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de Barros Motta P, Gonçalves MLL, Gallo JMAS, Sobral APT, Motta LJ, Santos EM, de Andrade DJC, Duran CCG, Fernandes KPS, Mesquita-Ferrari RA, Horliana ACRT, Bussadori SK. Evaluation of the Oral Microbiome before and after Treatments for Halitosis with Photodynamic Therapy and Probiotics-Pilot Study. Healthcare (Basel) 2024; 12:1123. [PMID: 38891198 PMCID: PMC11172044 DOI: 10.3390/healthcare12111123] [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: 02/16/2024] [Revised: 03/08/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND To compare photodynamic therapy and the use of probiotics in reducing halitosis assessed through gas chromatography and microbiome analysis. METHODS Participants aged from 18 to 25 years showing sulfide (SH2) ≥ 112 ppb on gas chromatography were selected. They were divided into four treatment groups: Group 1-Tongue Scraping; Group 2-Antimicrobial Photodynamic Therapy (aPDT); Group 3-Probiotics; and Group 4-Antimicrobial Photodynamic Therapy (aPDT) and Probiotics. The halimetry process was performed before, immediately after the treatments, and 7 days, 14 days, and 30 days after the initial collection. The collections for later microbiological analysis were made along with the halimetry for microbiome analysis. RESULTS Treatment with aPDT or probiotics under these experimental conditions was not able to change the bacteria present in the biofilm of the tongue. CONCLUSIONS More research is needed to know the behavior of the oral microbiome in the presence of halitosis and the effectiveness of new treatments.
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Affiliation(s)
- Pamella de Barros Motta
- Post Graduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo 01525-000, SP, Brazil; (P.d.B.M.); (L.J.M.); (C.C.G.D.); (K.P.S.F.); (R.A.M.-F.); (A.C.R.T.H.)
| | - Marcela Leticia Leal Gonçalves
- Post Graduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo 01525-000, SP, Brazil; (P.d.B.M.); (L.J.M.); (C.C.G.D.); (K.P.S.F.); (R.A.M.-F.); (A.C.R.T.H.)
- Post Graduation Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Santos 11045-002, SP, Brazil; (M.L.L.G.); (A.P.T.S.); (E.M.S.)
| | | | - Ana Paula Taboada Sobral
- Post Graduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo 01525-000, SP, Brazil; (P.d.B.M.); (L.J.M.); (C.C.G.D.); (K.P.S.F.); (R.A.M.-F.); (A.C.R.T.H.)
- Post Graduation Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Santos 11045-002, SP, Brazil; (M.L.L.G.); (A.P.T.S.); (E.M.S.)
| | - Lara Jansiski Motta
- Post Graduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo 01525-000, SP, Brazil; (P.d.B.M.); (L.J.M.); (C.C.G.D.); (K.P.S.F.); (R.A.M.-F.); (A.C.R.T.H.)
| | - Elaine Marcílio Santos
- Post Graduation Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Santos 11045-002, SP, Brazil; (M.L.L.G.); (A.P.T.S.); (E.M.S.)
| | | | - Cinthya Cosme Gutierrez Duran
- Post Graduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo 01525-000, SP, Brazil; (P.d.B.M.); (L.J.M.); (C.C.G.D.); (K.P.S.F.); (R.A.M.-F.); (A.C.R.T.H.)
| | - Kristianne Porta Santos Fernandes
- Post Graduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo 01525-000, SP, Brazil; (P.d.B.M.); (L.J.M.); (C.C.G.D.); (K.P.S.F.); (R.A.M.-F.); (A.C.R.T.H.)
| | - Raquel Agnelli Mesquita-Ferrari
- Post Graduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo 01525-000, SP, Brazil; (P.d.B.M.); (L.J.M.); (C.C.G.D.); (K.P.S.F.); (R.A.M.-F.); (A.C.R.T.H.)
| | - Anna Carolina Ratto Tempestini Horliana
- Post Graduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo 01525-000, SP, Brazil; (P.d.B.M.); (L.J.M.); (C.C.G.D.); (K.P.S.F.); (R.A.M.-F.); (A.C.R.T.H.)
| | - Sandra Kalil Bussadori
- Post Graduation Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo 01525-000, SP, Brazil; (P.d.B.M.); (L.J.M.); (C.C.G.D.); (K.P.S.F.); (R.A.M.-F.); (A.C.R.T.H.)
- Dentistry College, Universidade Metropolitana de Santos (UNIMES), Santos 11045-002, SP, Brazil
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Wuri G, Liu F, Sun Z, Fang B, Zhao W, Hung WL, Liu WH, Zhang X, Wang R, Wu F, Zhao L, Zhang M. Lactobacillus paracasei ET-22 and derived postbiotics reduce halitosis and modulate oral microbiome dysregulation - a randomized, double-blind placebo-controlled clinical trial. Food Funct 2023; 14:7335-7346. [PMID: 37493204 DOI: 10.1039/d3fo02271d] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
Oral microbial dysbiosis is the primary etiologic factor for halitosis and may be the critical preventive target for halitosis. This study included randomized controlled trials (RCTs) assessing the effects of Lactobacillus paracasei ET-22 live and heat-killed bacteria on halitosis and the related oral microbiome. 68 halitosis subjects were divided into placebo, ET-22 live (ET-22.L) and ET-22 heat-killed (ET-22.HK) groups. Subjects took different lozenges three times a day for 4 weeks and underwent saliva collection and assessment of breath volatile sulfur compound (VSC) levels at the beginning and end of the intervention. Salivary volatile organic compounds were measured using HS-SPME-GC/MS, and the microbiome profile was determined by 16S rRNA gene amplicon sequencing. A positive decrease in breath volatile sulfur compound (VSC) levels was observed in the means of both ET-22.L and ET-22.HK groups after 4 weeks of intervention, being more marked in the ET-22.L group (p = 0.0148). Moreover, ET-22.L and ET-22.HK intervention remarkably changed the composition of total salivary volatile organic compounds (VOCs) and aroma-active VOCs. Key undesirable VOCs, such as indole, pyridine, nonanoic acid, benzothiazole, and valeric acid, were significantly reduced. Meanwhile, ET-22.L or ET-22.HK also altered the taxonomic composition of the salivary microbiome. The halitosis pathogens Rothia and Streptococcus were significantly reduced in the ET-22.HK group and the pathogenic Solobacterium and Peptostreptococcus were significantly inhibited in the ET-22.L group. Collectively, our study suggests that both ET-22.L and ET-22.HK can significantly inhibit the production of undesirable odor compounds in subjects with halitosis, which may be related to the changes of the oral microbiome.
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Affiliation(s)
- Guna Wuri
- School of Food and Health, Beijing Technology and Business University, Beijing 100024, China.
| | - Fudong Liu
- Inner Mongolia Dairy Technology Research Institute Co., Ltd., Hohhot 010100, China
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot 010100, China
| | - Zhe Sun
- School of Food and Health, Beijing Technology and Business University, Beijing 100024, China.
| | - Bing Fang
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100083, China
| | - Wen Zhao
- Inner Mongolia Dairy Technology Research Institute Co., Ltd., Hohhot 010100, China
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot 010100, China
| | - Wei-Lian Hung
- Inner Mongolia Dairy Technology Research Institute Co., Ltd., Hohhot 010100, China
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot 010100, China
| | - Wei-Hsien Liu
- Inner Mongolia Dairy Technology Research Institute Co., Ltd., Hohhot 010100, China
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot 010100, China
| | - Xiaoxu Zhang
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100083, China
| | - Ran Wang
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100083, China
| | - Fang Wu
- Key Laboratory of Precision Nutrition and Food Quality, Department of Nutrition and Health, China Agricultural University, Beijing 100083, China
| | - Liang Zhao
- Key Laboratory of Functional Dairy, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing 100083, China
- Beijing Laboratory of Food Quality and Safety, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, 100083, China
| | - Ming Zhang
- School of Food and Health, Beijing Technology and Business University, Beijing 100024, China.
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Ceraulo S, Caccianiga P, Casto C, Baldoni M, Caccianiga G. COVID-19 and Prosthetic Emergencies, Home Care in Fragile Patients: A Case Report. Healthcare (Basel) 2022; 10:healthcare10081407. [PMID: 36011064 PMCID: PMC9408361 DOI: 10.3390/healthcare10081407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 11/26/2022] Open
Abstract
A case of home care is proposed on a frail non-ambulatory patient who presents an old lower total prosthesis in resin broken in several parts. The various pieces of the prosthesis were joined by the patient, as if it were a puzzle, using a glue for plastics and wood. The union of the parts attached with glue was the consequence of the lockdown in the COVID-19 period and of the economic hardship experienced by the elderly disabled patient during the pandemic period. The procedure for preserving the glued parts was carried out carefully, trying not to modify the edges of the glued pieces, to join them correctly, thereby restoring the correct occlusion to subsequently perform the relining. The old lower total prosthesis obtained after the repair and relining operations allowed for the restoration of the patient’s chewing and smile. The procedure presented is easily repeatable, risk-free and achievable even in a short time, satisfying elderly non-self-sufficient patients who need interventions for prosthetic emergencies during a period of confinement.
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Affiliation(s)
- Saverio Ceraulo
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (S.C.); (M.B.); (G.C.)
| | - Paolo Caccianiga
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (S.C.); (M.B.); (G.C.)
- Correspondence:
| | | | - Marco Baldoni
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (S.C.); (M.B.); (G.C.)
| | - Gianluigi Caccianiga
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy; (S.C.); (M.B.); (G.C.)
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The effect of Brazilian propolis type-3 against oral microbiota and volatile sulfur compounds in subjects with morning breath malodor. Clin Oral Investig 2021; 26:1531-1541. [PMID: 34392403 DOI: 10.1007/s00784-021-04125-x] [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: 09/08/2019] [Accepted: 08/03/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate propolis type-3 mouthrinse effects on the concentration of volatile sulfur compounds (VSCs) and on tongue dorsum microbial profile. MATERIALS AND METHODS A three-step double-blind, crossover, randomized study with 10 individuals divided into three groups: I-placebo (P); II-ethanolic extract of propolis type-3 3% (EEP); and III-chlorhexidine 0.12% (CHX) and instructed to rinse twice daily for 5 days. Each experimental period was followed by a 21-day washout interval. Morning mouth breath was assessed by VSC concentrations and microbiological samples were obtained from tongue dorsum at baseline and the end of period of rinses and analyzed using checkerboard DNA-DNA hybridization technique for 39 bacterial species. RESULTS CHX and EEP presented the lowest VSC concentration when compared with placebo (p < 0.05). Even in the absence of mechanical plaque control, CHX and EEP treatments reduced VSC levels and there were no statistical differences for VSC measurement between CHX and EEP. There was a significant reduction in mean counts of 10 species including some VSC producers (Prevotella intermedia, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia) by EEP. Total counts of organisms, gram-negative and gram-positive bacterial species showed a decrease for EEP and CHX (p < 0.05). In addition, no statistical difference was observed between EEP and CHX (p > 0.05). A positive correlation was observed between decrease of bacterial counts and decrease of VCSs concentration for the EEP and CHX. CONCLUSIONS The use of a 3% propolis type-3 mouthrinse is an effective way to prevent morning bad breath. Thus, propolis may be a promising agent for the treatment of halitosis. CLINICAL RELEVANCE Propolis type-3 may be used as adjuvant treatment for morning breath malodor.
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Xiang L, Rojo R, Prados-Frutos JC. Evaluation of the Efficacy of Lacer Hali TM Treatment on the Management of Halitosis: A Randomized Double-Blind Clinical Trial. J Clin Med 2021; 10:jcm10112256. [PMID: 34071005 PMCID: PMC8197132 DOI: 10.3390/jcm10112256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/14/2021] [Accepted: 05/21/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Halitosis of oral origin is very common in the general population. Due to their antimicrobial properties, chlorhexidine-based products are widely used in the management of this condition, but these are associated with reversible side effects. In this study we evaluated the efficacy of Lacer HaliTM mouthrinse and toothpaste in subjects with intraoral halitosis after several applications under normal conditions of use. Methods: In this randomized clinical trial with mouth rinse and toothpaste, single-center, double-blinded, parallel participants were assigned to an experimental group (Lacer HaliTM,, n = 20), a positive control group (HalitaTM, n = 20), and a placebo group (n = 20). The active duration of the study was 18 days. The clinical follow-up evaluations were performed at five time points (T0, T1, T2, T3, and T4). The intensity of halitosis was evaluated by organoleptic measurement and the portable gas chromatograph OralChromaTM. The data were analyzed using generalized mixed linear models. Results: Sixty patients completed the study. Lacer HaliTM, in comparison with HalitaTM, did not show statistically significant differences at any time during the study except for the levels of hydrogen sulfide and total volatile sulfur compounds at 15 days, where HalitaTM was better. Compared to the placebo treatment, Lacer HaliTM, was significantly more efficient, in terms of both the organoleptic evaluations at 8 days and the levels of hydrogen sulfide. Conclusions: Lacer HaliTM is an alternative to chlorhexidine-based toothpaste and mouthwashes in the management of halitosis.
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Affiliation(s)
- Laiqi Xiang
- Doctoral Program in Health Sciences, Faculty of Health Sciences, Rey Juan Carlos University, Avenida Atenas s/n, 28922 Alcorcón, Madrid, Spain;
- Practice of Dentistry and Halitosis at Core Centro Dental, 28001 Madrid, Spain
| | - Rosa Rojo
- Faculty of Dentistry, Alfonso X el Sabio University, Villanueva de la Cañada, 28691 Madrid, Spain
- Correspondence: ; Tel.: +34-918-109-200
| | - Juan Carlos Prados-Frutos
- Department of Medicine Specialties and Public Health, Faculty of Health Sciences, Rey Juan Carlos University, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain;
- IDIBO Group, Health, IDIBO Group (Research, Development and Innovation Group in Dental Biomaterials), Rey Juan Carlos University, Avenida de Atenas s/n, 28922 Alcorcón, Madrid, Spain
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Zhang Y, Zhu C, Cao G, Zhan J, Feng X, Chen X. Dynamic Alterations of Oral Microbiota Related to Halitosis in Preschool Children. Front Cell Infect Microbiol 2021; 11:599467. [PMID: 33718263 PMCID: PMC7952759 DOI: 10.3389/fcimb.2021.599467] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 01/27/2021] [Indexed: 12/31/2022] Open
Abstract
Objective This longitudinal study was aimed to evaluate the dynamic shift in oral microbiota during the process of halitosis progression among preschool children. Methods The oral examinations, questionnaires and tongue coating specimens were collected at the baseline and 12-month follow-up. All children were oral healthy at the enrollment. At the 12-month follow-up, children who developed halitosis were included to the halitosis group (n = 10). While children who matched the age, gender, kindergarten and without halitosis were included to the control group (n = 10). 16S rRNA gene sequencing was used to reveal the shift of the tongue coating microbiome in these children during the 12- month period with the Human Oral Microbiome Database. Results A remarkable shift in relative abundance of specific bacteria was observed prior to halitosis development. The principal coordinates and alpha diversity analyses revealed different shifting patterns of halitosis and the healthy participants’ microbiome structures and bacterial diversity over the 12-month follow-up. Both groups showed variable microbiota community structures before the onset of halitosis. Halitosis-enriched species Prevotella melaninogenica, Actinomyces sp._HMT_180 and Saccharibacteria TM7_G-1_bacterium_HMT_352 were finally selected as biomarkers in the halitosis-onset prediction model after screening, with a prediction accuracy of 91.7%. Conclusions The microbiome composition and relative abundance of the tongue coatings in the halitosis and control groups remarkably differed, even prior to the onset of the clinical manifestations of halitosis. The halitosis prediction model constructed on the basis of tongue coating microbiome biomarkers indicated the microbial shifts before the halitosis onset. Therefore, this can be considered for the timely detection and intervention of halitosis in children.
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Affiliation(s)
- Yu Zhang
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - Ce Zhu
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - Guizhi Cao
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jingyu Zhan
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xiping Feng
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xi Chen
- Department of Preventive Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Oral Diseases, Shanghai, China.,Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, Shanghai, China
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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.
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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;
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Renvert S, Noack MJ, Lequart C, Roldán S, Laine ML. The Underestimated Problem of Intra-Oral Halitosis in Dental Practice: An Expert Consensus Review. Clin Cosmet Investig Dent 2020; 12:251-262. [PMID: 32753975 PMCID: PMC7342603 DOI: 10.2147/ccide.s253765] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/27/2020] [Indexed: 12/20/2022] Open
Abstract
Approximately 90% of halitosis cases originate within the oral cavity (intra-oral halitosis). With a focus on intra-oral halitosis, this narrative review article provides a current summary of the epidemiology, diagnosis and management of halitosis and discusses practical considerations for healthcare professionals (HCPs), including dentists, dental hygienists, general practitioners, community pharmacists, nurses and medical specialists. MEDLINE and PubMed were searched up to 31 December 2019. Additional information was sourced from reference lists of relevant published literature. Full-text articles which reported on the epidemiology, diagnosis and management of halitosis were considered for inclusion. Halitosis affects substantial numbers of individuals globally and is an underestimated problem in dental practice. Current estimates of the prevalence of halitosis, in addition to diagnostic methods and management considerations for halitosis, are discussed. Although not a life-threatening condition, halitosis has a significant impact on patients’ quality of life and can result in psychological consequences including social, professional and affective limitations. Using a simple step-wise approach for diagnosis and treatment, dentists and dental hygienists are ideally placed to respond to an initial consultation for halitosis.
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Affiliation(s)
- Stefan Renvert
- Department of Oral Health, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| | - Michael J Noack
- Department of Operative Dentistry and Periodontology, University of Cologne, Cologne, Germany
| | - Christophe Lequart
- Private practice, Sorigny, Union Française pour la Santé Bucco-Dentaire (UFSBD), Paris, France
| | - Silvia Roldán
- ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain
| | - Marja L Laine
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Kumbargere Nagraj S, Eachempati P, Uma E, Singh VP, Ismail NM, Varghese E. Interventions for managing halitosis. Cochrane Database Syst Rev 2019; 12:CD012213. [PMID: 31825092 PMCID: PMC6905014 DOI: 10.1002/14651858.cd012213.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Halitosis or bad breath is a symptom in which a noticeably unpleasant breath odour is present due to an underlying oral or systemic disease. 50% to 60% of the world population has experienced this problem which can lead to social stigma and loss of self-confidence. Multiple interventions have been tried to control halitosis ranging from mouthwashes and toothpastes to lasers. This new Cochrane Review incorporates Cochrane Reviews previously published on tongue scraping and mouthrinses for halitosis. OBJECTIVES The objectives of this review were to assess the effects of various interventions used to control halitosis due to oral diseases only. We excluded studies including patients with halitosis secondary to systemic disease and halitosis-masking interventions. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 8 April 2019), the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 3) in the Cochrane Library (searched 8 April 2019), MEDLINE Ovid (1946 to 8 April 2019), and Embase Ovid (1980 to 8 April 2019). We also searched LILACS BIREME (1982 to 19 April 2019), the National Database of Indian Medical Journals (1985 to 19 April 2019), OpenGrey (1992 to 19 April 2019), and CINAHL EBSCO (1937 to 19 April 2019). The US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (8 April 2019), the World Health Organization International Clinical Trials Registry Platform (8 April 2019), the ISRCTN Registry (19 April 2019), the Clinical Trials Registry - India (19 April 2019), were searched for ongoing trials. We also searched the cross-references of included studies and systematic reviews published on the topic. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomised controlled trials (RCTs) which involved adults over the age of 16, and any intervention for managing halitosis compared to another or placebo, or no intervention. The active interventions or controls were administered over a minimum of one week and with no upper time limit. We excluded quasi-randomised trials, trials comparing the results for less than one week follow-up, and studies including advanced periodontitis. DATA COLLECTION AND ANALYSIS Two pairs of review authors independently selected trials, extracted data, and assessed risk of bias. We estimated mean differences (MDs) for continuous data, with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We included 44 trials in the review with 1809 participants comparing an intervention with a placebo or a control. The age of participants ranged from 17 to 77 years. Most of the trials reported on short-term follow-up (ranging from one week to four weeks). Only one trial reported long-term follow-up (three months). Three studies were at low overall risk of bias, 16 at high overall risk of bias, and the remaining 25 at unclear overall risk of bias. We compared different types of interventions which were categorised as mechanical debridement, chewing gums, systemic deodorising agents, topical agents, toothpastes, mouthrinse/mouthwash, tablets, and combination methods. Mechanical debridement: for mechanical tongue cleaning versus no tongue cleaning, the evidence was very uncertain for the outcome dentist-reported organoleptic test (OLT) scores (MD -0.20, 95% CI -0.34 to -0.07; 2 trials, 46 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Chewing gums: for 0.6% eucalyptus chewing gum versus placebo chewing gum, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.10, 95% CI -0.31 to 0.11; 1 trial, 65 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Systemic deodorising agents: for 1000 mg champignon versus placebo, the evidence was very uncertain for the outcome patient-reported visual analogue scale (VAS) scores (MD -1.07, 95% CI -14.51 to 12.37; 1 trial, 40 participants; very low-certainty evidence). No data were reported for dentist-reported OLT score or adverse events. Topical agents: for hinokitiol gel versus placebo gel, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.27, 95% CI -1.26 to 0.72; 1 trial, 18 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Toothpastes: for 0.3% triclosan toothpaste versus control toothpaste, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -3.48, 95% CI -3.77 to -3.19; 1 trial, 81 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Mouthrinse/mouthwash: for mouthwash containing chlorhexidine and zinc acetate versus placebo mouthwash, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.20, 95% CI -0.58 to 0.18; 1 trial, 44 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Tablets: no data were reported on key outcomes for this comparison. Combination methods: for brushing plus cetylpyridium mouthwash versus brushing, the evidence was uncertain for the outcome dentist-reported OLT scores (MD -0.48, 95% CI -0.72 to -0.24; 1 trial, 70 participants; low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. AUTHORS' CONCLUSIONS We found low- to very low-certainty evidence to support the effectiveness of interventions for managing halitosis compared to placebo or control for the OLT and patient-reported outcomes tested. We were unable to draw any conclusions regarding the superiority of any intervention or concentration. Well-planned RCTs need to be conducted by standardising the interventions and concentrations.
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Affiliation(s)
- Sumanth Kumbargere Nagraj
- Faculty of Dentistry, Melaka‐Manipal Medical College, Manipal Academy of Higher Education (MAHE), ManipalDepartment of Oral Medicine and Oral RadiologyJalan Batu HamparBukit BaruMelakaMalaysia75150
| | - Prashanti Eachempati
- Faculty of Dentistry, Melaka‐Manipal Medical College, Manipal Academy of Higher Education (MAHE)Department of ProsthodonticsJalan Batu HamparBukit BaruMelakaMalaysia75150
| | - Eswara Uma
- Faculty of Dentistry, Melaka‐Manipal Medical College, Manipal Academy of Higher Education (MAHE)Department of Paediatric DentistryJalan Batu HamparBukit BaruMelakaMalaysia75150
| | - Vijendra Pal Singh
- Faculty of Dentistry, Melaka‐Manipal Medical College, Manipal Academy of Higher Education (MAHE)Department of Periodontology and ImplantologyJalan Batu HamparBukit BaruMelakaMalaysia75150
| | - Noorliza Mastura Ismail
- Faculty of Dentistry, Melaka‐Manipal Medical College, Manipal Academy of Higher Education (MAHE)Department of Community DentistryJalan Batu HamparBukit BaruMelakaMelakaMalaysia75150
| | - Eby Varghese
- Melaka‐Manipal Medical College, Manipal Academy of Higher Education (MAHE)Department of Paediatric Dentistry, Faculty of DentistryMelakaMalaysia75150
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10
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Ye W, Zhang Y, He M, Zhu C, Feng XP. Relationship of tongue coating microbiome on volatile sulfur compounds in healthy and halitosis adults. J Breath Res 2019; 14:016005. [DOI: 10.1088/1752-7163/ab47b4] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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11
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Jeffet U, Sterer N. Effect of mucoadhesive agent HEC on herbal extracts retention and VSC producing bacteria reduction in an experimental oral biofilm. J Breath Res 2019; 13:026004. [DOI: 10.1088/1752-7163/aaf6f7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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12
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Cunha LDD, Peruzzo DC, Costa LA, Pereira ALP, Benatti BB. Effect of a single-tufted toothbrush on the control of dental biofilm in orthodontic patients: A randomized clinical trial. Int J Dent Hyg 2018; 16:512-518. [PMID: 30129268 DOI: 10.1111/idh.12360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 05/28/2018] [Accepted: 07/08/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To compare the effect of a single-tufted toothbrush combined or not with a conventional toothbrush to control dental biofilm in healthy orthodontic patients. MATERIALS AND METHODS Twenty orthodontic patients were randomly assigned to receive three different treatments: Group 1-conventional toothbrush; Group 2-single-tufted toothbrush and Group 3-combination of single-tufted and conventional toothbrushes. Stained plaque index (SPI), visible plaque index (VPI) and gingival bleeding index (GBI) were recorded. The data were analysed by Kolmogorov-Smirnov test. Wilcoxon test was used for intragroup comparison and Friedman test for the intergroup comparison (α = 5%). RESULTS Intragroup analysis showed that VPI and SPI significantly decreased (P < 0.05) after 72 hour in Group 3. Anterior and posterior teeth did not show any significant statistical differences after 72 hour (P > 0.05), but VPI values in the labial surfaces were different to Group 3 (P < 0.05) in comparison with the other groups after 72 hour. Group 3 showed a statistically significant reduction (P < 0.05) for SPI in the interproximal surfaces when compared with Group 1. CONCLUSION The combination of single-tufted and conventional toothbrushes was effective for controlling dental biofilm formation in orthodontic patients.
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Laleman I, Koop R, Teughels W, Dekeyser C, Quirynen M. Influence of tongue brushing and scraping on the oral microflora of periodontitis patients. J Periodontal Res 2017; 53:73-79. [DOI: 10.1111/jre.12489] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2017] [Indexed: 01/09/2023]
Affiliation(s)
- I. Laleman
- Department of Oral Health Sciences KU Leuven & Dentistry University Hospitals Leuven Leuven Belgium
| | - R. Koop
- Parodontologie Praktijk Twente Enschede the Netherlands
| | - W. Teughels
- Department of Oral Health Sciences KU Leuven & Dentistry University Hospitals Leuven Leuven Belgium
| | - C. Dekeyser
- Department of Oral Health Sciences KU Leuven & Dentistry University Hospitals Leuven Leuven Belgium
| | - M. Quirynen
- Department of Oral Health Sciences KU Leuven & Dentistry University Hospitals Leuven Leuven Belgium
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Erovic Ademovski S, Mårtensson C, Persson GR, Renvert S. The long-term effect of a zinc acetate and chlorhexidine diacetate containing mouth rinse on intra-oral halitosis-A randomized clinical trial. J Clin Periodontol 2017; 44:1010-1019. [PMID: 28727160 DOI: 10.1111/jcpe.12779] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2017] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the long-term effects of a zinc acetate and chlorhexidine diacetate mouth rinse (Zn/CHX) on intra-oral halitosis. MATERIALS AND METHODS Forty-six adults with intra-oral halitosis were randomized into a 6-month, double-blind, placebo-controlled clinical study. The presence of intra-oral halitosis was evaluated at baseline, 3 and 6 months after treatment by assessment of organoleptic score (OLS) and by total volatile sulphur compounds (T-VSC), hydrogen sulphide (H2 S) and methyl mercaptan (MM) concentrations in exhaled air. RESULTS A Zn/CHX mouth rinse provided significantly better control of intra-oral halitosis than a placebo mouth rinse. At 3 and 6 months, individuals rinsing with the Zn/CHX rinse presented with reductions of the OLS, T-VSC (p < .01, respectively), H2 S (p < .001), and MM (p < .01) in subjects' exhaled air. At 6 months, 68.2% of individuals using the Zn/CHX rinse experienced a 1 or 2 category improvement in OLS compared with 19.1% of placebo-treated subjects. 91% of subjects in the Zn/CHX group were categorized as being effectively treated for intra-oral halitosis (i.e. H2 S < 112 ppb), compared to 43% in the placebo group. CONCLUSION Zn/CHX mouth rinse provides effective long-term efficacy against intra-oral halitosis, assessed both objectively and subjectively. With regular rinsing, the effect was sustained for 6 months.
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Affiliation(s)
| | - Carina Mårtensson
- School for Health and Society, Kristianstad University, Kristianstad, Sweden
| | - Gösta Rutger Persson
- School for Health and Society, Kristianstad University, Kristianstad, Sweden.,Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Stefan Renvert
- School for Health and Society, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
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15
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Van der Sluijs E, Van der Weijden GA, Hennequin-Hoenderdos NL, Slot DE. The effect of a tooth/tongue gel and mouthwash regimen on morning oral malodour: A 3-week single-blind randomized clinical trial. Int J Dent Hyg 2017; 16:92-102. [PMID: 28544762 DOI: 10.1111/idh.12291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2017] [Indexed: 11/28/2022]
Abstract
AIM To compare the effects of a regimen consisting of a tooth/tongue gel, tongue cleaner and mouthwash with the effects of using standard fluoride dentifrice on the organoleptic oral malodour score (ORG) and volatile sulphur compounds (VSCs). MATERIALS AND METHODS A total, 66 non-dental students participated in a 3-week parallel, single-blind, randomized, controlled clinical trial. The test group used a tongue cleaner, a tooth/tongue gel and mouthwash containing amine fluoride/stannous fluoride and zinc lactate as oral malodour counteractive. The control group used a standard fluoride dentifrice. Measurements were taken in the morning at baseline, at days 1, 7 and 21. The primary outcome was the ORG score. The secondary outcome, the VSC measurement, was assessed using OralChroma™ (H2 S, CH3 SH, (CH3 )2 S) and Halimeter® . Tongue coating thickness and tongue discoloration were scored. At baseline and day 21, the participants' self-perceptions were assessed. RESULTS At day 1 for the ORG, H2 S, CH3 SH and Halimeter® readings, a significant decrease was observed in the test group. At day 21, the decrease in H2 S and the Halimeter® outcomes were maintained for the test group, and a significant increase in tongue surface discoloration was observed. The test group evaluated their "morning breath upon awakening" as significantly better (P=.001) after 21 days. CONCLUSION A significant overnight effect on morning oral malodour was observed for most of the parameters in favour of the test group. At day 21, the effect of prolonged use was significant for H2 S and the Halimeter® readings, although not for the primary ORG outcome parameter.
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Affiliation(s)
- E Van der Sluijs
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - G A Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - N L Hennequin-Hoenderdos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - D E Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
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Iwamura Y, Hayashi JI, Sato T, Sato S, Murakami T, Fujimura T, Sasaki Y, Okada K, Takahashi E, Kikuchi T, Aino M, Noguchi T, Shimazaki Y, Mitani A, Fukuda M. Assessment of oral malodor and tonsillar microbiota after gargling with benzethonium chloride. J Oral Sci 2017; 58:83-91. [PMID: 27021544 DOI: 10.2334/josnusd.58.83] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The oropharyngeal area can be a source of halitosis. However, the relationship between healthy tonsillar microbiota and halitosis is poorly understood. We conducted a pilot clinical study to clarify the effect of gargling with an antiseptic agent on tonsillar microbiota in patients with halitosis. Twenty-nine halitosis patients who did not have otolaryngologic disease or periodontitis were assigned randomly to one of three groups: benzethonium chloride (BZC) gargle; placebo gargle; no gargle. Concentrations of volatile sulfur compounds (VSCs) in mouth air, the organoleptic score (ORS) and tongue-coating score (TCS) were measured before and after testing. Tonsillar microbiota were assessed by detection of periodontal pathogens, and profiling with terminal-restriction fragment length polymorphism (T-RFLP) analysis and sequencing of 16SrRNA clone libraries for taxonomic assignment. Gargling with BZC reduced the concentrations of methyl mercaptan and hydrogen sulfide and the ORS, but did not affect the TCS or prevalence of periodontal pathogens. T-RFLP analyses and 16SrRNA clone sequencing showed a tendency for some candidate species to decrease in the test group. Although gargling of the oropharyngeal area with an antiseptic agent can reduce oral malodor, it appears that tonsillar microbiota are not influenced greatly. (J Oral Sci 58, 83-91, 2016).
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Affiliation(s)
- Yuki Iwamura
- Department of Periodontology, School of Dentistry, Aichi Gakuin University
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Ramadhani A, Kawada-Matsuo M, Komatsuzawa H, Oho T. Recombinant Sox Enzymes from Paracoccus pantotrophus Degrade Hydrogen Sulfide, a Major Component of Oral Malodor. Microbes Environ 2017; 32:54-60. [PMID: 28260736 PMCID: PMC5371076 DOI: 10.1264/jsme2.me16140] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Hydrogen sulfide (H2S) is emitted from industrial activities, and several chemotrophs possessing Sox enzymes are used for its removal. Oral malodor is a common issue in the dental field and major malodorous components are volatile sulfur compounds (VSCs), including H2S and methyl mercaptan. Paracoccus pantotrophus is an aerobic, neutrophilic facultatively autotrophic bacterium that possesses sulfur-oxidizing (Sox) enzymes in order to use sulfur compounds as an energy source. In the present study, we cloned the Sox enzymes of P. pantotrophus GB17 and evaluated their VSC-degrading activities for the prevention of oral malodor. Six genes, soxX, soxY, soxZ, soxA, soxB, and soxCD, were amplified from P. pantotrophus GB17. Each fragment was cloned into a vector for the expression of 6×His-tagged fusion proteins in Escherichia coli. Recombinant Sox (rSox) proteins were purified from whole-cell extracts of E. coli using nickel affinity chromatography. The enzyme mixture was investigated for the degradation of VSCs using gas chromatography. Each of the rSox enzymes was purified to apparent homogeneity, as confirmed by SDS-PAGE. The rSox enzyme mixture degraded H2S in dose- and time-dependent manners. All rSox enzymes were necessary for degrading H2S. The H2S-degrading activities of rSox enzymes were stable at 25–80°C, and the optimum pH was 7.0. The amount of H2S produced by periodontopathic bacteria or oral bacteria collected from human subjects decreased after an incubation with rSox enzymes. These results suggest that the combination of rSox enzymes from P. pantotrophus GB17 is useful for the prevention of oral malodor.
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Affiliation(s)
- Atik Ramadhani
- Department of Preventive Dentistry, Kagoshima University Graduate School of Medical and Dental Sciences
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18
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Costa da Mota AC, França CM, Prates R, Deana AM, Costa Santos L, Lopes Garcia R, Leal Gonçalves ML, Mesquita Ferrari RA, Porta Santos Fernandes K, Kalil Bussadori S. Effect of photodynamic therapy for the treatment of halitosis in adolescents - a controlled, microbiological, clinical trial. JOURNAL OF BIOPHOTONICS 2016; 9:1337-1343. [PMID: 27248838 DOI: 10.1002/jbio.201600067] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 05/05/2016] [Accepted: 05/06/2016] [Indexed: 06/05/2023]
Abstract
Halitosis can exert a negative influence on the social relations of adolescents and affect one's self-image. The aim of this study was to evaluate the clinical and microbiological effect of antimicrobial photodynamic therapy (aPDT) on halitosis in adolescents. Forty-six individuals aged 12 to 19 years were randomly allocated: Group 1 - treatment with photodynamic therapy; Group 2 - treatment with a tongue scraper and Group 3 - treatment with a tongue scraper and photodynamic therapy. The count of bacterial colony-forming units per milliliter was used for the microbiological analysis. Statistical analysis involved the Kruskal-Wallis test followed by the Student-Newman-Keuls test. ANOVA was used for the determination of colony-forming units after treatment. The level of significance for all statistical tests was 5% (p < 0.05). After treatment, a statistically significant reduction in total volatile sulfur compounds was found in all groups (p < 0.001), with the largest reduction (median: 0) found in Group 3 (tongue scraper and photodynamic therapy). Moreover, a statistically significant difference was found between treatment with aPDT and a tongue scraper alone (p < 0.001). The present findings demonstrate an option for the treatment of halitosis in adolescents, with an immediate effect and without the mechanical aggression to the toungue. Clinical Trials: NCT02007993.
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Affiliation(s)
| | - Cristiane Miranda França
- Biophotonics Applied to Science Health, Nove de Julho Universit, R. Vergueiro 235, São Paulo, Brasil
| | - Renato Prates
- Biophotonics Applied to Science Health, Nove de Julho Universit, R. Vergueiro 235, São Paulo, Brasil
| | - Alessandro Melo Deana
- Biophotonics Applied to Science Health, Nove de Julho Universit, R. Vergueiro 235, São Paulo, Brasil
| | - Larissa Costa Santos
- Biophotonics Applied to Science Health, Nove de Julho Universit, R. Vergueiro 235, São Paulo, Brasil
| | - Rubia Lopes Garcia
- Biophotonics Applied to Science Health, Nove de Julho Universit, R. Vergueiro 235, São Paulo, Brasil
| | | | | | | | - Sandra Kalil Bussadori
- Biophotonics Applied to Science Health, Nove de Julho Universit, R. Vergueiro 235, São Paulo, Brasil
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Zellmer M, Gahnberg L, Ramberg P. Prevalence of halitosis in elderly living in nursing homes. Int J Dent Hyg 2016; 14:295-300. [PMID: 27476817 DOI: 10.1111/idh.12236] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Halitosis is a concern for many people, but has sparsely been studied in elderly living in nursing homes. The aim of this investigation was to study the prevalence of halitosis in this particular group and factors that could be associated with this condition. METHOD AND MATERIALS One hundred and twenty-four residents at three different nursing homes were included in the study. The level of halitosis was assessed using an organoleptic method based on a 6-graded scale. Oral status, including registrations of plaque, gingivitis and assessment of hyposalivation, was performed by two investigators who both examined all patients. Medical history, that is medication, neurological conditions, diabetes, cardiovascular disease, chronic obstructive pulmonary disease (COPD)/asthma, dementia and mental illness, was obtained from the patient files. Registrations of the use of oral hygiene aids, ADL (Activity of Daily Life) and the frequency of contact with dental services were included in the clinical examination. RESULTS Halitosis occurred in over 50% of residents living in nursing homes and was found to be associated with the presence of hyposalivation, periodontal disease, calculus, fixed prosthodontics and dementia. CONCLUSION Halitosis was a common finding in the elderly living in Swedish nursing homes.
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Affiliation(s)
- M Zellmer
- Public Dental Health Service, Departments of Hospital Dentistry, Mölndal Hospital and Mun-H-Center, Gothenburg, Västra Götaland Region, Sweden
| | - L Gahnberg
- Department of Behavioural and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - P Ramberg
- Department of Periodontology, Institute of Odontology, The Sahlgrenska Academy at University of Gothenburg, University of Gothenburg, Gothenburg, Sweden.
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Seemann R, Filippi A, Michaelis S, Lauterbach S, John HD, Huismann J. Duration of effect of the mouthwash CB12 for the treatment of intra-oral halitosis: a double-blind, randomised, controlled trial. J Breath Res 2016; 10:036002. [PMID: 27328808 DOI: 10.1088/1752-7155/10/3/036002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Halitosis occurs in approximately 30% of the adult population and has a negative social and psychological impact on affected individuals. Mouthwashes may be used to prevent unpleasant odour, with long-duration of effect being a desirable attribute. The aim of this study was to assess the long-term efficacy of CB12 (a mixture of 0.3% zinc acetate and 0.025% chlorhexidine) for the treatment of intra-oral halitosis. Thirty-four subjects with confirmed intra-oral halitosis were randomized into a double-blind, controlled, cross-over study to one of 2 groups; (i) CB12-water-water or (ii) water-CB12-CB12. Each group comprised 3 treatments, each given evening and morning (12 h apart) on consecutive study days, with a 5 d washout between treatments. Intra-oral halitosis was assessed objectively by measuring concentrations of hydrogen sulphide, methyl mercaptan, dimethyl sulphide and total volatile sulphur compound (VSC) concentrations and subjectively using organoleptic score (OLS). These were measured at baseline, 12 h after the evening rinse (i.e. 12 h overnight assessment) and 12 h after the daytime rinse (i.e. 12 h day time assessment). CB12 significantly reduced mean hydrogen sulphide, methyl mercaptan, dimethyl sulphide and VSC concentrations, with a duration of effect lasting 12 h, whether assessed overnight (all p ⩽ 0.0003 versus water) or during the day (all p ⩽ 0.0007 versus water). CB12's effect on OLS was also evident for 12 h overnight (p = 0.0043). CB12 was well-tolerated. In conclusion, CB12 showed a clear and durable effect on intra-oral halitosis which lasted at least 12 h, both during the day and overnight, with consistent effect on both objective and subjective variables.
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Affiliation(s)
- Rainer Seemann
- Department of Preventive-, Restorative- and Pediatric Dentistry, zmk bern, University Bern, Freiburgstrasse 7, CH-3010 Bern, Switzerland. www.zmk.unibe.ch
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21
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The effect of periodontal therapy on intra-oral halitosis: a case series. J Clin Periodontol 2016; 43:445-452. [DOI: 10.1111/jcpe.12525] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2016] [Indexed: 12/01/2022]
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Feres M, Figueiredo LC, Faveri M, Guerra MC, Mateo LR, Stewart B, Williams M, Panagakos F. The efficacy of two oral hygiene regimens in reducing oral malodour: a randomised clinical trial. Int Dent J 2015; 65:292-302. [PMID: 26404947 DOI: 10.1111/idj.12183] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This study compared the efficacy of two oral hygiene regimens in reducing oral malodour and the proportions of bacterial species involved in the production of volatile sulphur compounds. MATERIAL AND METHODS Seventy subjects who participated in a halitosis-induction phase and achieved an organoleptic score of ≥ 3.0 [time point 0 (T0)] randomised into two groups: brushing with regular fluoride toothpaste alone (control group) or brushing with regular fluoride toothpaste followed by rinsing with a 0.075% cetylpyridinium chloride (CPC) mouthwash (CPC group). Subjects followed their assigned oral hygiene regimen for 21 days. Then, they underwent an organoleptic examination and measurement of volatile sulphur compounds (VSCs) using a portable gas chromatograph, 12 hours after their last oral hygiene procedure (T1) and 4 hours after an on-site oral hygiene (T2). Microbiological samples (supragingival biofilm, tongue coating and saliva) were analysed using checkerboard DNA-DNA hybridisation. RESULTS Both therapies statistically significantly improved the organoleptic scores (P < 0.05), but the VSC levels and/or concentrations were reduced only in the CPC group (P < 0.05). In subjects rinsing with CPC, oral malodour scores were reduced by 49% at the 4-hour assessment (T2) compared with those not rinsing (P < 0.05). Red-complex pathogens were reduced more effectively in the CPC group than in the control group. CONCLUSIONS Brushing followed by rinsing with a 0.075% CPC mouthwash provided statistically significantly greater reductions in oral malodour, measured organoleptically and instrumentally, and in the proportions of red-complex species when compared with brushing alone.
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Affiliation(s)
- Magda Feres
- Departament of Periodontology, Guarulhos University, Guarulhos, Brazil
| | | | - Marcelo Faveri
- Departament of Periodontology, Guarulhos University, Guarulhos, Brazil
| | - Marcelo C Guerra
- Departament of Periodontology, Guarulhos University, Guarulhos, Brazil
| | - Luis R Mateo
- LRM Statistical Consulting, LLC, West Orange, NJ, USA
| | - Bernal Stewart
- Dental Clinic, Colgate - Palmolive Company, Piscataway, NJ, USA
| | | | - Foti Panagakos
- Dental Clinic, Colgate - Palmolive Company, Piscataway, NJ, USA
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Slot DE, De Geest S, van der Weijden FA, Quirynen M. Treatment of oral malodour. Medium-term efficacy of mechanical and/or chemical agents: a systematic review. J Clin Periodontol 2015; 42 Suppl 16:S303-16. [DOI: 10.1111/jcpe.12378] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Dagmar E. Slot
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - Sophie De Geest
- Periodontology; Department of Oral Health Sciences; Katholieke Universiteit Leuven; University Hospitals & Dentistry Leuven; Leuven Belgium
| | - Fridus A. van der Weijden
- Department of Periodontology; Academic Centre for Dentistry Amsterdam (ACTA); Amsterdam The Netherlands
| | - Marc Quirynen
- Periodontology; Department of Oral Health Sciences; Katholieke Universiteit Leuven; University Hospitals & Dentistry Leuven; Leuven Belgium
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24
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do Nascimento C, Paulo DF, Pita MS, Pedrazzi V, de Albuquerque Junior RF. Microbial diversity of the supra- and subgingival biofilm of healthy individuals after brushing with chlorhexidine- or silver-coated toothbrush bristles. Can J Microbiol 2015; 61:112-23. [DOI: 10.1139/cjm-2014-0565] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Nanoparticulate silver has recently been reported as an effective antimicrobial agent. The aim of this clinical study was to investigate the potential changes on the oral microbiota of healthy individuals after controlled brushing with chlorhexidine- or silver-coated toothbrush bristles. Twenty-four healthy participants were enrolled in this investigation and randomly submitted to 3 interventions. All the participants received, in a crossover format, the following toothbrushing interventions: (i) chlorhexidine-coated bristles, (ii) silver-coated bristles, and (iii) conventional toothbrush (Control). All the interventions had a duration of 30 days. The DNA checkerboard hybridization method was used to identify and quantify up to 43 microbial species colonizing the supra- and subgingival biofilm. The supragingival samples presented higher genome counts than the subgingival samples (p < 0.0001). The total genome counts from the Control group showed the highest values, followed by the silver and chlorhexidine groups (p < 0.0001). After 4 weeks of brushing, the silver-coated and chlorhexidine-coated bristles were capable of reducing or maintaining lower levels of the bacterial counts of the putative periodontal pathogens Tanerella forsythia, Treponema denticola, and Porphyromonas gingivalis. Other major periodontal pathogens, such as Prevotella intermedia, Fusobacterium nucleatum, Prevotella nigrescens, and Parvimonas micra, were also detected at lower levels. The toothbrush bristles impregnated with silver nanoparticles reduced the total and individual genome count in the supra- and subgingival biofilm after 4 weeks of brushing. Chlorhexidine was not effective in reducing the total genome counts in both supra- or subgingival biofilm after 4 weeks of brushing. Chlorhexidine reduced the individual genome counts in the supragingival biofilm for most of the target species, including putative periodontal pathogens.
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Affiliation(s)
- Cássio do Nascimento
- Faculty of Dentistry of Ribeirão Preto, Department of Dental Materials and Prosthodontics, Molecular Diagnosis Laboratory, University of São Paulo, Av. Café s/n°, Monte Alegre, Ribeirão Preto-SP, 14040-904, Brazil
| | - Diana Ferreira Paulo
- Faculty of Dentistry of Ribeirão Preto, Department of Dental Materials and Prosthodontics, Molecular Diagnosis Laboratory, University of São Paulo, Av. Café s/n°, Monte Alegre, Ribeirão Preto-SP, 14040-904, Brazil
| | - Murillo Sucena Pita
- Faculty of Dentistry of Ribeirão Preto, Department of Dental Materials and Prosthodontics, Molecular Diagnosis Laboratory, University of São Paulo, Av. Café s/n°, Monte Alegre, Ribeirão Preto-SP, 14040-904, Brazil
| | - Vinícius Pedrazzi
- Faculty of Dentistry of Ribeirão Preto, Department of Dental Materials and Prosthodontics, Molecular Diagnosis Laboratory, University of São Paulo, Av. Café s/n°, Monte Alegre, Ribeirão Preto-SP, 14040-904, Brazil
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25
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Cortelli SC, Costa FO, Rode SDM, Haas AN, Andrade AKPD, Pannuti CM, Escobar EC, Almeida ERD, Cortelli JR, Pedrazzi V. Mouthrinse recommendation for prosthodontic patients. Braz Oral Res 2014; 28 Spec No:S1806-83242014000200201. [PMID: 25003786 DOI: 10.1590/1807-3107bor-2014.vol28.0020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 04/16/2014] [Indexed: 11/21/2022] Open
Abstract
Different reasons can contribute to classifying dental prosthesis wearers as high-risk individuals in relation to dental biofilm accumulation. These include a past history of oral disease, age and additional retentive areas. Other common complaints include inflammation and halitosis. Moreover, prosthesis replacement and prosthetic pillar loss are generally associated with caries and periodontal disease recurrence. Therefore, the present study undertook to make a critical review of the literature, aiming at discussing the main aspects related to chemical agent prescriptions for dental prosthesis wearers. Most of the articles were selected based on relevance, methods and availability in regard to the specific subject under investigation, without considering publication year limitations. Different types of prostheses and their impact on teeth and other oral tissues were reported. It was demonstrated that there is greater biofilm buildup and increased inflammatory levels in the presence of different types of prostheses, suggesting that additional measures are required both on population-wide and individual levels in order to control these factors. Mechanical control consists of a combination of manual or electric toothbrush and toothpaste, as well as specific devices for interdental cleaning. Although many chemical agents exhibit antimicrobial benefits when used for prosthesis disinfection, only a few agents can be used safely without causing damage. Regarding the selection of antiseptics by the overall population, chlorhexidine is the most indicated in the short term and in sporadic cases. The most indicated adjuncts to overcome the deficiencies and limitations of daily mechanical biofilm control are products containing essential oils as active ingredients.
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Affiliation(s)
- Sheila Cavalca Cortelli
- Periodontology Department, School of Dentistry, Universidade de Taubaté, Taubaté, SP, Brazil
| | - Fernando Oliveira Costa
- Periodontology Department, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Sigmar de Mello Rode
- Dental Materials and Prosthesis Department, Instituto de Ciência e Tecnologia, Univ Estadual Paulista, São José dos Campos, SP, Brazil
| | - Alex Nogueira Haas
- Periodontology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, RS, Brazil
| | | | - Claudio Mendes Pannuti
- Periodontology Department, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Elaine Cristina Escobar
- Periodontology Department, School of Dentistry, Faculdades Metropolitanas Unidas, São Paulo, SP, Brazil
| | - Eliete Rodrigues de Almeida
- Epidemiology and Pediatric Dentistry Department, School of Dentistry, Universidade Cruzeiro do Sul, São Paulo, SP, Brazil
| | - José Roberto Cortelli
- Periodontology Department, School of Dentistry, Universidade de Taubaté, Taubaté, SP, Brazil
| | - Vinicius Pedrazzi
- Endodontics and Prosthesis Department, Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Yang F, Huang S, He T, Catrenich C, Teng F, Bo C, Chen J, Liu J, Li J, Song Y, Li R, Xu J. Microbial basis of oral malodor development in humans. J Dent Res 2013; 92:1106-12. [PMID: 24101743 DOI: 10.1177/0022034513507065] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
To better understand the microbial basis of oral malodor development in humans, we used a cross-sectional and longitudinal study design and the pyrosequencing approach to track and compare the tongue microbiota associated with oral malodor in 29 Chinese adults who underwent a consecutive three-day evaluation for the amount of H2S excreted orally. Three levels of the oral malodor state (healthy, oral malodor, and severe oral malodor) were defined based on the H2S level. Community structure of the tongue plaques was more sensitive to changes of malodor state than to interpersonal variations or differences in sampling times. Within each individual, the structure of microbiota was relatively stable, while their variations were correlated with the change in the H2S level. Severe oral malodor microbiota were the most conserved in community structure, whereas the healthy ones were relatively varied. Oral-malodor-associated bacteria were identified. The relative abundance of Leptotrichia and Prevotella was positively correlated with oral malodor severity, whereas Hemophilus and Gemella exhibited a negative relationship with oral malodor severity. Our study provides one of the first landscapes of oral microbiota changes associated with oral malodor development and reveals microbes potentially useful to the evaluation and control of oral malodor.
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Affiliation(s)
- F Yang
- Oral Research Center, Qingdao Municipal Hospital, Qingdao, Shandong, China
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