1
|
Lallier TE, Goldfarb BS, Maney P. In vitro comparison of zinc-based, chlorhexidine, and essential oil mouth rinses. J Periodontol 2024. [PMID: 39012314 DOI: 10.1002/jper.23-0619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 06/12/2024] [Accepted: 06/14/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Chlorhexidine (CHX)-based mouth rinses are frequently prescribed following periodontal surgeries. A more recently available brand of zinc-based mouth rinses advertises one of its mouth rinses as a substitute for chlorhexidine. The purpose of this study was to evaluate, in vitro, the effects of this brand of zinc-based mouth rinses on cell survival, cell motility, and gene expression of human gingival fibroblasts (HGFs). METHODS HGFs were exposed to essential oil (EO), CHX, and three types of one brand of zinc-based mouth rinses designed to treat breath malodor (ZnA), dry mouth (ZnB), and gingivitis (ZnC). Each mouth rinse was tested over a range of concentrations for its effects on HGF survival and motility. Gene expression of cytokines, interleukins, and growth factors were evaluated via reverse transcriptase-polymerase chain reaction (RT-PCR), as a means to assess potential influences on inflammation and wound healing. RESULTS Cell survival was significantly decreased for CHX and ZnC at 10% dilutions (p < 0.05). For all time points, cells exposed to ZnC displayed the greatest reduction in cell motility (p < 0.05). The various mouth rinses examined differentially altered the expression of growth factor transcripts. ZnC particularly enhanced the expression of BMP-2 and FGF-2. CONCLUSION ZnC was more cytotoxic and inhibited cell motility to a greater extent than any of the other mouth rinses. Therefore, using ZnC as an alternative to CHX could potentially have negative effects on wound healing after periodontal surgery. However, further investigation is required to confirm the clinical relevance of these in vitro findings. PLAIN LANGUAGE SUMMARY One type of zinc-based mouth rinse designed to replace chlorhexidine (often prescribed after oral surgeries) demonstrated the greatest oral cell death and reduction in cell movement when compared to other zinc-based mouth rinses. These zinc-based mouth rinses also reduced the amounts of proteins involved in regulating inflammation, potentially reducing the destruction of bone holding the teeth in place. They also changed the amounts of several molecules involved in tissue healing. It is unknown if this will speed or slow the healing of the soft tissues of the mouth.
Collapse
Affiliation(s)
- Thomas E Lallier
- Department of Cell Biology and Anatomy, Louisiana State University Health New Orleans School of Medicine, New Orleans, Louisiana, USA
| | - Brian S Goldfarb
- Department of Periodontics, Louisiana State University Health New Orleans School of Dentistry, New Orleans, Louisiana, USA
| | - Pooja Maney
- Department of Periodontics and Dental Hygiene, University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas, USA
| |
Collapse
|
2
|
Szalai EÁ, Teutsch B, Babay V, Galvács A, Hegyi P, Hársfalvi P, Pál R, Varga G, Lohinai ZM, Kerémi B. Hyperpure chlorine dioxide versus chlorhexidine in intra-oral halitosis (ODOR trial) - protocol of a double-blinded, double-arm, parallel non-inferiority pilot randomized controlled trial. BDJ Open 2024; 10:35. [PMID: 38769314 PMCID: PMC11106080 DOI: 10.1038/s41405-024-00221-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/22/2024] Open
Abstract
INTRODUCTION Intra-oral halitosis (IOH) is the most common type of bad breath; its consequences impair quality of life. However, evidence-based treatment protocols and guidelines are lacking. Our aim is to investigate the effectiveness of chlorine dioxide as an applicable complementary treatment modality in IOH after tongue cleaning. METHODS AND ANALYSIS The ODOR trial will be a single-center, double-blinded, parallel-group, double-armed pilot randomized controlled trial with a non-inferiority design. The efficacy of hyperpure chlorine dioxide will be compared to chlorhexidine mouthwash. We plan to investigate the short-term effects of the intervention over a 3-h period. The primary endpoint will be changes in organoleptic test scores. At the end of the pilot investigation of the first 30 patients each, sample size calculation will be performed. If feasible, the investigators will continue the study by enrolling more patients. TRIAL REGISTRATION The trial has been registered at ClinicalTrials.gov (NCT06219226).
Collapse
Affiliation(s)
- Eszter Ágnes Szalai
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Brigitta Teutsch
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Viktória Babay
- Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Adél Galvács
- Faculty of Dentistry, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Division of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Péter Hársfalvi
- University of Veterinary Medicine Budapest, Department of Biostatistics, Budapest, Hungary
- BiTrial Clinical Research, Budapest, Hungary
| | | | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Zsolt M Lohinai
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Beáta Kerémi
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary.
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
| |
Collapse
|
3
|
Garrido L, Lyra P, Rodrigues J, Viana J, Mendes JJ, Barroso H. Revisiting Oral Antiseptics, Microorganism Targets and Effectiveness. J Pers Med 2023; 13:1332. [PMID: 37763100 PMCID: PMC10532628 DOI: 10.3390/jpm13091332] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/24/2023] [Accepted: 08/27/2023] [Indexed: 09/29/2023] Open
Abstract
A good oral health status is mostly dependent on good oral hygiene habits, which knowingly impacts systemic health. Although controversial, chemical oral antiseptics can be useful in adjunct use to mechanical dental plaque control techniques in the prevention and management of local and overall health and well-being. This review aims to revisit, gather and update evidence-based clinical indications for the use of the most popular oral antiseptics, considering different types, microorganism targets and effectiveness in order to establish updated clinical recommendations.
Collapse
Affiliation(s)
| | | | | | | | | | - Helena Barroso
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, 2829-511 Almada, Portugal (P.L.); (J.V.); (J.J.M.)
| |
Collapse
|
4
|
Li F, Wang C, Xu J, Wang X, Cao M, Wang S, Zhang T, Xu Y, Wang J, Pan S, Hu W. Evaluation of the antibacterial activity of Elsholtzia ciliate essential oil against halitosis-related Fusobacterium nucleatum and Porphyromonas gingivalis. Front Microbiol 2023; 14:1219004. [PMID: 37608950 PMCID: PMC10440386 DOI: 10.3389/fmicb.2023.1219004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023] Open
Abstract
The broad-spectrum antimicrobial activity of Elsholtzia ciliate essential oil (ECO) has been previously reported, but its effectiveness against halitosis-causing bacteria such as Fusobacterium nucleatum and Porphyromonas gingivalis is not well understood. In this study, we investigated the bacteriostatic activity of ECO against planktonic cells and biofilms of F. nucleatum and P. gingivalis, as well as its ability to inhibit bacterial metabolism and production of volatile sulfur compounds (VSCs) at sub-lethal concentrations. Our findings revealed that ECO exhibited comparable activities to chlorhexidine against these oral bacteria. Treatment with ECO significantly reduced the production of VSCs, including hydrogen sulfide, dimethyl disulfide, and methanethiol, which are major contributors to bad breath. As the major chemical components of ECO, carvacrol, p-cymene, and phellandrene, were demonstrated in vitro inhibitory effects on F. nucleatum and P. gingivalis, and their combined use showed synergistic and additive effects, suggesting that the overall activity of ECO is derived from the cumulative or synergistic effect of multiple active components. ECO was found to have a destructive effect on the bacterial cell membrane by examining the cell morphology and permeability. Furthermore, the application of ECO induced significant changes in the bacterial composition of saliva-derived biofilm, resulting in the elimination of bacterial species that contribute to halitosis, including Fusobacterium, Porphyromonas, and Prevotella. These results provide experimental evidence for the potential clinical applications of ECOs in the prevention and treatment of halitosis.
Collapse
Affiliation(s)
- Fengjiao Li
- College of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Chuandong Wang
- State Key Laboratory of Microbial Technology, Microbial Technology Institute, Shandong University, Qingdao, China
| | - Jing Xu
- Shenzhen RELX Technology Co., Ltd., Shenzhen, China
| | - Xiaoyu Wang
- State Key Laboratory of Microbial Technology, Microbial Technology Institute, Shandong University, Qingdao, China
| | - Meng Cao
- Shandong Aobo Biotechnology Co., Ltd., Liaocheng, China
| | - Shuhua Wang
- Shandong Aobo Biotechnology Co., Ltd., Liaocheng, China
| | | | - Yanyong Xu
- Beijing Xinyue Technology Co., Ltd., Beijing, China
| | - Jing Wang
- College of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shaobin Pan
- College of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Wei Hu
- State Key Laboratory of Microbial Technology, Microbial Technology Institute, Shandong University, Qingdao, China
| |
Collapse
|
5
|
Veeray JM, Gupta KK, Soni S, Kothari D. Comparison of clinical indices with halitosis grading in chronic periodontitis: A randomized control trial. J Indian Soc Periodontol 2023; 27:422-427. [PMID: 37593549 PMCID: PMC10431231 DOI: 10.4103/jisp.jisp_197_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 02/05/2023] [Accepted: 03/05/2023] [Indexed: 08/19/2023] Open
Abstract
Background Oral malodor is a major periodontal complaint, but the best method for assessing the halitosis grade is still undefined. The primary objective of the study was to detect the halitosis grade in the exhaled breath using the three distinct techniques and to compare the readings with different clinical indices to find out the best method of halitosis grading. Materials and Methods A total of 90 patients with chronic periodontitis having oral malodor were included in the study. The subjective assessment of the exhaled breath (halitosis grading) was done by three different methods; using a handheld portable Tanita FitScan sulfide monitor, by Halitox toxin assay, and by organoleptic (Sniff test) method. The findings were then compared with the clinical parameters of poor oral hygiene like plaque index (PI), gingival index (GI), gingival bleeding index (BI), and pocket depth (PD) to detect the best method of halitosis grading. Results The mean age of the patients included was 38.23 ± 8.83 (mean ± standard deviation) years. The median value of halitosis grading as obtained by Tanita FitScan was 3.0 (95% confidence interval as 2 and 4) which was then compared with clinical indices (PI, GI, BI, and PD) and the results were statistically significant (P < 0.05), whereas the other two techniques of halitosis grading gave insignificant results. Conclusion The results confirmed that the halitosis grading done using Tanita FitScan sulfide monitor is more appropriate with respect to clinical indices when compared with the other two techniques.
Collapse
Affiliation(s)
- Junaid Mushtaq Veeray
- Department of Periodontology and Oral Implantology, Vyas Dental College and Hospital, Jodhpur, Rajasthan, India
| | - K. K. Gupta
- Department of Periodontology and Oral Implantology, Vyas Dental College and Hospital, Jodhpur, Rajasthan, India
| | - Sweta Soni
- Department of Periodontology and Oral Implantology, Vyas Dental College and Hospital, Jodhpur, Rajasthan, India
| | - Divya Kothari
- Department of Periodontics, Pacific Dental College and Research Centre, Udaipur, Rajasthan, India
| |
Collapse
|
6
|
Muzzamil M, Pervez H, Nawaz R, Raza S, Tharwani ZH, Nisa M. Impact of facemasks on the mouth as an emerging dental concern: A survey among residents of Karachi. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2023; 19:101183. [PMID: 36467549 PMCID: PMC9699707 DOI: 10.1016/j.cegh.2022.101183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/08/2022] [Accepted: 11/13/2022] [Indexed: 11/27/2022] Open
Abstract
Background The illness known as "mask-mouth syndrome," which is brought on by constantly covering one's mouth and nose with a mask, was particularly prevalent among healthcare personnel. The covid-19 pandemic, however, had far-reaching effects on people's daily lives all around the world, to the point where mask use became practically mandatory. With Covid-19 posing a new threat to dental health, this study aims to assess the public's awareness of the issue and investigate how wearing a facemask affects oral hygiene. Methods Cross-sectional research was conducted at Karachi's Jinnah Medical & Dental College. From February to May of 2022, it was carried out in the Dental Opd. A survey of 400 people was conducted, representing a cross-section of society in terms of age, gender, occupation, and other criteria. The poll had 11 closed-ended questions. The data was analyzed using SPSS 24. Descriptive analysis was used to examine the responses. Results Men made up 44.5% (n = 174) of responses and women 56.5% (n = 226). Mean participant age was 27.31, ranging from 18 to 50. 99% (n = 396) of respondents wear masks. 48% (n = 192) of participants were uncomfortable using facemasks. Disposable face masks were voted the best option by 60.5% of respondents (n = 242). Negative effects or conditions brought on by mask use, such as halitosis (47.3%, n = 189) and dehydration (64.3%, n = 257). Conclusion Mask-mouth syndrome can occur as a result of using a face mask for prolonged periods of time. Mask benefits outweigh the danger of mask mouth syndrome.
Collapse
Affiliation(s)
| | | | | | | | - Zoaib Habib Tharwani
- Dow University of Health Sciences (Dow Medical College), Pakistan,Corresponding author
| | - Maryam Nisa
- Health Services Academy, Islamabad, Pakistan
| |
Collapse
|
7
|
Muacevic A, Adler JR, Balappanavar AY, Rijhwani K, Chahar P, Gupta R. Self-Perceived Halitosis and Related Factors Among the Mask-Wearing Population During the COVID-19 Pandemic in Delhi, India: A Cross-Sectional Study. Cureus 2022; 14:e32507. [PMID: 36654644 PMCID: PMC9840413 DOI: 10.7759/cureus.32507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Halitosis (oral malodor) is a common health condition throughout the world. In India, data on self-reported halitosis and related factors is limited. Mouth mask usage has been made compulsory after the coronavirus disease 2019 (COVID-19) pandemic. This could possibly alter oral microflora and environment and contribute to halitosis. The aim of the study was to determine the prevalence of self-perceived halitosis (SPH) among mask-wearing patients visiting a tertiary care dental hospital in Delhi, India. Methods A cross‑sectional study was conducted among a convenience sample of 300 patients visiting a tertiary care dental hospital in the capital of India. SPH status was measured using a self-designed and structured questionnaire containing socio-demographic factors, mask-related habits, and self-perceived oral health status. Statistical analysis was done using Jamovi software (The jamovi project, Sydney, Australia) version 1.8. Descriptive analysis followed by a chi-square test and a multivariate logistic regression test was applied. Results Bad breath was perceived by 86 study subjects. Of the participants, 16.7% felt that they had bad breath before the pandemic, and 38% of the participants had an increased perception or feeling of bad breath since regular mask usage. Of the participants, 42.7% felt that they had an increased feeling of dryness in the mouth post-pandemic. SPH status was associated with mask usage frequency (p<0.001), change (p<0.001) and type of mask (p=0.004), increased feeling of dryness (p<0.001), frequency of toothbrushing (p<0.001), self-reported oral disease (p=0.007), and dental treatment in the past 12 months (p=0.005). Conclusion The SPH status of the study population was associated with mask-related habits and self-reported oral health status. The findings highlight the importance of possible amendments in preventive and curative care for patients with halitosis post-COVID-19 pandemic.
Collapse
|
8
|
Motta PDB, Motta LJ, Campos TM, Gonçalves MLL, Santos EM, Martimbianco ALC, de Andrade DJC, Mesquita-Ferrari RA, Fernandes KPS, Horliana ACRT, Bussadori SK. Effect of Photodynamic Therapy on Halitosis: A Systematic Review of Randomized Controlled Trials. SENSORS (BASEL, SWITZERLAND) 2022; 22:469. [PMID: 35062433 PMCID: PMC8780921 DOI: 10.3390/s22020469] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/03/2022] [Accepted: 01/06/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND This systematic review aimed to assess the effectiveness and safety of aPDT for the treatment of halitosis. METHODS Search strategies were conducted in October 2021 without language or data restrictions, on the following databases: MEDLINE, EMBASE, CENTRAL, LILACS and BBO, as well as a manual search. Randomized clinical trials (RCTs) with parallel design were considered for inclusion, assessing individuals (adolescents and adults) with a clinical diagnosis of halitosis treated with photodynamic therapy (aPDT). Primary outcomes assessed were halitosis measurements, adverse events and quality of life. The risk of bias for each included study was evaluated with the Cochrane Risk of Bias tool and the certainty of the body of the evidence was assessed with the GRADe approach. RESULTS Six RCTs (total of 225 participants) were included and due to clinical diversities it was not possible to group the outcome data in meta-analyses. Based on very low-certainty evidence (GRADE) the results showed that, when compared to tongue scraper, aPDT seems to promote a little to no difference in reducing halitosis and in the microbiological analysis. No adverse events were reported. Considering aPDT combined with tongue scraper, better outcome results were observed when compared to tongue scraper alone. CONCLUSIONS Based on very low-certainty evidence, the findings of this review are uncertain about the effects of aPDT for halitosis control. Further RCTs with higher number of participants and long term assessments need to be conducted to support the use of this intervention. The protocol was registered in the PROSPERO database (number: CRD42020215319) on 19 November 2020-retrospectively registered.
Collapse
Affiliation(s)
- Pamella de Barros Motta
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), Sao Paulo 01504-001, SP, Brazil; (P.d.B.M.); (L.J.M.); (T.M.C.); (M.L.L.G.); (R.A.M.-F.); (K.P.S.F.); (A.C.R.T.H.)
| | - Lara Jansiski Motta
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), Sao Paulo 01504-001, SP, Brazil; (P.d.B.M.); (L.J.M.); (T.M.C.); (M.L.L.G.); (R.A.M.-F.); (K.P.S.F.); (A.C.R.T.H.)
| | - Thalita Molinos Campos
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), Sao Paulo 01504-001, SP, Brazil; (P.d.B.M.); (L.J.M.); (T.M.C.); (M.L.L.G.); (R.A.M.-F.); (K.P.S.F.); (A.C.R.T.H.)
| | - Marcela Leticia Leal Gonçalves
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), Sao Paulo 01504-001, SP, Brazil; (P.d.B.M.); (L.J.M.); (T.M.C.); (M.L.L.G.); (R.A.M.-F.); (K.P.S.F.); (A.C.R.T.H.)
- Postgraduation Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Santos 11045-002, SP, Brazil; (E.M.S.); (A.L.C.M.)
| | - Elaine Marcílio Santos
- Postgraduation Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Santos 11045-002, SP, Brazil; (E.M.S.); (A.L.C.M.)
| | - Ana Luiza Cabrera Martimbianco
- Postgraduation Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Santos 11045-002, SP, Brazil; (E.M.S.); (A.L.C.M.)
| | | | - Raquel Agnelli Mesquita-Ferrari
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), Sao Paulo 01504-001, SP, Brazil; (P.d.B.M.); (L.J.M.); (T.M.C.); (M.L.L.G.); (R.A.M.-F.); (K.P.S.F.); (A.C.R.T.H.)
| | - Kristianne Porta Santos Fernandes
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), Sao Paulo 01504-001, SP, Brazil; (P.d.B.M.); (L.J.M.); (T.M.C.); (M.L.L.G.); (R.A.M.-F.); (K.P.S.F.); (A.C.R.T.H.)
| | - Anna Carolina Ratto Tempestini Horliana
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), Sao Paulo 01504-001, SP, Brazil; (P.d.B.M.); (L.J.M.); (T.M.C.); (M.L.L.G.); (R.A.M.-F.); (K.P.S.F.); (A.C.R.T.H.)
| | - Sandra Kalil Bussadori
- Postgraduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), Sao Paulo 01504-001, SP, Brazil; (P.d.B.M.); (L.J.M.); (T.M.C.); (M.L.L.G.); (R.A.M.-F.); (K.P.S.F.); (A.C.R.T.H.)
| |
Collapse
|
9
|
Jones JA, Chavarri-Guerra Y, Corrêa LBC, Dean DR, Epstein JB, Fregnani ER, Lee J, Matsuda Y, Mercadante V, Monsen RE, Rajimakers NJH, Saunders D, Soto-Perez-de-Celis E, Sousa MS, Tonkaboni A, Vissink A, Yeoh KS, Davies AN. MASCC/ISOO expert opinion on the management of oral problems in patients with advanced cancer. Support Care Cancer 2022; 30:8761-8773. [PMID: 35717462 PMCID: PMC9633484 DOI: 10.1007/s00520-022-07211-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/07/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE The Palliative Care Study Group in conjunction with the Oral Care Study Group of the Multinational Association for Supportive Care in Cancer (MASCC) formed a sub-group to develop evidence-based guidance on the management of common oral problems in patients with advanced cancer. METHODS This guidance was developed in accordance with the MASCC Guidelines Policy. A search strategy for Medline was developed, and the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials were explored for relevant reviews and trials, respectively. Guidance was categorised by the level of evidence, and "category of guideline" (i.e., "recommendation", "suggestion" or "no guideline possible"). RESULTS Twelve generic suggestions (level of evidence - 5), three problem-specific recommendations and 14 problem-specific suggestions were generated. The generic suggestions relate to oral hygiene measures, assessment of problems, principles of management, re-assessment of problems and the role of dental/oral medicine professionals. CONCLUSIONS This guidance provides a framework for the management of common oral problems in patients with advanced cancer, although every patient requires individualised management.
Collapse
Affiliation(s)
- Jac A. Jones
- grid.416224.70000 0004 0417 0648Royal Surrey County Hospital, Guildford, UK
| | - Yanin Chavarri-Guerra
- grid.416850.e0000 0001 0698 4037Department of Hemato-Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - David R. Dean
- grid.34477.330000000122986657Department of Oral Medicine, University of Washington/Seattle Cancer Care Alliance, Seattle, USA
| | - Joel B. Epstein
- grid.50956.3f0000 0001 2152 9905City of Hope Comprehensive Cancer Center, Duarte & Cedars Sinai Health System, Los Angeles, USA
| | | | - Jiyeon Lee
- grid.15444.300000 0004 0470 5454College of Nursing & Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, South Korea
| | - Yuhei Matsuda
- grid.411621.10000 0000 8661 1590Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo, Japan
| | | | - Ragnhild Elisabeth Monsen
- grid.5510.10000 0004 1936 8921Department of Medicine, Lovisenberg Diaconal Hospital & Department for Interdisciplinary Health Sciences, University of Oslo, Oslo, Norway
| | - Natasja J. H. Rajimakers
- grid.470266.10000 0004 0501 9982Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Deborah Saunders
- grid.436533.40000 0000 8658 0974Department of Dental Oncology, Health Services North, Northern Ontario School of Medicine, Sudbury, Canada
| | - Enrique Soto-Perez-de-Celis
- grid.416850.e0000 0001 0698 4037Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Mariana S. Sousa
- grid.117476.20000 0004 1936 7611IMPACCT, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Arghavan Tonkaboni
- grid.411705.60000 0001 0166 0922Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Arjan Vissink
- grid.4830.f0000 0004 0407 1981Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Keng Soon Yeoh
- Special Needs Dental Unit, South Australia Dental Service, Adelaide, Australia
| | - Andrew N. Davies
- grid.8217.c0000 0004 1936 9705Trinity College Dublin, University College Dublin & Our Lady’s Hospice Dublin, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
10
|
Wyszyńska M, Nitsze-Wierzba M, Białożyt-Bujak E, Kasperski J, Skucha-Nowak M. The Problem of Halitosis in Prosthetic Dentistry, and New Approaches to Its Treatment: A Literature Review. J Clin Med 2021; 10:jcm10235560. [PMID: 34884262 PMCID: PMC8658399 DOI: 10.3390/jcm10235560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/21/2021] [Accepted: 11/25/2021] [Indexed: 12/03/2022] Open
Abstract
The aim of this work is a review of recent scientific literature about intra-oral halitosis among patients using dentures. Halitosis is a condition in which an unpleasant smell comes out of the oral cavity, which is caused mainly by volatile sulfur and non-sulfured compounds. The etiology of halitosis may be intra- or extra-oral; in most patients, however, it is due to the activity of microorganisms in the oral cavity. The problem of the occurrence of intra-oral halitosis has accompanied patients for many years. In dental prosthetics, the problem of halitosis occurs in patients using removable or fixed dentures. In both cases, new niches for the development of microorganisms may be created, including those related to intra-oral halitosis. It should be noted that dentures—both fixed and removable—are a foreign body placed in the patient’s oral cavity which, in case of insufficient hygiene, may constitute a reservoir of microorganisms, causing this unpleasant condition. Conventional treatment of intraoral halitosis reduces microbial activity via chemical and/or mechanical action. Currently, the search for new strategies in the treatment of halitosis is in progress. One idea is to use photodynamic therapy, while another is to modify poly(methyl methacrylate) (PMMA) with silver and graphene nanoparticles. Additionally, attempts have been made to combine those two methods. Another unconventional method of treating halitosis is the use of probiotics.
Collapse
Affiliation(s)
- Magdalena Wyszyńska
- Unit of Dental Material Sciences, Department/Institute of Prosthetic Dentistry and Dental Material Sciences, Division of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Poniatowskiego Str., 40-055 Katowice, Poland;
- Correspondence:
| | - Monika Nitsze-Wierzba
- Department/Institute of Prosthetic Dentistry and Dental Material Sciences, Division of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Poniatowskiego Str., 40-055 Katowice, Poland; (M.N.-W.); (J.K.)
| | - Ewa Białożyt-Bujak
- Unit of Dental Material Sciences, Department/Institute of Prosthetic Dentistry and Dental Material Sciences, Division of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Poniatowskiego Str., 40-055 Katowice, Poland;
| | - Jacek Kasperski
- Department/Institute of Prosthetic Dentistry and Dental Material Sciences, Division of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Poniatowskiego Str., 40-055 Katowice, Poland; (M.N.-W.); (J.K.)
| | - Małgorzata Skucha-Nowak
- Unit of Dental Propedeutics, Department of Conservative Dentistry with Endodontics, Division of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 15 Poniatowskiego Str., 40-055 Katowice, Poland;
| |
Collapse
|
11
|
Raval P, Moreno F, Needleman I. Patient involvement to explore research prioritisation and self-care management in people with periodontitis and diabetes. Br Dent J 2021:10.1038/s41415-021-3175-9. [PMID: 34239054 DOI: 10.1038/s41415-021-3175-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/27/2020] [Indexed: 11/09/2022]
Abstract
Aim To investigate, firstly, research priorities for people with periodontitis and those with periodontitis and diabetes. Secondary aims were to explore disease self-management barriers, difficulties and enhancers for people with periodontitis and/or diabetes, mutual learning in patient groups regarding self-care and views of academic researchers on patient-derived research prioritisation.Materials and methods Research prioritisation and self-care management was based on the James Lind Alliance workshop methodology. Participants generated and ranked research priorities and enhancers and barriers to self-care management. Semi-structured interviews were undertaken to explore the views of academic staff about patient and public involvement (PPI) and the findings from this research.Results Periodontitis patients ranked preventive educational interventions highest, whereas the top priority for those with both periodontitis and diabetes was increasing public awareness about periodontitis and systemic health links. Regarding self-care, both periodontitis and diabetes groups highly ranked the importance of being able to self-assess their condition and efficacy of management. Important barriers for the diabetes patients were psychological issues, while for periodontitis patients, the main barrier was receiving conflicting or lacking information. Both groups reported that shared learning helped to develop a better understanding of their conditions and improved management. Academics believed it was essential to involve patients in developing research and most felt the findings would influence their institutions' research priorities; however, they would not change their own research only based on patients' perspectives.Conclusions The workshops led to new insights for research priorities and approaches for health self-management. PPI should be further investigated across oral health applications.
Collapse
Affiliation(s)
- Pritesh Raval
- Unit of Periodontology, UCL Eastman Dental Institute, Rockefeller Building, 21 University Street, London, WC1E 6DE, UK
| | - Federico Moreno
- Unit of Periodontology, UCL Eastman Dental Institute, Rockefeller Building, 21 University Street, London, WC1E 6DE, UK
| | - Ian Needleman
- Unit of Periodontology, UCL Eastman Dental Institute, Rockefeller Building, 21 University Street, London, WC1E 6DE, UK.
| |
Collapse
|
12
|
Knowledge and Management of Halitosis in France and Lebanon: A Questionnaire-Based Study. J Clin Med 2021; 10:jcm10030502. [PMID: 33535399 PMCID: PMC7867103 DOI: 10.3390/jcm10030502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/10/2021] [Accepted: 01/25/2021] [Indexed: 12/01/2022] Open
Abstract
Halitosis is a growing issue and its management is highly challenging. The aim of this study was to evaluate the knowledge and treatment strategies used by French (FD) and Lebanese (LD) dentists. A self-administered structured questionnaire was sent to FD and LD comprising questions about professional characteristics, management, and treatment of halitosis, patients’ referral, and halitosis-related knowledge. A multivariate analysis was conducted to determine differences between FD and LD and to identify parameters that could influence dentists’ management of halitosis. The questionnaire was filled out by 156 FD and 257 LD. Among them, 78.8% of FD and 68.9% of LD were confronted with halitosis management, while only a few routinely asked their patients about halitosis (16% FD, 13.2% LD). Regarding anamnesis, oral hygiene habits were more investigated by FD than LD (p < 0.05). The overall treatment satisfaction was low with 39.7% of FD and 28.4% of LD considering their treatment effective. Regarding halitosis-related knowledge, extra-oral causes were overestimated in both populations. FD (83.4%) and LD (65.8%) considered their education regarding halitosis as insufficient. This study highlights the need of professional education in both countries, targeting proper diagnosis and treatment strategies of halitosis.
Collapse
|
13
|
Dixit UB, Moorthy L. The use of interactive distraction technique to manage gagging during impression taking in children: a single-blind, randomised controlled trial. Eur Arch Paediatr Dent 2020; 22:219-225. [PMID: 33247395 DOI: 10.1007/s40368-020-00582-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 11/06/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the effect of interactive distraction technique on the severity of gagging and success of impression taking in children between age 5 and 10 years. METHODS This single blind, randomised controlled trial recruited 48 children aged 5-10 years requiring maxillary impressions. Selected children were randomly allocated to one of the two groups: (1) Test group, use of interactive distraction, and (2) Control group, no use of interactive distraction, during impression taking. Dental anxiety was scored using Facial Image Scale (FIS) before and after impression taking. Gagging-related Impression Success Scale (GISS) and Gagging Severity Index (GSI) were recorded by a blinded assessor. Nonparametric tests were used to compare the variables between the groups. RESULTS Maxillary impressions were successfully recorded in all children in the Test group; either with no gag (87.5%) or with gag (12.5%). In 33.3% control children impressions could not be recorded. Statistically significant, strong association was found between the interactive distraction and GISS (p = 0.003, Cramer's V = 0.32). Mean GSI and post-impression FIS scores were significantly lesser in the Test group (p = 0.029 and p = 0.048, respectively). Significant increase in the mean FIS scores was observed after recording impression in the Control group. Post-impression FIS showed significant positive correlation with GSI (Test: p = 0.003, Control: p = 0.009) and significant inverse correlation with GISS (Test: p = 0.003, Control: p = 0.01). CONCLUSION Interactive distraction technique used in this study is a simple, non-invasive and cost-effective method to effectively manage gagging and successfully record a maxillary impression in children between age 5 and 10 years.
Collapse
Affiliation(s)
- U B Dixit
- Department of Pedodontics and Preventive Dentistry, DY Patil University-School of Dentistry, Sector 7, Nerul, Navi Mumbai, India.
| | - L Moorthy
- Department of Pedodontics and Preventive Dentistry, DY Patil University-School of Dentistry, Sector 7, Nerul, Navi Mumbai, India
| |
Collapse
|
14
|
Effects of Labrador Tea, Peppermint, and Winter Savory Essential Oils on Fusobacterium nucleatum. Antibiotics (Basel) 2020; 9:antibiotics9110794. [PMID: 33182686 PMCID: PMC7697736 DOI: 10.3390/antibiotics9110794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/06/2020] [Accepted: 11/06/2020] [Indexed: 01/10/2023] Open
Abstract
Bad breath or halitosis is an oral condition caused by volatile sulfur compounds (VSC) produced by bacteria found in the dental and tongue biofilms. Fusobacterium nucleatum is a Gram-negative anaerobic bacterium that has been strongly associated with halitosis. In this study, essential oils (EO) from three plants, Labrador tea (Rhododendron groenlandicum [Oeder] Kron & Judd), peppermint (Mentha x piperita L.), and winter savory (Satureja montana L.), were investigated for their effects on growth, biofilm formation and killing, and VSC production by F. nucleatum. Moreover, their biocompatibility with oral keratinocytes was investigated. Using a broth microdilution assay, winter savory EO and to a lesser extent Labrador tea and peppermint EO showed antibacterial activity against F. nucleatum. A treatment of pre-formed biofilms of F. nucleatum with EO also significantly decreased bacterial viability as determined by a luminescence assay monitoring adenosine triphosphate production. The EO were found to permeabilize the bacterial cell membrane, suggesting that it represents the target of the tested EO. The three EO under investigation were able to dose-dependently reduce VSC production by F. nucleatum. Lastly, no significant loss of cell viability was observed when oral keratinocytes were treated with the EO at concentrations effective against F. nucleatum. This study supports the potential of Labrador tea, peppermint, and winter savory EO as promising agents to control halitosis and promote oral health.
Collapse
|
15
|
Hampelska K, Jaworska MM, Babalska ZŁ, Karpiński TM. The Role of Oral Microbiota in Intra-Oral Halitosis. J Clin Med 2020; 9:E2484. [PMID: 32748883 PMCID: PMC7465478 DOI: 10.3390/jcm9082484] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 12/18/2022] Open
Abstract
Halitosis is a common ailment concerning 15% to 60% of the human population. Halitosis can be divided into extra-oral halitosis (EOH) and intra-oral halitosis (IOH). The IOH is formed by volatile compounds, which are produced mainly by anaerobic bacteria. To these odorous substances belong volatile sulfur compounds (VSCs), aromatic compounds, amines, short-chain fatty or organic acids, alcohols, aliphatic compounds, aldehydes, and ketones. The most important VSCs are hydrogen sulfide, dimethyl sulfide, dimethyl disulfide, and methyl mercaptan. VSCs can be toxic for human cells even at low concentrations. The oral bacteria most related to halitosis are Actinomyces spp., Bacteroides spp., Dialister spp., Eubacterium spp., Fusobacterium spp., Leptotrichia spp., Peptostreptococcus spp., Porphyromonas spp., Prevotella spp., Selenomonas spp., Solobacterium spp., Tannerella forsythia, and Veillonella spp. Most bacteria that cause halitosis are responsible for periodontitis, but they can also affect the development of oral and digestive tract cancers. Malodorous agents responsible for carcinogenesis are hydrogen sulfide and acetaldehyde.
Collapse
Affiliation(s)
- Katarzyna Hampelska
- Department of Genetics and Pharmaceutical Microbiology, Poznań University of Medical Sciences, Święcickiego 4, 60-781 Poznań, Poland; (K.H.); (M.M.J.)
- Central Microbiology Laboratory, H. Święcicki Clinical Hospital, Poznań University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Marcelina Maria Jaworska
- Department of Genetics and Pharmaceutical Microbiology, Poznań University of Medical Sciences, Święcickiego 4, 60-781 Poznań, Poland; (K.H.); (M.M.J.)
| | - Zuzanna Łucja Babalska
- Chair and Department of Medical Microbiology, Poznań University of Medical Sciences, Wieniawskiego 3, 61-712 Poznań, Poland;
| | - Tomasz M. Karpiński
- Chair and Department of Medical Microbiology, Poznań University of Medical Sciences, Wieniawskiego 3, 61-712 Poznań, Poland;
| |
Collapse
|