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Lu C, Qing L, Yina L. Phyllanthus emblica fruit extract alleviates halitosis and reduces the inflammatory response to oral bacteria. J Appl Oral Sci 2024; 32:e20240047. [PMID: 38922243 PMCID: PMC11178350 DOI: 10.1590/1678-7757-2024-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 04/14/2024] [Accepted: 04/30/2023] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE To assess the efficacy of Phyllanthus emblica extract in alleviating halitosis and reducing the inflammatory response to halitosis-related bacteria. METHODOLOGY This investigation, using Phyllanthus emblica fruit extract (PE), involved four aspects. First, we evaluated the effect on growth and aggregation of halitosis-related bacteria, including Fusobacterium nucleatum, Porphyromonas gingivalis, and Solobacterium moorei, using a microdilution assay and scanning electron microscopy. Second, volatile sulfur compound (VSC) levels were measured on individuals with halitosis in randomized short-term (26 participants) and double-blind randomized long-term trials (18 participants in each group) after rinsing with PE for 3, 6, and 12 h, and 28 days. Third, we analyzed pro-inflammatory cytokine expression in TR146 cells using quantitative real-time PCR and enzyme-linked immunosorbent assays. Lastly, we assessed pro-inflammatory cytokine secretion and Toll-like receptor (TLR) 2 mRNA expression via the same experimental methods in a three-dimensional oral mucosal epithelial model (3D OMEM). RESULTS PE extract dose-dependently inhibited the growth of F. nucleatum (50% inhibition concentration [IC50]=0.079%), P. gingivalis (IC50=0.65%), and S. moorei (IC50=0.07%) and effectively prevented bacterial aggregation. Furthermore, VSC contents decreased significantly at 3, 6, and 12 h after rinsing with 5% PE compared with those in the control. Long-term use of mouthwash containing 5% PE for 28 days led to a significant decrease in VSC contents. PE attenuated the F. nucleatum- or P. gingivalis-stimulated mRNA expression and protein release of interleukin (IL)-6 and IL-8 in TR146 cells. It also suppressed IL-8 and prostaglandin E2 secretion and TLR2 mRNA expression in F. nucleatum-induced OMEMs. CONCLUSION Our findings support the use of PE in oral care products to alleviate halitosis and it may reduce inflammation.
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Affiliation(s)
- Cheng Lu
- JAKA Biotechnology Co., LTD, Tiangong Road No. 818, Jinshan District, Shanghai 201507, China
| | - Liu Qing
- JAKA Biotechnology Co., LTD, Tiangong Road No. 818, Jinshan District, Shanghai 201507, China
| | - Lu Yina
- JAKA Biotechnology Co., LTD, Tiangong Road No. 818, Jinshan District, Shanghai 201507, China
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Lu L, Zhao D, Li C, Sun Y, Geng F, Zhang S, Li W, Wang S, Pan Y. The role of periodontitis in the development of atherosclerotic cardiovascular disease in participants with the components of metabolic syndrome: a systematic review and meta-analysis. Clin Oral Investig 2024; 28:339. [PMID: 38801482 DOI: 10.1007/s00784-024-05731-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/18/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVES Prevention of atherosclerotic cardiovascular disease (ASCVD) is important in individuals with metabolic syndrome components (MetS), and periodontitis may play an important role in this process. This study aims to evaluate the association between periodontitis and ASCVD in participants with the components of MetS, including obesity, dysglycemia, hypertension, and dyslipidemia. MATERIALS AND METHODS This study conducted followed the MOOSE reporting guidelines and the PRISMA 2020 guidelines. EMBASE, MEDLINE, Web of Science, Cochrane Library, PubMed and OpenGrey were searched for observational studies about the linkage of periodontitis to ASCVD in people with MetS components up to April 9, 2023. Cohort, case-control and cross-sectional studies were included after study selection. Quality evaluation was carried out using the original and modified Newcastle-Ottawa Scale as appropriate. Random-effects model was employed for meta-analysis. RESULTS Nineteen studies were finally included in the quality analysis, and all of them were assessed as moderate to high quality. Meta-analyses among fifteen studies revealed that the participants with periodontitis were more likely to develop ASCVD in those who have dysglycemia (RR = 1.25, 95% CI = 1.13-1.37; p < 0.05), obesity (RR = 1.13, 95% CI = 1.02-1.24; p < 0.05), dyslipidemia (RR = 1.36, 95% CI = 1.13-1.65; p < 0.05), or hypertension (1.20, 95% CI = 1.05-1.36; p < 0.05). CONCLUSIONS Periodontitis promotes the development of ASCVD in participants with one MetS component (obesity, dysglycemia, hypertension or dyslipidemia). CLINICAL RELEVANCE In people with MetS components, periodontitis may contribute to the ASCVD incidence.
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Affiliation(s)
- Lijie Lu
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Dan Zhao
- Department of Implant Dentistry, Beijing Stomatological Hospital, Capital Medical University, Beijing, China
| | - Chen Li
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Yangyang Sun
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Fengxue Geng
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Shuwei Zhang
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China
| | - Weiqi Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, Sichuan University, Chengdu, China
| | - Songlin Wang
- Salivary Gland Disease Center, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Laboratory of Oral Health and Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050, China.
| | - Yaping Pan
- Department of Periodontics, School and Hospital of Stomatology, China Medical University, Shenyang, China.
- Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.
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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).
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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.
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Huang Z, Cheng Y. Oral microbiota transplantation for intra-oral halitosis: a feasibility analysis based on an oral microbiota colonization trial in Wistar rats. BMC Microbiol 2024; 24:170. [PMID: 38760711 PMCID: PMC11100045 DOI: 10.1186/s12866-024-03322-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/06/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Intra-oral halitosis (IOH) is bad breath produced locally by the mouth in addition to systemic diseases and is one of the main causes of interpersonal communication and psychological disorders in modern society. However, current treatment modalities still only alleviate IOH and do not eradicate it. Therefore, based on the differential performance of oral microecology in IOH patients, we propose a microbiota transplantation treatment aimed at restoring oral microecological balance and analyze its feasibility by oral flora colonization test in Wistar rats. OBJECTIVE Saliva flora samples were collected from IOH patients and healthy subjects to analyze the feasibility of oral microbiota transplantation (OMT) for the treatment of IOH by the Wistar rat oral flora colonization test. METHODS Seven patients with IOH who visited the First Affiliated Hospital of Xinjiang Medical University from June 2017 to June 2022 with the main complaint of halitosis and three healthy subjects were randomly selected. A Halimeter portable breath detector was used to record breath values and collect saliva flora samples. Sixteen SPF-grade male Wistar rats were housed in the Animal Experiment Center of Xinjiang Medical University and randomly divided into an experimental group (Group E) and a control group (Group C) for the oral flora colonization test. Species composition and associated metabolic analysis of oral flora during the Wistar rat test using 16SrRNA sequencing technology and PICRUSt metabolic analysis. Also, the changes in the breath values of the rats were recorded during the test. RESULTS The proportion of Porphyromonas, Fusobacterium, Leptotrichia, and Peptostreptococcus was significantly higher in group E compared to group C after colonization of salivary flora of IOH patients (all P < 0.05), and the abundance with Gemella was zero before colonization, while no colonization was seen in group C after colonization compared to baseline. PICRUSt metabolic analysis also showed significantly enhanced IOH-related metabolic pathways after colonization in group E (all P < 0.05), as well as significantly higher breath values compared to baseline and group C (all P < 0.0001). After colonization by salivary flora from healthy subjects, group E rats showed a decrease in the abundance of associated odor-causing bacteria colonization, a reduction in associated metabolism, and a significant decrease in breath values. In contrast, group C also showed differential changes in flora structure and breath values compared to baseline after salivary flora colonization of IOH patients. CONCLUSIONS OMT for IOH is a promising green treatment option, but the influence of environmental factors and individual differences still cannot be ignored.
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Affiliation(s)
- Zhiqiang Huang
- Department of Gastroenterology I, The First Affiliated Hospital of Xinjiang Medical University, 393th Xinyi Road, Urumqi, Xinjiang, 830054, China
| | - Yongbo Cheng
- Department of Gastroenterology I, The First Affiliated Hospital of Xinjiang Medical University, 393th Xinyi Road, Urumqi, Xinjiang, 830054, China.
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Hoefer KC, Barbe AG, Adams A, Schoppmeier C, Wicht MJ, Weber LT, Noack MJ, Graf I. Halitosis in young patients with chronic kidney disease: findings from a randomized controlled trial. Head Face Med 2024; 20:32. [PMID: 38750491 PMCID: PMC11094915 DOI: 10.1186/s13005-024-00428-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 04/09/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) directly affects oral health. Yet data about halitosis in young CKD patients and the impact of dental prophylaxis is limited. Therefore, as part of this randomized clinical trial, halitosis in young CKD patients undergoing intensive or standard oral preventive procedures was to be explored. METHODS Three volatile sulfur compounds (hydrogen sulfide, methyl mercaptan and dimethyl sulfide) were measured in 30 young patients with CKD (mean age 14.2 years; 16 males, 14 females). Breath samples were taken after 3 and 6 months and analyzed with selective gas chromatography (OralChroma). Tongue coating (Winkel Index) and clinical indices to determine local inflammation or oral hygiene (Papillary Bleeding Index and Quigley-Hein Index) were assessed. Within an extended anamnesis, patients and their mothers and nurses were questioned about the perceived halitosis. Corresponding quotes were noted verbatim. Patients were randomized to either intensive need-related oral health care measures (oral preventative program, OPP) or a one-stage standard prevention (treatment as usual, TAU). RESULTS While there were no differences in volatile sulfur compound levels between TAU and OPP at the three time points of measurements (p > 0.05), there was a tendency towards a reduction in dimethyl sulfide and hydrogen sulfide of affected patients within the OPP group over time. Looking at potential differences between both groups with regard to tongue coating, significant differences were observed between baseline and 3 months after study start in the OPP group, and between baseline and 6 months after study start in the TAU group (p < 0.05). The burden of halitosis was frequently reported by patients' mothers and nurses. CONCLUSIONS Young CKD patients regularly suffered from halitosis and dimethyl sulfide was its main source. Preventive measures mainly resulted in a reduction of tongue coating. TRIAL REGISTRATION The German Clinical Trial Register (# DRKS00010580).
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Affiliation(s)
- Karolin Charlotte Hoefer
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Anna Greta Barbe
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Anne Adams
- Institute of Medical Statistics and Computational Biology, Medical Faculty, University of Cologne, Cologne, Germany
| | - Christoph Schoppmeier
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Michael Jochen Wicht
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Lutz T Weber
- Department of Pediatric Nephrology, Children's and Adolescents' Hospital, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Michael J Noack
- Department of Operative Dentistry and Periodontology, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Isabelle Graf
- Department of Orthodontics, Faculty of Medicine, University Hospital of Cologne, University of Cologne, Cologne, Germany.
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Maruyama T, Ekuni D, Yokoi A, Nagasaki J, Sawada N, Morita M. Effect of Antimicrobial Photodynamic Therapy on the Tongue Dorsum on Reducing Halitosis and the Duration of the Effect: A Randomized Clinical Trial. Healthcare (Basel) 2024; 12:980. [PMID: 38786391 PMCID: PMC11121130 DOI: 10.3390/healthcare12100980] [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: 03/27/2024] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
Antimicrobial photodynamic therapy (PDT) is a treatment that is gaining popularity in modern clinical medicine. However, little is known about the effect of PDT alone on reducing oral halitosis and the duration of the effect. This trial examined the effect of PDT on the tongue dorsum on reducing oral halitosis and the duration of the effect. This study was approved by the Ethics Committee of Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, and Okayama University Hospital (CRB20-015), and it was registered in the Japan Registry of Clinical Trials (jRCTs061200060). Twenty-two participants were randomly assigned to two groups: an intervention group and control group. PDT was performed in the intervention group using red laser emission and methylene blue gel on the middle and posterior area of the tongue dorsum. The concentration of volatile sulfur compounds, bacterial count on the tongue dorsum, probing pocket depth, bleeding on probing, and simplified oral debris index score were determined before and 1 week after PDT. The Mann-Whitney U test was used to assess the significance of the differences in each parameter between the two groups. We found that the hydrogen sulfide concentration and bacterial count on the tongue dorsum were decreased in the intervention group, but there was no statistically significant difference between the two groups. These results indicated that performing only PDT on the tongue dorsum may not contribute to reducing halitosis.
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Affiliation(s)
- Takayuki Maruyama
- Department of Preventive Dentistry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (D.E.); (A.Y.)
- Advanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental School, Okayama 700-8558, Japan
| | - Daisuke Ekuni
- Department of Preventive Dentistry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (D.E.); (A.Y.)
| | - Aya Yokoi
- Department of Preventive Dentistry, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8558, Japan; (D.E.); (A.Y.)
| | | | - Nanami Sawada
- Department of Preventive Dentistry, Okayama University Hospital, Okayama 700-8558, Japan;
| | - Manabu Morita
- Department of Oral Health Sciences, Takarazuka University of Medical and Health Care, Takarazuka 666-0162, Japan;
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Ha NY, Jeong H, Son J, Cha MR, Song S, Hwang JH, Kim J. Preliminary investigation of a combined herbal extract of Aruncus dioicus, Cirsium nipponicum, and Ocimum basilicum for halitosis. Medicine (Baltimore) 2024; 103:e37061. [PMID: 38363943 PMCID: PMC10869069 DOI: 10.1097/md.0000000000037061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/04/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Halitosis, the unpleasant odor in the oral cavity, has garnered increased attention and concern due to the growing significance of social interaction. SGE-107, a blend of 3 botanical drugs-Korean goat's beard, Cirsium tanakae, and Basil-with caffeic acid as its indicator component. This study aims to investigate the efficacy of SGE-107 in treating halitosis in patients with mild gastrointestinal symptoms. METHODS We enrolled 25 participants with oral malodor and dyspeptic symptoms. We assessed the severity of halitosis using the visual analog scale. Throughout a 4-week period of administering SGE-107, we evaluated both objective and subjective parameters, including the halitosis-associated life-quality test, the Korean gastrointestinal symptom rating scale, levels of volatile sulfur compounds, salivary flow rate, oral moisture, tongue index, Winkel tongue coating index, and tongue temperature. RESULTS After the intervention period, both the visual analog scale (5.88 ± 1.03 vs 2.38 ± 0.93, P < .001) and the scores of the halitosis-associated life-quality test (31.21 ± 11.78 vs 13.83 ± 6.38, P < .001) showed significant reductions. The proportion of participants with abnormal levels of methyl mercaptan (a volatile sulfur compound) also significantly decreased (17, 70.8% vs 9, 37.5%, P = .039). Furthermore, there were significant improvements in reflux, constipation, diarrhea, and the total scores on the Korean gastrointestinal symptom rating scale. Throughout the study period, only 2 participants experienced mild adverse events. CONCLUSION SGE-107 appears to be a safe and effective treatment for halitosis-associated with gastrointestinal symptoms; nevertheless, the limited sample size necessitates further large-scale randomized, controlled studies to confirm our findings.
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Affiliation(s)
- Na-Yeon Ha
- Division of Digestive Diseases, Department of Korean Internal Medicine, Kyung Hee University Korean Medicine Hospital, Seoul, Republic of Korea
- Department of Digestive Diseases, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Haein Jeong
- Division of Digestive Diseases, Department of Korean Internal Medicine, Kyung Hee University Korean Medicine Hospital, Seoul, Republic of Korea
- Department of Digestive Diseases, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Juah Son
- USCAREPHARM Co., Ltd., Suwon, Republic of Korea
| | - Mi-Ran Cha
- USCAREPHARM Co., Ltd., Suwon, Republic of Korea
| | - Sukjin Song
- USCAREPHARM Co., Ltd., Suwon, Republic of Korea
| | | | - Jinsung Kim
- Division of Digestive Diseases, Department of Korean Internal Medicine, Kyung Hee University Korean Medicine Hospital, Seoul, Republic of Korea
- Department of Digestive Diseases, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
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Lee WY, Marc O'Donnell J, Kuo SY. Effects of preoperative oral care on bacterial colonisation and halitosis in patients undergoing elective surgery: A randomised controlled study. Intensive Crit Care Nurs 2024; 80:103532. [PMID: 37793316 DOI: 10.1016/j.iccn.2023.103532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/12/2023] [Accepted: 08/14/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVES To evaluate the effects of single-dose chlorhexidine oral care on bacterial colonisation and halitosis in patients undergoing elective surgery. RESEARCH METHODOLOGY We conducted a two-arm parallel, single-blinded, randomised controlled trial. The intervention group (n = 102) received preoperative oral care with 0.12% chlorhexidine gluconate, and the control group (n = 105) received standard care. The data of the microbiological cultures between the groups were compared at the time of tracheal intubation, at extubation and 30 min after surgery. The presence of halitosis was measured using a survey questionnaire administered to the anaesthesia nurses assigned to the patients. RESULTS At baseline, no significant differences were found between the intervention and control groups for bacterial colonisation or halitosis. After the intervention, there was no significant difference in microbiological culture, including gram-positive, gram-negative bacilli and cocci results, between the two groups (p > 0.05). The presence of halitosis in the intervention group was significantly lower than in the control group during intubation (p < 0.0001) and at 30 min after surgery (p < 0.02). Regression analysis indicated that receiving oral was protective towards halitosis, while poor oral health was a risk factor. CONCLUSIONS Preoperative oral care using a single dose of chlorhexidine significantly improved the patients' halitosis in the perioperative period, but no significant effect was found on bacterial colonisation. Further studies are needed regarding the safe use of chlorhexidine for oral care. IMPLICATION FOR CLINICAL PRACTICE Oral hygiene using chlorhexidine could be beneficial in improving halitosis for anaesthesia personnel who take care of intubated adult patients undergoing elective surgery with general anaesthesia.
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Affiliation(s)
- Wen-Yi Lee
- Second Degree Bachelor of Science in Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - John Marc O'Donnell
- Department of Nurse Anesthesia, Director, University of Pittsburgh Nurse Anesthesia Program, Senior Associate Director, Winter Institute for Simulation, Education and Research (WISER) VB 360A, 3500 Victoria St., Pittsburgh, PA 15261, United States.
| | - Shu-Yu Kuo
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan.
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Choi Y, Kim J, Rhee Y, Park JH, Nam W, Park W. The assessment of halitosis with a new screening tool in medication-related osteonecrosis of the jaw. Clin Oral Investig 2024; 28:102. [PMID: 38233664 DOI: 10.1007/s00784-024-05506-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024]
Abstract
OBJECTIVES This study aimed to identify the levels of halitosis in patients with Medication-related osteonecrosis of the jaw (MRONJ) and osteoporosis and to suggest a new MRONJ screening method using halitosis measurement. MATERIALS AND METHODS From October 2019 to April 2023, participants aged 19 years or older without periodontal disease were selected. Seventy-five participants, 25 in each group, were divided into an MRONJ group, an osteoporosis group without MRONJ, and a control group without osteoporosis and not taking osteoporosis drugs or antibiotics. Each participant underwent halitosis assessment twice using an exhaled breath analyzer to measure halitosis twice by blowing a straw for 1 min. Measured concentrations of hydrogen, hydrogen sulfide, and methyl mercaptan were compared between groups. RESULTS Data from 22 patients in the MRONJ group, 25 in the osteoporosis group, and 25 in the control group were analyzed. The concentrations of hydrogen sulfide and methyl mercaptan were significantly higher in the MRONJ group than in the other groups, but the concentrations of hydrogen did not differ between the groups. When comparing the concentrations of hydrogen sulfide and methyl mercaptan in osteoporosis patients and solid cancer patients in the MRONJ group, there was a significant difference in hydrogen sulfide concentration, but there was no significant difference in methyl mercaptan. CONCLUSIONS Quantifying the level of halitosis can be used to screen for MRONJ in patients taking bisphosphonates, such as patients with osteoporosis, prostate cancer, and breast cancer. CLINICAL RELEVANCE MRONJ is accompanied by bad breath, and the concentrations of hydrogen sulfide and methyl mercaptan are associated with MRONJ.
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Affiliation(s)
- Yiseul Choi
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jaeyeon Kim
- Department of Advanced General Dentistry, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Yumie Rhee
- Department of Internal Medicine, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin Hoo Park
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Woong Nam
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Wonse Park
- Institute for Innovation in Digital Healthcare, Yonsei University, Seoul, Republic of Korea.
- Department of Advanced General Dentistry, Human Identification Research Institute, Yonsei University College of Dentistry, Seoul, Republic of Korea.
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Potocka W, Assy Z, Bikker FJ, Laine ML. Current and Potential Applications of Monoterpenes and Their Derivatives in Oral Health Care. Molecules 2023; 28:7178. [PMID: 37894657 PMCID: PMC10609285 DOI: 10.3390/molecules28207178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Plant products have been employed in medicine for centuries. As the world becomes more health-conscious, there is a growing interest in natural and minimally processed products for oral health care. This has led to an increase in research into the bioactive compounds found in plant products, particularly monoterpenes. Monoterpenes are known to have beneficial biological properties, but the specific mechanisms by which they exert their effects are not yet fully understood. Despite this, some monoterpenes are already being used in oral health care. For example, thymol, which has antibacterial properties, is an ingredient in varnish used for caries prevention. In addition to this, monoterpenes have also demonstrated antifungal, antiviral, and anti-inflammatory properties, making them versatile for various applications. As research continues, there is potential for even more discoveries regarding the benefits of monoterpenes in oral health care. This narrative literature review gives an overview of the biological properties and current and potential applications of selected monoterpenes and their derivatives in oral health care. These compounds demonstrate promising potential for future medical development, and their applications in future research are expected to expand.
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Affiliation(s)
- Wiktoria Potocka
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands; (Z.A.); (F.J.B.)
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands;
| | - Zainab Assy
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands; (Z.A.); (F.J.B.)
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands;
| | - Floris J. Bikker
- Department of Oral Biochemistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands; (Z.A.); (F.J.B.)
| | - Marja L. Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands;
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Lee YH, Hong JY. Oral microbiome as a co-mediator of halitosis and periodontitis: a narrative review. FRONTIERS IN ORAL HEALTH 2023; 4:1229145. [PMID: 37719278 PMCID: PMC10500072 DOI: 10.3389/froh.2023.1229145] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/18/2023] [Indexed: 09/19/2023] Open
Abstract
Objective Halitosis or oral malodor is an unpleasant odor from the oral cavity. However, although patients with periodontitis often complain of halitosis, their relationship has not been fully elucidated. We reviewed previous literature based on the hypothesis that the relationship between halitosis and periodontitis is mediated by the oral microbiome. Materials and methods This narrative review sought to provide insight into the causative role of the oral microbiome in influencing halitosis and periodontitis. In addition, we tried to deepen knowledge related to the relationship between halitosis and periodontitis generated by the oral microbiome accumulated over the past 40 years. Results From 1984 to 2023, a total of 106 papers that carefully and scientifically dealt with halitosis and periodontitis were included in this narrative review. Based on previous results, halitosis and periodontitis were closely related. For decades, researchers have taken an intriguing approach to the question of whether there is a relationship between halitosis and periodontitis. Central factors in the relationship between halitosis and periodontitis include volatile sulfur compounds (VSCs), the oral microbiota that produce VSCs, and the inflammatory response. Conclusions Taken together, the more severe periodontitis, the higher the level of VSC in halitosis, which may be mediated by oral microbiome. However, the relationship between the occurrence, maintenance, and exacerbation of periodontitis and halitosis is not a necessary and sufficient condition for each other because they are complex interplay even in one individual.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University School of Dentistry, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Ji-Youn Hong
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
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Lee YH, Shin SI, Hong JY. Investigation of volatile sulfur compound level and halitosis in patients with gingivitis and periodontitis. Sci Rep 2023; 13:13175. [PMID: 37580412 PMCID: PMC10425441 DOI: 10.1038/s41598-023-40391-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/09/2023] [Indexed: 08/16/2023] Open
Abstract
This study aimed to measure the levels of volatile sulfur compounds and investigate the occurrence of halitosis in patients with gingivitis and periodontitis. Additionally, the incidence rates of gingivitis and periodontitis in patients with halitosis were investigated. Through various statistical analyses, we attempted to determine the relationship between periodontal disease and halitosis. One-hundred-and-four participants (52 females and 52 males, mean age: 46.49 ± 16.03 years) were enrolled in this cross-sectional study, comprising 33 healthy controls, 43 patients with gingivitis, and 28 patients with periodontitis. Gas chromatography was used to measure hydrogen sulfide (H2S) and methyl mercaptan (CH3SH), which are representative VSCs. The VSC cut-off values for diagnosing halitosis were 65.79 ppb for women and 79.94 ppb for men. Total VSC level was significantly higher in the gingivitis than the healthy control group (186.72 ± 374.83 ppb vs. 19.80 ± 40.19 ppb, p = 0.035). There was no significant difference between the gingivitis and periodontitis (153.79 ± 278.51 ppb) groups. H2S level was significantly higher in the gingivitis (100.51 ± 183.69 ppb) and periodontitis (91.57 ± 132.06 ppb) groups than in healthy controls (14.97 ± 31.22 ppb), and CH3SH level was significantly higher in gingivitis group (29.31 ± 59.16 ppb) than in the healthy control (5.73 ± 14.10 ppb) (all p < 0.05). Halitosis was found in 3% of healthy controls and 39.5% and 42.9% of patients with gingivitis and periodontitis patients, respectively, making it significantly higher in the gingivitis and periodontitis groups than the healthy controls (p = 0.005). Conversely, among participants with halitosis, 53.1% had gingivitis, 37.5% had periodontitis, and 90.6 incidence had periodontal disease. Multivariate logistic regression analysis to predict the presence of halitosis, found periodontal disease was a significant predictor of halitosis (OR = 3.607, 95% CI 1.023-12.718, p = 0.046). Considering area under curve value for halitosis, the cut-off value of healthy control (H2S:61.5 ppb, CH3SH:3.5 ppb), gingivitis (H2S:50.0 ppb, CH3SH:6 ppb), and periodontitis (H2S:62.0 ppb, CH3SH:3.5 ppb) were (all p < 0.05). Our results emphasize the close and strong relationship between periodontal disease and halitosis through human clinical evidence based on the high co-occurrence rate of mutual diseases. Additionally, the presence of periodontal disease increased the probability of halitosis by 3.607 times. These results suggest that H2S can be used as a biomarker of halitosis in patients with periodontal disease.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University, Kyung Hee University Dental Hospital, #613 Hoegi-dong, Dongdaemun-gu, Seoul, 02447, Korea.
| | - Seung-Il Shin
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Korea
| | - Ji-Youn Hong
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Korea
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Budala DG, Martu MA, Maftei GA, Diaconu-Popa DA, Danila V, Luchian I. The Role of Natural Compounds in Optimizing Contemporary Dental Treatment-Current Status and Future Trends. J Funct Biomater 2023; 14:jfb14050273. [PMID: 37233383 DOI: 10.3390/jfb14050273] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 04/28/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023] Open
Abstract
For a long period of time, natural remedies were the only ailment available for a multitude of diseases, and they have proven effective even after the emergence of modern medicine. Due to their extremely high prevalence, oral and dental disorders and anomalies are recognized as major public health concerns. Herbal medicine is the practice of using plants with therapeutic characteristics for the purpose of disease prevention and treatment. Herbal agents have made a significant entry into oral care products in recent years, complementing traditional treatment procedures due to their intriguing physicochemical and therapeutic properties. There has been a resurgence of interest in natural products because of recent updates, technological advancements, and unmet expectations from current strategies. Approximately eighty percent of the world's population uses natural remedies, especially in poorer nations. When conventional treatments have failed, it may make sense to use natural drugs for the treatment of pathologic oral dental disorders, as they are readily available, inexpensive, and have few negative effects. The purpose of this article is to provide a comprehensive analysis of the benefits and applications of natural biomaterials in dentistry, to gather relevant information from the medical literature with an eye toward its practical applicability, and make suggestions for the directions for future study.
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Affiliation(s)
- Dana Gabriela Budala
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Maria-Alexandra Martu
- Department of Periodontology, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
| | - George-Alexandru Maftei
- Department of Dento-Alveolar Surgery and Oral Pathology, "Grigore T. Popa" University of Medicine and Pharmacy Iași, Universitatii Street 16, 700115 Iași, Romania
| | - Diana Antonela Diaconu-Popa
- Department of Implantology, Removable Prostheses, Dental Prostheses Technology, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
| | - Vlad Danila
- Department of Dento-Alveolar Surgery and Oral Pathology, "Grigore T. Popa" University of Medicine and Pharmacy Iași, Universitatii Street 16, 700115 Iași, Romania
| | - Ionut Luchian
- Department of Periodontology, Faculty of Dental Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
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Schertel Cassiano L, Leite FRM, López R, Fjaeldstad AW, Nascimento GG. The association between halitosis and chemosensory disorders: A systematic review. Oral Dis 2023; 29:369-375. [PMID: 33660384 DOI: 10.1111/odi.13823] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Luisa Schertel Cassiano
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Fábio R M Leite
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Rodrigo López
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Alexander W Fjaeldstad
- Flavour Clinic, Department of Otolaryngology, Hospital Unit West, Holstebro, Denmark
- Flavour Institute, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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The tongue biofilm metatranscriptome identifies metabolic pathways associated with the presence or absence of halitosis. NPJ Biofilms Microbiomes 2022; 8:100. [PMID: 36535943 PMCID: PMC9763428 DOI: 10.1038/s41522-022-00364-2] [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: 01/10/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
Intra-oral halitosis usually results from the production of volatile sulfur compounds, such as methyl mercaptan and hydrogen sulfide, by the tongue microbiota. There are currently no reports on the microbial gene-expression profiles of the tongue microbiota in halitosis. In this study, we performed RNAseq of tongue coating samples from individuals with and without halitosis. The activity of Streptococcus (including S. parasanguinis), Veillonella (including V. dispar) and Rothia (including R. mucilaginosa) was associated with halitosis-free individuals while Prevotella (including P. shahi), Fusobacterium (including F. nucleatum) and Leptotrichia were associated with halitosis. Interestingly, the metatranscriptome of patients that only had halitosis levels of methyl mercaptan was similar to that of halitosis-free individuals. Finally, gene expression profiles showed a significant over-expression of genes involved in L-cysteine and L-homocysteine synthesis, as well as nitrate reduction genes, in halitosis-free individuals and an over-expression of genes responsible for cysteine degradation into hydrogen sulfide in halitosis patients.
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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.
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Woźniak A, Matys J, Grzech-Leśniak K. Effectiveness of lasers and aPDT in elimination of intraoral halitosis: a systematic review based on clinical trials. Lasers Med Sci 2022; 37:3403-3411. [DOI: 10.1007/s10103-022-03656-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/04/2022] [Indexed: 11/25/2022]
Abstract
AbstractIn recent years, there has been increasing interest in research showing positive results in antimicrobial photodynamic therapy (aPDT) and laser therapy (LT) in dentistry. The authors of this review tried to answer the question: “Is the effectiveness of lasers and aPDT in the elimination of intraoral halitosis possible?” For this purpose, the electronic database of PubMed and Cochrane Library were searched until September 2021 using a combination of different keywords: (bad breath OR fetor ex ore OR halitosis OR oral malodor) AND (laser OR PDT OR PACT OR photodynamic inactivation OR photodynamic therapy OR photodynamic antimicrobial chemotherapy). Initially, 83 studies were identified. A total of 9 articles were qualified after the application of the eligibility criteria. Eight works concerned aPDT treatment, and only one dedicated to the Er,Cr:YSGG laser. A significant reduction in halitosis occurred immediately after both LT and aPDT. The review found the confirmation of the effectiveness of laser therapy in reducing the number of volatile sulfur compounds (VSC) and the amount of anaerobic bacteria responsible for VSC formation. In most studies, a positive effect was observed for a 1-week follow-up. Laser therapy (aPDT, Er,Cr:YSGG) effectively eliminates microorganisms that produce volatile compounds and can effectively eliminate bad breath for the longer period of time than traditional methods of combatting this ailment.
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Muniz FWMG, Moreno LB, da Silviera TM, Rösing CK, Colussi PRG. Prevalence and associated factors of self‐reported halitosis among institutionalized adolescents: cross‐sectional study. Int J Dent Hyg 2022; 21:409-416. [PMID: 36102281 DOI: 10.1111/idh.12624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/24/2022] [Accepted: 09/11/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To assess the prevalence and associated factors of self-reported halitosis in institutionalized adolescents in a city in southern Brazil. METHODS This cross-sectional study involved male institutionalized adolescents, aged 15-19 years old, at the Socio-Educational Assistance Center in the city of Passo Fundo, Brazil. Data collection was performed by a research team composed of two interviewers, two clinical examiners of oral health and two examiners of salivary flow. A structured questionnaire was applied, which included demographical, socioeconomical, general health behaviour, presence of health problems and oral health self-perception variables. Decayed, Missing, Filled Index was used for the clinical examination. The salivary flow collection was performed using the mechanically stimulated total saliva method, in which only the liquid component was measured. RESULTS The prevalence of self-reported halitosis in this sample was 51.5% (n = 35). In the final multivariate analysis, halitosis was significantly associated with the non-white racial group (prevalence ratio [RP]:1.703; 95% confidence interval [95%CI]:1.101-2.634), use of crack (RP:1.857; 95%CI:1.270-2.714) and number of decayed teeth (PR: 1.123; 95%CI:1.008-1.252). The use of alcohol and access to dental care in the last 12 months were not significantly associated with self-reported halitosis. CONCLUSION It was concluded that non-white and crack-user youngsters had a high occurrence of self-reported halitosis. Higher rates of dental caries are also associated with halitosis.
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Yu WW, Goh R, Cheong E, Guan G, Jin C, Cannon RD, Farella M, Mei L. Prevalence of halitosis among young adults in Dunedin, New Zealand. Int J Dent Hyg 2022; 20:700-707. [PMID: 35924391 DOI: 10.1111/idh.12609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 01/25/2022] [Accepted: 07/31/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To investigate the prevalence of halitosis in young adults. METHODS Young adults (n = 372; mean age = 21.0 ± 2.6 years old, range = 18-30 years) in Dunedin, New Zealand were recruited into the cross sectional study after providing informed consent. The prevalence of halitosis was determined using both objective measurements (parts per billion [ppb] volatile sulphur compounds [VSCs] in the exhaled air) and subjective measurements (self-reported halitosis questionnaire, tongue coating index, and organoleptic assessment). RESULTS VSC measurements indicated that the prevalence of halitosis (values ≥ 140 ppb) was 31.2%; 25.6% of participants self-reported halitosis. The organoleptic assessment revealed that 14.3% of the participants had a score of ≥2. A positive correlation was found between the VSC measurements and organoleptic assessment (p < 0.05). No significant relationship was found between self-reported halitosis and either organoleptic assessment or VSC measurements. Self-reported dry mouth, smoking, oral hygiene index, DMFT index, and tongue coating score were significantly associated with the organoleptic assessment (p < 0.05). The self-reported dry mouth, mouth breathing and tongue coating score were significantly associated with the VSC scores (p < 0.05). CONCLUSION Halitosis, as represented by VSC, was found in 31.2% of the participants. VSC scores and organoleptic assessment were positively correlated. There was no significant relationship between self-reported halitosis and either organoleptic assessment or VSC measurements.
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Affiliation(s)
- Wing Wan Yu
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Rayner Goh
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Esther Cheong
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Guangzhao Guan
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Carrol Jin
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Richard D Cannon
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Mauro Farella
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Li Mei
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Moreno LB, Colussi PRG, Marostega MG, Rosalen NP, Rösing CK, Muniz FWMG. Self-reported halitosis and associated factors among older adults: A cross-sectional study. J Oral Biol Craniofac Res 2022; 12:431-436. [DOI: 10.1016/j.jobcr.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/10/2022] [Accepted: 05/21/2022] [Indexed: 11/29/2022] Open
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Patil P, Patil L, Triveni MG, Usha GV, Shah R, Kumar AT. Efficacy of antimicrobial photodynamic therapy on the tongue surface in the management of halitosis – A real-time polymerase chain reaction analysis. Photodiagnosis Photodyn Ther 2022; 39:102989. [DOI: 10.1016/j.pdpdt.2022.102989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/22/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
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BERKMAN M, ALTUNTAŞ E, TUNCER S, KARABAY F, DEMİRCİ M, TEKÇE N. ANTİ-HALİTOSİS GARGARALARININ REZİN BAZLI RESTORATİF DENTAL MATERYALLERİN YÜZEY ÖZELLİKLERİ ÜZERİNE ETKİSİ. CUMHURIYET DENTAL JOURNAL 2022. [DOI: 10.7126/cumudj.985788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Amaç: Bu in-vitro çalışmanın amacı anti-halitosis etkili beş farklı ağız gargarasının iki farklı restoratif materyalin renk stabilitesi ve yüzey pürüzlülüğü üzerine olan etkisinin araştırılmasıdır.
Gereç ve Yöntemler: Çalışmada nano-hibrit (Filtek Z550, 3M ESPE) ve giomer (Beautifill II, Shofu Dental) yapıda olan iki çeşit reçine bazlı restoratif materyal kullanılmıştır. Her iki materyalden test edilmek üzere toplam 120 adet kompozit disk üretici talimatları doğrultusunda 10x2mm ebatlarında silindir kalıplar kullanılarak hazırlanmıştır. Rastgele seçilen örnekler, 5 farklı ağız gargarası (Listerine Fresh Burst, Listerine Total Care, Colgate Plax, Oderol, Halitosil) ve 1 kontrol grubunda (distile su) bekletilmek üzere toplam 6 farklı gruba ayrılmıştır. Başlangıç renk koordinatları CIELAB renk sistemine göre spektrofotometre (Easyshade Compact) ile yüzey pürüzlülük değerleri (Ra) ise kontakt profilometre (Surtronic 25) ile ölçülmüştür. Tüm örnekler 37°C'de ağız gargaralarında 12boyunca bekletilmiş ardından renk ve pürüzlülük ölçüm prosedürleri aynı şekilde gerçekleştirilmiştir. Elde edilen veriler SPSS 24.0 programı ile Kruskal-Wallis H ve Bonferroni Post Hoc testleri kullanılarak 0.05 anlamlılık düzeyinde analiz edilmiştir.
Bulgular: Bu çalışmanın sonuçları, yüzey pürüzlülük değerlerinde istatistiksel olarak anlamlı bir artış olmadığını göstermiştir. Ağız gargaralarında bekletilen Beautifil II materyallerinin tamamında CIELAB değerlerinde önemli bir değişiklik olmuştur (P
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Affiliation(s)
| | - Ezgi ALTUNTAŞ
- MARMARA UNIVERSITY, FACULTY OF DENTISTRY, DENTISTRY PR. (ENGLISH)
| | - Safa TUNCER
- ISTANBUL UNIVERSITY, FACULTY OF DENTISTRY, DENTISTRY PR
| | - Ferda KARABAY
- ISTANBUL UNIVERSITY, FACULTY OF DENTISTRY, DENTISTRY PR
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Tay JRH, Ng E, Lai CWM, Lim LP, Ong MMA. The efficacy of probiotics in the management of intra-oral halitosis: a systematic review. Clin Oral Investig 2022; 26:4687-4700. [PMID: 35536439 DOI: 10.1007/s00784-022-04522-w] [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: 03/21/2021] [Accepted: 04/23/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the efficacy of probiotics in reducing halitosis of dental origin. METHODS MEDLINE, EMBASE, and CENTRAL were searched up to and including June 2020. Randomised placebo-controlled, double-blinded clinical trials in systemically healthy adult patients who were given any form of probiotics to manage halitosis of dental origin were included. Primary outcome measures were organoleptic scores and volatile sulphur concentration levels. Secondary outcome measures were microbiologic parameters and quality of life (QOL). RESULTS Of the 301 potentially relevant articles, eight articles were selected for the review. The risk of bias assessment showed that two studies were of low risk of bias, four studies had some concerns, and two studies had a high risk of bias. The beneficial effect of probiotics could neither be confirmed in periodontally treated patients administered with up to 8 weeks of probiotics, nor in periodontitis patients who received both non-surgical periodontal therapy and adjunctive probiotics up to 90 days. Microbiological findings 1 month after probiotics administration and QOL measures showed no significant differences compared to control. Considerable heterogeneity was observed among probiotic administration protocols. CONCLUSIONS The available evidence suggests no convincing benefit for the use of probiotics in the management of halitosis. Standardised protocols on recruitment of halitosis subjects and organoleptic measurements are required for future studies on probiotics as an intervention. CLINICAL RELEVANCE The lack of well-conducted studies with a low risk of bias precludes any clinical recommendation. Further research is needed to verify the efficacy of probiotics in the management of intra-oral halitosis.
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Affiliation(s)
- John Rong Hao Tay
- Department of Restorative Dentistry, National Dental Centre Singapore, 5 Hospital Avenue, Singapore, 168938, Singapore.
| | - Ethan Ng
- Department of Restorative Dentistry, National Dental Centre Singapore, 5 Hospital Avenue, Singapore, 168938, Singapore
| | - Clement Wei Ming Lai
- Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore
| | - Lum Peng Lim
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore
| | - Marianne Meng Ann Ong
- Department of Restorative Dentistry, National Dental Centre Singapore, 5 Hospital Avenue, Singapore, 168938, Singapore
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Sreenivasan PK, Haraszthy VI. Chlorhexidine Improves Hygiene Reducing Oral Polymorphonuclear Leukocytes with Antimicrobial Effects at Distinct Microenvironments amongst Subjects Stratified by Health Status. Antibiotics (Basel) 2022; 11:antibiotics11050603. [PMID: 35625248 PMCID: PMC9137765 DOI: 10.3390/antibiotics11050603] [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: 04/08/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 11/30/2022] Open
Abstract
Oral conditions such as gingivitis and oral malodor are commonly reported globally. Objective: This investigation clinically stratified subjects to healthy, malodor and gingivitis groups and enumerated oral polymorphonuclear leukocytes (PMN) as a measure of inflammation prior to and after rinsing with a chlorhexidine (CHX) mouthwash. The study also assessed clinical outcomes (dental plaque and gingival bleeding indices), malodor (halimeter scores, organoleptic and tongue coat index and microbiological parameters (anaerobic and malodor organisms of dental plaque, tongue surface and saliva) for a comprehensive assessment of the oral inflammatory burden. Methods: Consenting adults were stratified into control (n = 17), gingivitis (n = 19) and halitosis (n = 17) groups based on clinical criteria. At baseline, oral samples were examined for PMN in addition to microbiological analysis of dental plaque, saliva and tongue scrapings for anaerobic and malodor bacteria. Subjects were issued a commercially available fluoride toothpaste and a chlorhexidine mouthwash for two-week use prior to post-treatment assessments identical to baseline. Results: At baseline, PMN were lowest in the control that increased amongst the halitosis subjects, with the gingivitis group registering the highest levels (p < 0.05) with these outcomes corresponding with clinical parameters (p < 0.05). CHX use improved outcomes with a 56−61% reduction in PMN with significant differences between groups (p < 0.05). Dental plaque and bleeding indices were lower by 57−78% with oral malodor, demonstrating reductions of 33−59% (p < 0.05). Significant reductions in anaerobic and malodor organisms ranging from 78−96% and 76−94%, respectively, were noted after CHX use (p < 0.05). Conclusions: At study enrollment, PMN scores were lowest in healthy subjects, with increasing numbers amongst halitosis followed by gingivitis. Amongst all subject groups, CHX use significantly reduced oral PMN and corroborated with corresponding decreases in clinical, malodor and bacterial outcomes. Together, these results demonstrate the significant reductions in the oral inflammatory burden following CHX use.
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Affiliation(s)
- Prem K. Sreenivasan
- HITLAB, 3960 Broadway, New York, NY 10032, USA
- Department of Oral Biology, Rutgers School of Dental Medicine, Newark, NJ 07103, USA
- Correspondence:
| | - Violet. I. Haraszthy
- Department of Restorative Dentistry, University at Buffalo, Buffalo, NY 14214, USA;
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Gurpinar B, Kumral TL, Sari H, Tutar B, Uyar Y. A new halitosis screening tool: halitosis finding score derivation and validation. Acta Odontol Scand 2022; 80:44-50. [PMID: 34102953 DOI: 10.1080/00016357.2021.1936162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The lack of a valid and appropriate halitosis screening survey prompted us to develop and validate a simple, 15-item questionnaire to be used as a screening tool to score halitosis for the daily practise. METHODS After calculating the sample size, 200 participants were included in the study. All participants filled a 15-item questionnaire with the subsequent measurements of halitosis through the organoleptic scoring system and a halimeter. The application of questionnaire and the halitosis measurements were repeated 15 days after the first control. RESULTS Mann-Whitney's U test was statistically significant between the halimeter measurements and Halfins scores (p=.000, p<.05). ROC curve is drawn due to halitometer analyses. The cut-off point was determined such as Halfins scores greater than 14 indicated halitosis (65.75 sensitivity, 66.04 specificity). The content validation and concurrent validity were proven successful. CONCLUSIONS A new halitosis-specific screening tool called Halfins was proven as a valid diagnostic tool for measuring halitosis in the present study. Nevertheless, we believe this questionnaire could be used as complementary tool for the diagnosis of halitosis, seeing as its use alone is not able to firmly conclude the presence of halitosis in all cases, an organoleptic test or VSC assessment would still be necessary.
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Affiliation(s)
- Berk Gurpinar
- Department of Otolaryngology, Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Tolgar Lutfi Kumral
- Department of Otolaryngology, Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Huseyin Sari
- Department of Otolaryngology, Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Belgin Tutar
- Department of Otolaryngology, Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Yavuz Uyar
- Department of Otolaryngology, Cemil Tascioglu City Hospital, Istanbul, Turkey
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Banjar AA, Hassan SM, Alyafi RA, Alawady SA, Alghamdi MH, Baik KM. Self-perceived halitosis among young adults undergoing orthodontic treatment. Int J Dent Hyg 2021; 20:479-486. [PMID: 34951749 DOI: 10.1111/idh.12572] [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: 06/03/2021] [Revised: 12/14/2021] [Accepted: 12/22/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Halitosis is a common oral health problem that significantly impacts the quality of life of the affected individuals. In most cases, poor oral hygiene is responsible for the problem. Orthodontic therapy aims to correct malocclusion using different devices. It has been suggested that orthodontic treatment can promote gingival health by facilitating daily oral hygiene measures. However, the treatment may harm gingival health as these appliances may lead to a more significant accumulation of plaque, increasing the microbial load in the subgingival environment leading to halitosis. OBJECTIVE The primary goal of this survey is to assess the prevalence of self-perceived halitosis in patients undergoing orthodontic treatment. MATERIALS AND METHODS An online questionnaire was randomly distributed to patients undergoing orthodontic treatment. A total of 289 subjects completed the questionnaire. It included questions about: demographic data, medical history, social habits, past dental treatment and oral hygiene habits. Descriptive statistics as frequency distributions and percentages were calculated for the study variables. RESULTS The prevalence of self-perceived halitosis was 41.5%. The majority of the participants started to notice this problem during and after orthodontic treatment (62.5%). A statistically significant correlation was found between the regular dental visits and halitosis in patients with fixed orthodontic appliances (p-value = 0.010). Also, those patients had a substantial increase in tongue coating formation (p- value = 0.010). CONCLUSION Self-perceived halitosis is a common problem in patients receiving orthodontic treatment.
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Affiliation(s)
- Arwa A Banjar
- Department of Periodontics, Faculty of Dentistry, King Abudlaziz University, Jeddah, Saudi Arabia
| | - Shaymaa M Hassan
- Department of Oral medicine and periodontology, Faculty of Dentistry, Cairo University, Cario, Egypt
| | - Rusha A Alyafi
- Department of Periodontics, Faculty of Dentistry, King Abudlaziz University, Jeddah, Saudi Arabia
| | - Sara A Alawady
- Faculty of Dentistry, King Abudlaziz University, Jeddah, Saudi Arabia
| | - Morouj H Alghamdi
- Faculty of Dentistry, King Abudlaziz University, Jeddah, Saudi Arabia
| | - Khadijah M Baik
- Prosthodontic Department, Faculty of Dentistry, King Abudlaziz University, Jeddah, Saudi Arabia
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Vieira WDA, Pecorari VGA, Figueiredo-de-Almeida R, Carvas Junior N, Vargas-Neto J, Santos ECA, Gomes BPFDA, Almeida JFAD, de-Jesus-Soares A. Prevalence of dental trauma in Brazilian children and adolescents: a systematic review and meta-analysis. CAD SAUDE PUBLICA 2021; 37:e00015920. [PMID: 34909926 DOI: 10.1590/0102-311x00015920] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/06/2021] [Indexed: 12/24/2022] Open
Abstract
This study aimed to investigate the prevalence of dental trauma in Brazilian children and adolescents. A systematic review was conducted considering eight databases: MEDLINE (via PubMed), LILACS, BBO, Scopus, Embase, Web of Science, Open Access Theses and Dissertations, and OpenThesis. Only prevalence studies that used a probabilistic sampling method were included, without restriction on year or language of publication. The JBI critical appraisal tools for prevalence studies were used to assess the individual risk of bias. The individual studies were combined in the meta-analysis using the random-effects model. The heterogeneity between the studies was analyzed by Cochran's Q and the I-square statistics. A meta-regression analysis was performed to evaluate the sources of heterogeneity. The GRADE approach assessed the certainty of evidence across included studies. The search resulted in 2,069 records, of which 36 were included in the study. The eligible studies were published from 2000 to 2021, with a total sample of 40,194 children and adolescents. Most studies (75%) had a low risk of bias. In permanent teeth, the prevalence of dental trauma was 21% (95%CI: 16.0; 26.0) and in deciduous teeth; 35% (95%CI: 26.0; 44.0). The prevalence of dental trauma among boys was higher than among girls for both dentitions. Based on a low certainty, the prevalence of traumatic dental injuries in Brazilian children and adolescents is higher than that found worldwide both in deciduous and permanent teeth. Also, the prevalence of dental trauma among boys is higher than among girls.
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Affiliation(s)
| | | | | | | | - Júlio Vargas-Neto
- Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, Brasil
| | | | | | | | - Adriana de-Jesus-Soares
- Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba, Brasil
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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.
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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;
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Botelho Dinis M, Agnello M, He X, Shi W, Chaichanasakul Tran N. Pilot study on selective antimicrobial effect of a halitosis mouthrinse: monospecies and saliva-derived microbiome in an in vitro model system. J Oral Microbiol 2021; 13:1996755. [PMID: 34745444 PMCID: PMC8567964 DOI: 10.1080/20002297.2021.1996755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Halitosis refers to malodor emanating from the oral cavity. Several mouthrinses with halitosis-reduction exist on the market, but their effect on the oral microbiome is largely unknown. In this study, we used an efficient in vitro model system to investigate a test mouthrinse's impact on the oral microbiome. Methods Single halitosis-associated species and other common oral microorganism cultures were exposed to the test mouthrinse over time, and their viability was determined by culture-based selective plating. Next, the saliva-derived microbiome from healthy and halitosis-associated individuals was cultured in the presence of the test mouthrinse over time using the previously developed in vitro model system. The microbiome composition was assessed with 16S rRNA gene sequencing and downstream bioinformatics analyses. Results The test mouthrinse displayed antimicrobial activity against known anaerobic bacterial species producing halitosis-related compounds such as Fusobacterium nucleatum, F. periodonticum, and Prevotella intermedia but not against other common oral microorganisms. In the multispecies, saliva-derived cultures, mouthrinse exposure decreased the relative abundance of the Fusobacterium and Prevotella genera while not affecting overall diversity. Conclusions The test mouthrinse had promising anti-halitosis characteristics at the microbiome level, as demonstrated by the reduction in the relative abundance of halitosis-associated taxa while maintaining microbial diversity.
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Affiliation(s)
| | | | - Xuesong He
- The Forsyth Institute, Cambridge, MA, USA
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Dos Santos DDL, Besegato JF, Vieira SM, Rached Dantas AA, Silva AM, da Silva AM. Effect of fixed orthodontic appliances on self-assessment and diagnosis of halitosis in undergraduate dental students. J Indian Soc Periodontol 2021; 25:432-437. [PMID: 34667388 PMCID: PMC8452163 DOI: 10.4103/jisp.jisp_327_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/11/2020] [Accepted: 12/12/2020] [Indexed: 11/12/2022] Open
Abstract
Background: The effects of fixed orthodontic therapy on the occurrence of halitosis are not yet fully understood. This study aimed to evaluate the effect of fixed orthodontic appliances on self-assessment and diagnosis of halitosis in undergraduate dental students. Materials and Methods: Sixty-two undergraduate dental students were included in this cross-sectional study. Two groups (n = 31 per group) were composed of participants with (study group) or without (control group) fixed orthodontic appliance. Halitosis self-assessment and clinical diagnosis were assessed using a visual analogic scale (VAS) and sulfur volatile compounds (SVCs) assessment, respectively. The subjective (VAS) and objective (SVC) malodor assessments were classified in absence, light, moderate, or severe malodor. Chi-square Pearson test and Spearman's correlation were applied for data analysis, with a significance level of 5%. Results: The use of fixed orthodontic appliances had no effect on self-assessment (P = 0.490) or clinical diagnosis (P = 0.610) of halitosis. Self-assessment was not significantly associated with the diagnosis of halitosis regardless the use of fixed orthodontic appliance (P ≥ 0.737). Male participants showed higher diagnosis of halitosis (P = 0.007). SVC measurements showed the absence of halitosis in 51.6% and 58.1% of participants with or without orthodontic appliances, respectively. Conclusion: The use of fixed orthodontic appliances affected the self-assessment of halitosis but no SVC measurements. It was not verified a correlation between subjective and objective methods to diagnose halitosis in dental students.
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Affiliation(s)
| | - João Felipe Besegato
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Sâmmea Martins Vieira
- Department of Dentistry, Faculdade Integral Diferencial - FACID/ Wyden, Teresina, PI, Brazil
| | - Andrea Abi Rached Dantas
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, SP, Brazil
| | - Aryvelto Miranda Silva
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, Araraquara, SP, Brazil
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Quality and Reliability of Halitosis Videos on YouTube as a Source of Information. Dent J (Basel) 2021; 9:dj9100120. [PMID: 34677182 PMCID: PMC8534361 DOI: 10.3390/dj9100120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/11/2021] [Accepted: 10/11/2021] [Indexed: 12/20/2022] Open
Abstract
Halitosis is a common condition that adversely affects quality of life. Through YouTube, people access oral health information. This study aimed to analyze the quality and comprehensiveness of the content, and reliability of halitosis videos hosted on YouTube. In total, 300 videos were collected based on three search keywords, and the number of likes, dislikes, views, duration, interaction index, viewing rate, and source category. Subsequently, the video score, which represents the content quality and comprehensiveness was used to categorize videos as poor, good, and excellent. DISCERN score was used to assess video reliability. Of the 105 videos analyzed, 68 (64.8%) were uploaded by personal users. In general, videos were categorized as poor and have low reliability. Videos sourced from healthcare professionals showed the highest quality, comprehensiveness of the content, and reliability (p < 0.05). There was no difference in the number of viewers for video duration less than or more than 4 min (p > 0.05). YouTube users prefer low-quality videos over high-quality ones, indicating that viewers cannot differentiate between reliable and potentially biased content. It is critical to enable viewers to critically assimilate information hosted on YouTube to make effective oral healthcare decisions.
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Elsenberg CPM, Sidiqi S, Buunk-Werkhoven YAB. Halitosis, what experiences and methods apply Dutch dental hygienists. Int J Dent Hyg 2021; 20:219-224. [PMID: 34547173 DOI: 10.1111/idh.12554] [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: 07/08/2021] [Accepted: 09/10/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this research is to gain more insight in the methods and experiences of dental hygienists in the Netherlands regarding the treatment of patients with halitosis. MATERIAL AND METHODS A total of 92 dental hygienists completed the questionnaire (consisting of 19 questions on personal and professional characteristics, clinical observation and treatment of halitosis, the referral of patients with halitosis, the presence and usefulness of a protocol). The questionnaire was distributed using a social media platform for dental professionals in oral health care from all over the Netherlands. RESULTS 83.4% of 90 dental hygienists had paid attention to the patient's breath but only 37.8% of dental hygienists always informed the patient. Reasons for not informing patients were the fear of the patient's possible reaction or because other oral health problems were more important. Of the included dental hygienists 67.8% had never referred a patient for treatment of halitosis. 86.7% of the dental hygienists stated there was no protocol for diagnosis and treatment of patients with halitosis. However, 90.0% of the dental hygienists acknowledged a protocol would be useful. CONCLUSIONS The majority of the dental hygienists in the Netherlands had paid attention to the patient's breath, but only a small group of dental hygienists informed their patients about halitosis. In dental practices halitosis is an underestimated problem. During the coronavirus pandemic people are more aware with the smell of their breath. Dental hygienists indicated scaling and root planning and/or providing information and instruction by patients with a bad breath.
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Schertel Cassiano L, Abdullahi F, Leite FRM, López R, Peres MA, Nascimento GG. The association between halitosis and oral-health-related quality of life: A systematic review and meta-analysis. J Clin Periodontol 2021; 48:1458-1469. [PMID: 34409629 DOI: 10.1111/jcpe.13530] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 07/16/2021] [Accepted: 07/28/2021] [Indexed: 01/18/2023]
Abstract
AIM To investigate whether halitosis is associated with impaired oral-health-related quality of life (OHRQoL). MATERIALS AND METHODS This is a systematic review of the literature. Electronic searches were performed in PubMed via Medline, Web of Science, Scopus, and EMBASE up to and including June 2021. Observational studies that assessed halitosis in association with OHRQoL were included. The pooled standardized mean difference (SMD) was estimated by meta-analysis. RESULTS Thirteen studies were included in the review; however, the meta-analysis included only 10 studies, all cross-sectional, comprising 2692 individuals. The overall meta-analysis showed an association between halitosis and impaired OHRQoL (SMD 0.51; 95% confidence interval 0.27-0.75). Subgroup analyses, however, indicated that this association remained only among adults. Neither the OHRQoL instrument nor the halitosis assessment method, or the cultural background, influenced the pooled estimates. Meta-regression analyses revealed that the OHRQoL instrument, the halitosis assessment method, and the sample composition did not explain the between-study heterogeneity. Methodological quality appeared to explain 20% of the overall heterogeneity, as studies with high risk of bias overestimated the magnitude of the association. CONCLUSION Our findings suggest that halitosis is associated with impaired OHRQoL.
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Affiliation(s)
- Luisa Schertel Cassiano
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Farhiya Abdullahi
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Fábio R M Leite
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Rodrigo López
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Marco A Peres
- National Dental Research Institute Singapore, National Dental Centre, Singapore.,Oral Health Academic Clinical Programme, Health Services and Systems Research Programme, Duke-NUS Medical School, Singapore
| | - Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
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Faria SFS, Costa FO, Godinho Pereira A, Miranda Cota LO. Self-perceived and self-reported breath odour and the wearing of face masks during the COVID-19 pandemic. Oral Dis 2021; 28 Suppl 2:2406-2416. [PMID: 34245645 PMCID: PMC8447418 DOI: 10.1111/odi.13958] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/26/2021] [Accepted: 07/08/2021] [Indexed: 02/07/2023]
Abstract
Objectives To assess the self‐perception of breath odour (SPBO) and oral hygiene habits (OHHs) while the wearing of face masks during the COVID‐19 pandemic. Subjects and Methods This cross‐sectional study included 4647 individuals who answered a structured questionnaire containing demographic, medical and dental variables and self‐perceived breath odour. Variables associated with changes in self‐perceived breath odour, self‐perceived halitosis and changes in OHHs were assessed through multivariate logistic regression. Results Changes in self‐perceived breath odour were reported by 1572 individuals and were associated with smoking, systemic conditions, dry mouth, tongue coating, the period of face mask use and its interaction with prior thinking of having bad breath. Likewise, 645 individuals started to consider having bad breath. This was associated with the interaction between prior family/friends saying they have bad breath and period of face mask use. Changes in OHHs were strongly associated with changes in SPBO and starting to consider having bad breath. Conclusion Changes in one's SPBO was associated with the wearing of face masks and was significant for changes in OHHs. Findings may be important to guide comprehensive preventive and therapeutic strategies in relation to oral health care.
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Affiliation(s)
- Sandro Felipe Santos Faria
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte Minas Gerais, Brazil
| | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte Minas Gerais, Brazil
| | - Alexandre Godinho Pereira
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte Minas Gerais, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte Minas Gerais, Brazil
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Nascimento GG, Goettems ML, Schertel Cassiano L, Horta BL, Demarco FF. Clinical and self-reported oral conditions and quality of life in the 1982 Pelotas birth cohort. J Clin Periodontol 2021; 48:1200-1207. [PMID: 34169558 DOI: 10.1111/jcpe.13512] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 05/11/2021] [Accepted: 06/05/2021] [Indexed: 12/17/2022]
Abstract
AIM To investigate and compare the effects of clinical and self-perceived oral conditions on oral health-related quality of life (OHRQoL) among young adults. MATERIALS AND METHODS Adults enrolled in the 1982 Pelotas birth cohort were included in this study. OHRQoL was assessed by the Oral Health Impact Profile-14 (OHIP-14) instrument. Clinical parameters such as dental caries, periodontitis, aesthetics, and occlusal characteristics, and tongue coating were collected through clinical evaluation, while dental anxiety and halitosis were self-reported. Direct and indirect effects of clinical and self-perceived oral conditions on OHRQoL were assessed using structural equation modelling. RESULTS Five-hundred and thirty-nine individuals participated in this study. Dental caries (β = 0.12) and periodontitis (β = 0.11) were directly and indirectly (via halitosis, β = 0.05 for periodontitis only) associated with greater OHIP-14 scores, while the other clinical conditions did not influence the OHIP-14 scores. Dental anxiety and halitosis were also associated with higher OHIP-14 scores (β = 0.31 and β = 0.27, respectively). CONCLUSIONS This study found a positive association between clinically diagnosed and self-reported oral conditions and OHRQoL; however, the self-reported conditions had a higher impact on OHRQoL.
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Affiliation(s)
- Gustavo G Nascimento
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Marília L Goettems
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Luisa Schertel Cassiano
- Section for Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
| | - Bernardo L Horta
- Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Flávio F Demarco
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Brazil.,Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
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Karbalaei M, Keikha M, Kobyliak N, Khatib Zadeh Z, Yousefi B, Eslami M. Alleviation of halitosis by use of probiotics and their protective mechanisms in the oral cavity. New Microbes New Infect 2021; 42:100887. [PMID: 34123388 PMCID: PMC8173312 DOI: 10.1016/j.nmni.2021.100887] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 02/06/2023] Open
Abstract
Regarding the relation of halitosis with oral infections and its effects on social relations between humans, the present study investigated the positive effects of probiotics on prevention or treatment of halitosis. The causative agents of halitosis are volatile sulphur compounds (VSCs), and halitosis is divided into oral and non-oral types according to the source of the VSCs. H2S and CH3SH are two main halitosis metabolites-produced following the degradation of proteins by bacteria in the mouth-however, CH3SCH3 has a non-oral origin, and is a blood neutral molecule. Just as much as halitosis is important in medicine, its psychological aspects are also considered, which can even lead to suicide. Today, the use of probiotics as a new therapeutic in many roles is in progress. Most probiotics are used for the treatment of gastrointestinal tract disorders, but various studies on the alleviation of halitosis by use of probiotics have reported satisfactory results. The genera Lactobacillus, Streptococcus and Weissella are among the most useful probiotics for the prevention or treatment of halitosis in the oral cavity.
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Affiliation(s)
- M. Karbalaei
- Department of Microbiology and Virology, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran
| | - M. Keikha
- Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - N.M. Kobyliak
- Department of Endocrinology, Bogomolets National Medical University, Kyiv, Ukraine
| | - Z. Khatib Zadeh
- School of Dentistry, Semnan University of Medical Sciences, Semnan, Iran
| | - B. Yousefi
- Department of Immunology, Semnan University of Medical Sciences, Semnan, Iran
| | - M. Eslami
- Department of Bacteriology and Virology, Semnan University of Medical Sciences, Semnan, Iran
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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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38
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Foo LH, Balan P, Pang LM, Laine ML, Seneviratne CJ. Role of the oral microbiome, metabolic pathways, and novel diagnostic tools in intra-oral halitosis: a comprehensive update. Crit Rev Microbiol 2021; 47:359-375. [PMID: 33653206 DOI: 10.1080/1040841x.2021.1888867] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Halitosis or oral malodor is one of the most common reasons for the patients' visit to the dental clinic, ranking behind only dental caries and periodontitis. In the present times, where social and professional communications are becoming unavoidable, halitosis has become a concern of growing importance. Oral malodor mostly develops due to the putrefaction of substrates by the indigenous bacterial populations. Although culture-based studies have provided adequate information on halitosis, the high throughput omics technologies have amplified the resolution at which oral microbial community can be examined and has led to the detection of a broader range of taxa associated with intra-oral halitosis (IOH). These microorganisms are regulated by the interactions of their ecological processes. Thus to develop effective treatment strategies, it is important to understand the microbial basis of halitosis. In the current review, we provide an update on IOH in context to the role of the oral microbiome, metabolic pathways involved, and novel diagnostic tools, including breathomics. Understanding oral microbiota associated with halitosis from a broader ecological perspective can provide novel insights into one's oral and systemic health. Such information can pave the way for the emergence of diagnostic tools that can revolutionize the early detection of halitosis and various associated medical conditions.
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Affiliation(s)
- Lean Heong Foo
- Department of Restorative Dentistry, Periodontic Unit, National Dental Centre Singapore, Singapore, Singapore.,Oral Health ACP, Duke NUS Medical School, Singapore, Singapore
| | - Preethi Balan
- Oral Health ACP, Duke NUS Medical School, Singapore, Singapore.,Singapore Oral Microbiomics Initiative (SOMI), National Dental Research Institute Singapore (NDRIS), National Dental Centre Singapore, Singapore, Singapore
| | - Li Mei Pang
- Singapore Oral Microbiomics Initiative (SOMI), National Dental Research Institute Singapore (NDRIS), National Dental Centre Singapore, Singapore, Singapore
| | - Marja L Laine
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Chaminda Jayampath Seneviratne
- Oral Health ACP, Duke NUS Medical School, Singapore, Singapore.,Singapore Oral Microbiomics Initiative (SOMI), National Dental Research Institute Singapore (NDRIS), National Dental Centre Singapore, Singapore, Singapore
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39
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Alzoman H, Rashid Habib S, Alghamdi S, Al-Juhani H, Daabash R, Al-Khalid W, Al-Askar M, Al-Johany S. Relationship between Fixed Dental Crowns and Volatile Sulphur Compounds. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031283. [PMID: 33535384 PMCID: PMC7908311 DOI: 10.3390/ijerph18031283] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/18/2021] [Accepted: 01/25/2021] [Indexed: 11/16/2022]
Abstract
Objectives: The aim of this study was to investigate and compare the level of halitosis in patients with/without fixed crowns and in addition the influence of various crown parameters on halitosis was also explored. Methods: In total, 96 subjects (fixed crowns = 52; no crowns = 44) participated in the study. The levels volatile sulphur compounds (VSCs) of hydrogen sulphide (H2S), methyl mercaptan (CH3SH), and dimethyl sulphide (CH3SCH3) were evaluated with breath samples using gas chromatography and used for classification as presence or absence of halitosis. The periodontal clinical parameters for all the participants as well as the crown parameters for participants with fixed crowns were also evaluated. Cross tabulation, Chi-square test, and one-way analysis of variance tests were used for the statistical analysis and comparisons. Results: Breath samples revealed, 50 (52.1%) participants were suffering from halitosis. Out of VSCs, the level of CH3SCH3 (62.5%) was found to be the most prevalent. Significant correlations were observed between the presence of fixed crowns and oral halitosis (p < 0.001). Statistically significant difference in the concentration of H2S and CH3SH (p < 0.001) and no significance for CH3SCH3 (p = 0.075) between patients with/without fixed crowns was found. The presence of halitosis was more prevalent in the subjects with crown parameters (subgingival margin, over-contoured margin, open-crown margin, over-contoured and under-contoured crowns) considered clinically defective/unacceptable (p < 0.05). Conclusions: Presence of fixed dental crowns significantly contributes to the oral halitosis. Dental crowns with defects significantly impair the hygienic conditions and oral microflora resulting in high prevalence of halitosis.
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Affiliation(s)
- Hamad Alzoman
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
- Correspondence:
| | - Syed Rashid Habib
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.R.H.); (S.A.-J.)
| | - Sultan Alghamdi
- Internship Program, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.A.); (H.A.-J.); (R.D.); (W.A.-K.)
| | - Hebah Al-Juhani
- Internship Program, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.A.); (H.A.-J.); (R.D.); (W.A.-K.)
| | - Rawan Daabash
- Internship Program, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.A.); (H.A.-J.); (R.D.); (W.A.-K.)
| | - Wijdan Al-Khalid
- Internship Program, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.A.); (H.A.-J.); (R.D.); (W.A.-K.)
| | - Mansour Al-Askar
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia;
| | - Sulieman Al-Johany
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh 11545, Saudi Arabia; (S.R.H.); (S.A.-J.)
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40
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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.
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41
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Wylleman A, Vuylsteke F, Dekeyser C, Teughels W, Quirynen M, Laleman I. Alternative therapies in controlling oral malodour: a systematic review. J Breath Res 2021; 15. [PMID: 33227726 DOI: 10.1088/1752-7163/abcd2b] [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: 07/01/2020] [Accepted: 11/23/2020] [Indexed: 11/12/2022]
Abstract
Is there a role for alternative therapies in controlling intra-oral halitosis? Treatments other than tongue cleaning and anti-halitosis products containing zinc, chlorhexidine and cetylpyridinium chloride were considered as alternative therapies. Four databases were searched (PubMed, EMBASE, Web of Science and The Cochrane Library). Inclusion criteria were: examination of alternative halitosis therapies, study population with oral malodour, a (negative or positive) control group and evaluation of breath odour via organoleptic and/or instrumental assessment. Data were extracted for descriptive analysis. The screening of 7656 titles led to the inclusion of 26 articles. Analysis showed heterogeneity concerning the population of interest (from cysteine-induced to genuine halitosis), the examined treatment and the reported outcomes. This made a meta-analysis impossible. Essential oils, fluoride-containing products and herbal substances were the most studied. Results varied enormously and none of the active ingredients had an unambiguously positive effect on the malodour. The risk of bias was assessed as high in all articles. Given the fact that little evidence was found for each of the investigated treatments, it could be concluded that there is currently insufficient evidence that alternative therapies are of added value in the treatment of halitosis.Clinical relevanceScientific rationale:Halitosis is a common problem causing social isolation. Out of embarrassment, patients search the internet, leading to many questions about alternative solutions (e.g. oil pulling, herbs). This is the first systematic review on these alternative therapies.Principal findings: Results varied among studies. Some promising results were found for fluoride-containing toothpastes and probiotics. For other products (such as herbal and antibacterial products and essential oils) results were inconsistent. Long-term follow-up studies on these products are scarce. Moreover, the quality of the studies was poor.Practical implications:No clear evidence was found to support a certain alternative anti-halitosis therapy.
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Affiliation(s)
- A Wylleman
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, Leuven 3000, Belgium.,Equally contributing first authors.,Author to whom any correspondence should be addressed
| | - F Vuylsteke
- KU, Leuven, Belgium.,Equally contributing first authors
| | - C Dekeyser
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, Leuven 3000, Belgium
| | - W Teughels
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, Leuven 3000, Belgium
| | - M Quirynen
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, Leuven 3000, Belgium
| | - I Laleman
- Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, Leuven 3000, Belgium
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Moghadam ET, Yazdanian M, Tahmasebi E, Tebyanian H, Ranjbar R, Yazdanian A, Seifalian A, Tafazoli A. Current herbal medicine as an alternative treatment in dentistry: In vitro, in vivo and clinical studies. Eur J Pharmacol 2020; 889:173665. [PMID: 33098834 DOI: 10.1016/j.ejphar.2020.173665] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/16/2020] [Accepted: 10/21/2020] [Indexed: 12/29/2022]
Abstract
Since the time that human population comprehended the importance of general health maintenance and the burden of disease, there has been a search for healing properties in the natural environment. Herbal medicine is the use of plants with medical properties for prevention and treatment of conditions that can affect general health. Recently, a growing interest has been observed toward the use of traditional herbal medicine alongside synthetic modern drugs. Around 80% of the population, especially in developing countries relies on it for healthcare. Oral healthcare is considered a major part of general health. According to the world health organization (WHO), oral health is considered an important part of general health and quality of life. The utilization of natural medications for the management of pathologic oro-dental conditions can be a logical alternative to pharmaceutical methods due to their availability, low costs, and lower side effects. The current literature review aimed at exploration of the variety and extent of herbal products application in oral health maintenance including different fields of oral healthcare such as dental caries, periodontal maintenance, microbial infections, oral cancers, and inflammatory conditions.
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Affiliation(s)
- Ehsan Tafazoli Moghadam
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Elahe Tahmasebi
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Hamid Tebyanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Reza Ranjbar
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Alireza Yazdanian
- Department of Veterinary, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Alexander Seifalian
- Nanotechnology and Regenerative Medicine Commercialization Centre (NanoRegMed Ltd), The London Bioscience Innovation Centre, London, United Kingdom
| | - Ali Tafazoli
- Clinical Pharmacy Department, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Alade O, Ajoloko E, Dedeke A, Uti O, Sofola O. Self-reported halitosis and oral health related quality of life in adolescent students from a suburban community in Nigeria. Afr Health Sci 2020; 20:2044-2049. [PMID: 34394270 PMCID: PMC8351855 DOI: 10.4314/ahs.v20i4.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Halitosis is an important cause of impaired quality of life in adolescents. Little is known about the prevalence of self-reported halitosis in adolescents in Nigeria and the extent to which self-reported halitosis impairs their oral health related quality of life. Objectives To determine the prevalence and impact of self-reported halitosis on the oral health related quality of life of adolescent students in a suburban community in Nigeria. Methods An analytical cross-sectional study. Pre-tested self-administered pro-forma was used to obtain the adolescents' demographic data and their self-perception of halitosis. The Oral Health Impact Profile (OHIP-14) was used to assess the adolescents' OHRQoL. The Mann-Whitney U test was used to compare the median OHIP-14 scores between adolescents who reported halitosis and those who did not. The level of significance was set at p < 0.05. Ethics approval for this study was obtained from the Health Research and Ethics Committee of the Lagos University Teaching Hospital. Results A total of 361 adolescents aged 10 – 19 years (mean age 14.1 ± 1.79 years) took part in the study. Of these, 32.7% (n=118) had self-reported halitosis. The median OHIP-14 score among adolescents with self-reported halitosis was 3 (0–9) while those who did not report halitosis had a median OHIP-14 score of 0 (0 – 5). This difference was statistically significant (p < 0.0001). Conclusion Self-reported halitosis significantly impaired the oral health related quality of life of the adolescents.
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Affiliation(s)
- Omolola Alade
- Obafemi Awolowo University, Department of Preventive and Community Dentistry
| | - Ebenezer Ajoloko
- Lagos University Teaching Hospital, Department of Oral & Maxillofacial Surgery
| | - Aderonke Dedeke
- University of Lagos College of Medicine, Department of Preventive Dentistry
| | - Omolara Uti
- University of Lagos College of Medicine, Department of Preventive Dentistry
| | - Oyinkansola Sofola
- University of Lagos College of Medicine, Department of Preventive Dentistry
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Antimicrobial capacity of photodynamic therapy on oral health-related quality of life and halitosis among elderly patients wearing removal dentures. Photodiagnosis Photodyn Ther 2020; 32:102059. [PMID: 33065302 DOI: 10.1016/j.pdpdt.2020.102059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/05/2020] [Accepted: 10/05/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE The aim of the present clinical trial was to evaluate the efficacy of antimicrobial photodynamic therapy (PDT) for the treatment of halitosis in elderly patients wearing dentures. METHODS Elderly patients (>60 years age) wearing complete dentures and diagnosed with halitosis (H2S levels >112 ppb) were divided into two groups: patients undergoing treatment with tongue scraper and full mouth disinfection (Group I) and patients undergoing treatment with tongue scraper, full mouth disinfection and single application of PDT (Group II). Oral health related quality of life (OHRQoL) was assessed using a 14-point Likert scale used in oral health impact profile (OHIP). The assessment of halitosis was done with the help of a device called Oral Chroma™. Microbial sampling for detection of Porphyromonas gingivalis (P. gingivalis) was performed from the dorsum of the tongue using a sterile swab at baseline and after treatment on day 5, 15 and 30 and quantified using polymerase chain reaction. RESULTS Forty elderly patients with halitosis completed the trial. The mean age in Group I and Group II was estimated to be 66.42 years and 67.91 years, respectively. Group II participants also maintained good OHRQoL in the post-operative period that reported statistically significant difference when compared with the control group (p < 0.01). Group II showed significant improvement in H2S concentration values at final analysis compared to Group-I (p = 0.001). P. gingivalis showed statistically significant reduction on day 5 only with PDT in Group II (p < 0.05). CONCLUSION Antimicrobial PDT helped in reducing H2S gas concentration and improving quality of life in elderly patients wearing dentures. A significant reduction of P. gingivalis occurred only in the short-term follow-up.
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Romero SS, do Vale KL, Remolina VG, Silva TG, Schalch TO, Ramalho KM, Negreiros RM, Ando ES, Mayer MPA, Mesquita Ferrari RA, Motta LJ, Fernandes KPS, Bussadori SK, Horliana ACRT. Oral hygiene associated with antimicrobial photodynamic therapy or lingual scraper in the reduction of halitosis after 90 days follow up: A randomized, controlled, single-blinded trial. Photodiagnosis Photodyn Ther 2020; 33:102057. [PMID: 33238198 DOI: 10.1016/j.pdpdt.2020.102057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 09/27/2020] [Accepted: 10/02/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Although antimicrobial photodynamic therapy (aPDT) can reduce halitosis immediately after application, it returns after a week. This probably occurs because bacteria residing in the oral cavity may recolonize the dorsum of the tongue. OBJECTIVE Verify if modification of oral hygiene behavior associated with aPDT or lingual scraper can reduce halitosis after a 90-day follow-up. METHODS Forty adults with positive halitosis were randomized in G1 (n = 20) -aPDT + oral hygiene behavior (OHB) or G2 (n = 20)- lingual scraper + OHB. G1 group were submitted to 0.005 % methylene blue in the middle and posterior third of the tongue, with pre-irradiation of 1 min. Irradiations were performed with red laser diode (λ =660 nm), 100 mW, 318 J/cm2, 3537 mW/cm2, 9 J per point at 6 points. In the G2 group, the tongue was scraped 10 times on the right side and on the left side with a tongue scraper. All patients were instructed on OHB at baseline, 7 and 90 days (guidance on the use of dental floss and the Bass technique for brushing). Halitosis was evaluated by gas chromatography (OralChroma®). Values > 112 ppb for Hydrogen sulfide (H2S) gas was considered positive halitosis. Methylmercaptanes and dimethylsulfide were also measured. The gas measures were assessed at baseline, immediately, and at 7 and 90 days. Paired t-test was used for the statistical analysis. For comparison between groups, the t-test was used. Values of p < 0.05 were considered statistically significant. RESULTS There was no difference between groups immediately after treatment (p = .1532) after 7 days (p = 0.9312) and 90 days (p = 0.6642). For the aPDT group, there was a decrease in hydrogen sulfide immediately after treatment (p = 0.0001), after 7 days, values remained 3-fold smaller (p = 0.0088) and 2-fold smaller after 90 days (p = 0.0270). For the scraper group, there was a decrease immediately after treatment (p = 0.0001), the values remains 2-fold smaller (p = 0.0003) after 7 days and 3 months (p = 0.0001). CONCLUSION The oral hygiene behavior associated with aPDT or tongue scraper was not able to reduce halitosis after 90-day follow-up. Despite halitosis remaining higher than 112 ppb in all follow-up periods, the mean values remain 2 or 3 fold smaller than baseline values. Future studies should include other oral hygiene behavior to achieve better results in the treatment of halitosis.
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Affiliation(s)
- Sergio Santos Romero
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil.
| | - Katia Llanos do Vale
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil.
| | - Vanessa Gomes Remolina
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil.
| | - Thayná Gomes Silva
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil.
| | - Tânia Oppido Schalch
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil.
| | | | - Renata Matalon Negreiros
- Specialization in Oral Maxillofacial Surgery and Traumatology at Fundecto - FFO, School of Dentistry - FOUSP, University of São Paulo, São Paulo, Brazil.
| | - Ellen Sayuri Ando
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
| | - Marcia Pinto Alves Mayer
- Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil.
| | - Raquel Agnelli Mesquita Ferrari
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil.
| | - Lara Jansiski Motta
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil.
| | | | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil.
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Do KY. Relationship between Insufficient Sleep and Bad Breath in Korean Adolescent Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197230. [PMID: 33023266 PMCID: PMC7579004 DOI: 10.3390/ijerph17197230] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/22/2020] [Accepted: 09/30/2020] [Indexed: 06/11/2023]
Abstract
This cross-sectional study sought to evaluate the association between insufficient sleep and bad breath among Korean adolescent population. It was based on the 13th Korea Youth Risk Behavior Web-Based Survey (2017). From 64,991 participants (aged 13-18 years), the final participation rate in the survey was 95.8% (62,276 participants; 31,624 boys and 30,652 girls). A complex sample logistic regression was performed to identify the relationship between insufficient sleep and halitosis, after adjusting for all covariates. In Model II for estimating the adjusted odds ratio (AOR) for general characteristics, students who answered "not at all sufficient", indicating insufficient sleep, were at higher risk of bad breath than those who answered "completely sufficient" (AOR = 2.09, 95% confidence interval, CI = 1.91-2.30). In Model III, for estimating the AOR adjusted for all covariates, students who answered "not at all sufficient", indicating insufficient sleep, were at higher risk of bad breath than those who answered "completely sufficient" (AOR = 1.47, 95% CI = 1.33-1.83). It is necessary for families and schools to have health education lessons that recognize insufficient sleep among adolescents may be a cause of bad breath and therefore optimal sleeping habits and oral health behaviors should be promoted.
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Affiliation(s)
- Kyung-Yi Do
- Department of Dental Hygiene, Hanseo University, 46 Hanseo 1-ro, Haemi-Myun Seosan-si, Chungcheognam-do 31962, Korea
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Javed F. Halitosis and photodynamic therapy. Photodiagnosis Photodyn Ther 2020; 32:102006. [PMID: 32950729 DOI: 10.1016/j.pdpdt.2020.102006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 09/08/2020] [Indexed: 01/29/2023]
Affiliation(s)
- Fawad Javed
- Division of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, NY, United States.
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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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Romano F, Pigella E, Guzzi N, Manavella V, Campanelli L, Aimetti M. Etiology and characteristics of halitosis in patients of a halitosis center in Northern Italy. ACTA ACUST UNITED AC 2020; 69:174-182. [PMID: 32610725 DOI: 10.23736/s0026-4970.19.04186-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND As there are few studies in Europe describing characteristics of breath malodor for large groups of patients, this retrospective study was designed to analyse the etiology of halitosis among patients attending a breath malodor center in Northern Italy. METHODS Clinical records of 547 consecutive patients were reviewed and data on self-perceived halitosis, organoleptic scores, volatile sulphur compound (VSC) levels, and oral health condition were extracted and analysed. RESULTS The prevalence of intra-oral halitosis was 90.7%. In 21 patients no objective signs of breath malodor could be found. Periodontitis and gingivitis were the main cause of bad breath in 33.9% of subjects and in combination with tongue coating in 55.2%. Only eight subjects have tongue coating as the only cause of halitosis. Ear, nose and throat (ENT)/extra-oral causes were found in 5.2% of the patients. VSC concentrations were lower in the psychogenic halitosis group, whereas no statistically significant differences were detected when comparing intra-oral and extra-oral halitosis except for (CH3)2S. CONCLUSIONS Psychogenic halitosis is a rare condition among subjects complaining of suffering from bad breath. The most prevalent cause of halitosis is intra-oral, in particular a combination of tongue coating and periodontal disease. Tongue coating is rarely the primary cause of oral malodor.
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Affiliation(s)
- Federica Romano
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy -
| | - Enrico Pigella
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Nicoletta Guzzi
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Valeria Manavella
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Lorena Campanelli
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
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Microbiota and Malodor-Etiology and Management. Int J Mol Sci 2020; 21:ijms21082886. [PMID: 32326126 PMCID: PMC7215946 DOI: 10.3390/ijms21082886] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 02/06/2023] Open
Abstract
Accumulating evidence indicates that microbiota plays a critical role in physiological processes in humans. However, it might also contribute to body malodor by producing numerous odorous molecules such as ammonia, volatile sulfur compounds or trimethylamine. Although malodor is commonly overlooked by physicians, it constitutes a major problem for many otherwise healthy people. Thus, this review aims to investigate most common causes of malodor and describe potential therapeutic options. We searched PUBMED and Google Scholar databases to identify the clinical and pre-clinical studies on bad body smell, malodor, halitosis and microbiota. Unpleasant smell might originate from the mouth, skin, urine or reproductive fluids and is usually caused by odorants that are produced by resident bacterial flora. The accumulation of odorous compounds might result from diet, specific composition of microbiota, as well as compromised function of the liver, intestines and kidneys. Evidence-based guidelines for management of body malodor are lacking and no universal treatment exists. However, the alleviation of the symptoms may be achieved by controlling the diet and physical elimination of bacteria and/or accumulated odorants.
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