sold in boxes of 24, 72, or 100 lozenges.

# Intended Use/Indications for Use

TheraBreath Dry Mouth Oral Rinse is intended for relief of dry mouth symptoms and is indicated for use to refresh, moisturize, lubricate and soothe the oral cavity, and alleviate discomfort due to dry mouth.

TheraBreath Dry Mouth Lozenges are intended for relief of dry mouth symptoms, and are indicated for use to refresh, moisturize, lubricated, and soothe the oral cavity, and alleviate discomfort due to dry mouth.

# TheraBreath Dry Mouth Program

When the TheraBreath dry mouth products are used together along with routine oral cleansing (i.e., toothbrushing), it provides a simple three-step solution to clean and moisturize the mouth:

- Step 1. Cleansing: Brush with TheraBreath Dry Mouth Toothpaste at least twice daily.
- Step 2, Rinsing: Rinse with TheraBreath Dry Mouth Oral Rinse after brushing, for up to ● 12 hours of dry mouth relief.
- Step 3, Moisturizing: Use TheraBreath Dry Mouth Lozenges for convenience and ● moisturizing during the day, as often as required, to effectively relieve oral dryness by temporarily lubricating and moisturizing the mouth.

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#### Comparison of Technological Characteristics

TheraBreath Dry Mouth Oral Rinse and TheraBreath Dry Mouth Lozenges are substantially equivalent to Dr. Fresh Orazyme Dry Mouth Mouthwash (K111250) and to MedActive Oral Relief Spray and Gel (K152201) in intended use, design, materials, chemical composition, and performance. The products are all artificial saliva agents designed for relief from dry mouth symptoms. TheraBreath Dry Mouth Oral Rinse and Dr. Fresh Orazyme Dry Mouth Mouthwash both contain salivary enzymes. The TheraBreath and MedActive products contain Spilanthes Extract as a flavor. TheraBreath Dry Mouth Oral Rinse and TheraBreath Dry Mouth Lozenges are both manufactured for and distributed in the U.S.A. by Dr. Harold Katz. LLC (dba TheraBreath; Los Angeles, California). Dr. Fresh Orazyme Dry Mouth Mouthwash is manufactured and distributed in the U.S.A. by Dr. Fresh, LLC (Buena Park, California). MedActive Oral Relief Spray and Gel are manufactured and distributed in the U.S.A. by MedActive Oral Pharmaceuticals, LLC (Odessa, Florida).

The primary technological differences between the oral rinses are that: (1) the proprietary composition of the salivary enzymes in TheraBreath and Orazyme products are very similar, but not identical; (2) the product raw materials and chemical composition are similar, but not identical; and, (3) the TheraBreath products are directed for use as needed, whereas, Orazyme is directed for use 2 to 3 times per day.

#### Brief Summary of Non-Clinical Tests and Results

Testing of the TheraBreath dry mouth products was performed to determine product composition and demonstrate conformity with product specifications for color, appearance, pH, specific gravity, and preservative efficacy. Biocompatibility testing of the TheraBreath oral rinse and lozenge formulations was performed according to ISO 10993-5 for cytotoxicity and according to ISO 10993-10 for mucosal sensitization and irritation. The products passed all tests in conformity with the standards and testing determined that the TheraBreath dry mouth products were non-cytotoxic, non-sensitizing, and non-irritating. Accelerated aging testing was performed to establish a 3 year shelf-life for TheraBreath Dry Mouth Oral Rinse and real-time aging was performed to establish a 2 year shelf-life for TheraBreath Dry Mouth Lozenges.

Comparative laboratory testing was performed for TheraBreath Dry Mouth Oral Rinse and Dr. Fresh Orazyme Dry Mouth Mouthwash and confirmed that the physical properties were similar for the two products for pH, specific gravity, odor, color and appearance.

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|                                                    | TheraBreath<br>Dry Mouth<br>Oral Rinse                                                                                                                                                                                                                       | TheraBreath<br>Dry Mouth<br>Lozenges                                                                                                                                                                                                                               | Dr. Fresh<br>Orazyme Dry<br>Mouth<br>Mouthwash<br>(Reference<br>Device)                                   | MedActive<br>Oral Relief<br>Spray, Gel<br>(Predicate)                                                                                                                                                                                                                           | Same or<br>Different                                                                                                                                                          |
|----------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------------------------------------------------------------------------------------------------|---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Biocompatible                                      | Yes                                                                                                                                                                                                                                                          | Yes                                                                                                                                                                                                                                                                | Yes                                                                                                       | Yes                                                                                                                                                                                                                                                                             | Same.<br>TheraBreath<br>products passed<br>testing criteria<br>in conformity<br>with ISO<br>10993-5 and<br>10993-10 for<br>cytotoxicity,<br>irritation, and<br>sensitization. |
| Physiologic<br>Physico-Chemical<br>Characteristics | Yes                                                                                                                                                                                                                                                          | Yes                                                                                                                                                                                                                                                                | Yes                                                                                                       | Yes                                                                                                                                                                                                                                                                             | Similar pH,<br>specific gravity,<br>color, odor and<br>appearance for<br>oral rinse<br>formulations                                                                           |
|                                                    | TheraBreath<br>Dry Mouth<br>Oral Rinse                                                                                                                                                                                                                       | TheraBreath<br>Dry Mouth<br>Lozenges                                                                                                                                                                                                                               | Dr. Fresh<br>Orazyme Dry<br>Mouth<br>Mouthwash<br>(Reference<br>Device)                                   | MedActive<br>Oral Relief<br>Spray, Gel<br>(Predicate)                                                                                                                                                                                                                           | Same or<br>Different                                                                                                                                                          |
| Intended Use                                       | Relief of dry<br>mouth<br>symptoms                                                                                                                                                                                                                           | Relief of dry<br>mouth<br>symptoms                                                                                                                                                                                                                                 | Relief of dry<br>mouth<br>symptoms                                                                        | Relief of dry<br>mouth<br>symptoms                                                                                                                                                                                                                                              | Same                                                                                                                                                                          |
| Indications for Use                                | TheraBreath<br>Dry Mouth<br>Oral Rinse is<br>intended for<br>relief of dry<br>mouth<br>symptoms and<br>is indicated for<br>use to refresh,<br>moisturize,<br>lubricate and<br>soothe the oral<br>cavity, and<br>alleviate<br>discomfort due<br>to dry mouth. | TheraBreath<br>Dry Mouth<br>Lozenges are<br>intended for<br>relief of dry<br>mouth<br>symptoms, and<br>are indicated<br>for use to<br>refresh,<br>moisturize,<br>lubricated, and<br>soothe the oral<br>cavity, and<br>alleviate<br>discomfort due<br>to dry mouth. | Relieves the<br>symptoms of<br>dry mouth,<br>while<br>moisturizing<br>and<br>lubricating oral<br>dryness. | Provides<br>symptom relief<br>from Dry<br>Mouth and low<br>saliva including:<br>Oral discomfort,<br>Mucosal soft<br>tissue dryness,<br>Oral side effects<br>of illness,<br>therapies, and<br>medications.<br>Soothes<br>moistens and<br>lubricates.<br>Hydrates soft<br>tissue. | Indications for<br>artificial<br>salivas differ<br>slightly based<br>on product<br>offering                                                                                   |
| Disease State                                      | Xerostomia                                                                                                                                                                                                                                                   | Xerostomia                                                                                                                                                                                                                                                         | Xerostomia                                                                                                | Xerostomia                                                                                                                                                                                                                                                                      | Same                                                                                                                                                                          |
| Area of Use                                        | Oral cavity                                                                                                                                                                                                                                                  | Oral cavity                                                                                                                                                                                                                                                        | Oral cavity                                                                                               | Oral cavity                                                                                                                                                                                                                                                                     | Same                                                                                                                                                                          |
| Product Offering                                   | Liquid oral<br>rinse                                                                                                                                                                                                                                         | Oral Lozenge                                                                                                                                                                                                                                                       | Liquid Oral<br>Rinse                                                                                      | Spray, Gel                                                                                                                                                                                                                                                                      | Different,<br>unique to each<br>Product                                                                                                                                       |
| Enzymes                                            | Yes                                                                                                                                                                                                                                                          | No                                                                                                                                                                                                                                                                 | Yes                                                                                                       | No                                                                                                                                                                                                                                                                              | Similar for<br>products<br>containing<br>enzymes                                                                                                                              |
| Flavor/Moisturizer                                 | Yes                                                                                                                                                                                                                                                          | Yes                                                                                                                                                                                                                                                                | Yes                                                                                                       | Yes                                                                                                                                                                                                                                                                             | Similar,<br>formulation<br>unique to each<br>product                                                                                                                          |
| Sterility                                          | Non-sterile                                                                                                                                                                                                                                                  | Non-sterile                                                                                                                                                                                                                                                        | Non-sterile                                                                                               | Non-sterile                                                                                                                                                                                                                                                                     | Same                                                                                                                                                                          |
| Xylitol                                            | Yes                                                                                                                                                                                                                                                          | Yes                                                                                                                                                                                                                                                                | Yes                                                                                                       | Yes                                                                                                                                                                                                                                                                             | Same                                                                                                                                                                          |
| Color Additive                                     | No                                                                                                                                                                                                                                                           | No                                                                                                                                                                                                                                                                 | No                                                                                                        | No                                                                                                                                                                                                                                                                              | Same                                                                                                                                                                          |
| Sugar-Free/Gluten-<br>Free                         | Yes                                                                                                                                                                                                                                                          | Yes                                                                                                                                                                                                                                                                | Yes                                                                                                       | Yes                                                                                                                                                                                                                                                                             | Same                                                                                                                                                                          |
| Intended Population                                | Unsupervised                                                                                                                                                                                                                                                 | Unsupervised                                                                                                                                                                                                                                                       | Unsupervised                                                                                              | Unsupervised                                                                                                                                                                                                                                                                    | Same                                                                                                                                                                          |
| Applications Per Day                               | As needed                                                                                                                                                                                                                                                    | As needed                                                                                                                                                                                                                                                          | 2-3 times/day                                                                                             | As needed                                                                                                                                                                                                                                                                       | Similar, instructions for use are unique to each product offering                                                                                                             |
|                                                    |                                                                                                                                                                                                                                                              |                                                                                                                                                                                                                                                                    |                                                                                                           |                                                                                                                                                                                                                                                                                 |                                                                                                                                                                               |

## Basis of Substantial Equivalence

TheraBreath Dry Mouth Oral Rinse and TheraBreath Dry Mouth Lozenges are substantially equivalent to Dr. Fresh Orazyme Dry Mouth Mouthwash (K111250) and to MedActive Oral Relief Spray and Gel (K152201) in intended use, design, materials, chemical composition, and performance as artificial saliva products designed for relief from dry mouth symptoms. The ingredients used to formulate TheraBreath Dry Mouth Oral Rinse and TheraBreath Dry Mouth Lozenges are used in the predicate and reference devices, which are legally marketed for the same intended use and indications. Technological characteristics of the TheraBreath products and predicate and reference devices are summarized in the table below and support the substantial equivalence of the products.

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|                                                     | TheraBreath<br>Dry Mouth<br>Oral Rinse | TheraBreath<br>Dry Mouth<br>Lozenges | Dr. Fresh<br>Orazyme Dry<br>Mouth<br>Mouthwash<br>(Reference<br>Device) | MedActive<br>Oral Relief<br>Spray, Gel<br>(Predicate) | Same or<br>Different                                                                                                                                                             |
|-----------------------------------------------------|----------------------------------------|--------------------------------------|-------------------------------------------------------------------------|-------------------------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Biocompatible                                       | Yes                                    | Yes                                  | Yes                                                                     | Yes                                                   | Same.<br>TheraBreath<br>products<br>passed testing<br>criteria in<br>conformity<br>with ISO<br>10993-5 and<br>10993-10 for<br>cytotoxicity,<br>irritation, and<br>sensitization. |
| Physiologic Physico-<br>Chemical<br>Characteristics | Yes                                    | Yes                                  | Yes                                                                     | Yes                                                   | Similar pH,<br>specific<br>gravity, color,<br>odor and<br>appearance for<br>oral rinse<br>formulations                                                                           |

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**Source:** [https://fda.innolitics.com/device/K171542](https://fda.innolitics.com/device/K171542)

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