Effect of visible light on malodour production by mixed oral microflora

Association of Graphene Silver Polymethyl Methacrylate (PMMA) with Photodynamic Therapy for Inactivation of Halitosis Responsible Bacteria in Denture Wearers

(1) Background: Poor hygiene and denture presence in the oral cavity are factors that favor bacterial accumulation, the cause of halitosis and of various oral and general diseases. Aim: This study aimed to evaluate the possibility of inactivating bacteria associated with halitosis in acrylic denture wearers using polymethyl methacrylate resin enhanced with graphene silver nanoparticles and the effect of the resin association with extra oral photodynamic therapy. (2) Methods: Graphene silver nanoparticles in 1 and 2 wt% were added to a commercial acrylic resin powder. Three study groups containing samples from the three different materials were established. The first group was not exposed to the light treatment, and the other two were exposed to red light (laser and light emitting diode) after photosensitizer placement on the disk’s surface. Samples were incubated with Porphyromonas gingivalis and Enterococcus faecalis. (3) Results: For both bacterial strains, inhibition zones were obtained, showing significant differences for the light-treated samples. (4) Conclusions: Denture resins with antibacterial properties associated with extra oral photodynamic therapy exhibited enhanced antibacterial effects. The procedure could be used as a safer and more efficient alternative technique against halitosis and oral infections in denture wearers.

Effect of Sublethal Blue Light on Herbal Extract Activity Against Volatile Sulfide Compound Production by Fusobacterium nucleatum

Previously, we have shown that sublethal exposure of blue light caused increased cell membrane permeability in Fusobacterium nucleatum. The aim of the present study was to test the effect of this exposure on the activity of Lavender, Sage, Echinacea and Mastic gum extracts against volatile sulfide compound (VSC) production by Fusobacterium nucleatum. Bacterial suspensions were pre-exposed to blue light (400-500 nm) bellow minimal inhibitory dosage (sub-MID). Exposed and nonexposed samples were inoculated into test tubes containing growth medium, filtered saliva with or without herbal extracts. Following incubation, test tubes were tested for malodor production (odor judge scores), VSC levels (OralChroma), salivary protein degradation (SDS-PAGE) and bacterial cell membrane damage (fluorescence microscopy). Results showed that sub-MID blue light exposure significantly increased the ability of Lavender and Echinacea to reduce VSC production by Fusobacterium nucleatum by more than 30%. These results suggest that sublethal blue light exposure may be useful to increase the efficacy of antimalodor agents.

Exposure of Streptococcus mutans and Streptococcus sanguinis to blue light in an oral biofilm model

The potential anti-cariogenic effect of blue light was evaluated using an oral biofilm model. Two species, Streptococcus mutans and Streptococcus sanguinis, were cultivated ex vivo on bovine enamel blocks for 24 h, either separately or mixed together, then exposed to blue light (wavelengths 400-500 nm) using 112 J/cm². Twenty four or 48 h after exposure to light the biofilm structure and biomass were characterized and quantified using SEM and qPCR, respectively. Bacterial viability was analyzed by CLSM using live/dead bacterial staining. Gene expression was examined by RT-qPCR. After exposure to light, S. mutans biomass in mono-species biofilm was increased mainly by dead bacteria, relative to control. However, the bacterial biomass of S. mutans when grown in mixed biofilm and of S. sanguinis in mono-species biofilm was reduced after light exposure, with no significant change in viability when compared to control. Furthermore, when grown separately, an upregulation of gene expression related to biofilm formation of S. mutans, and downregulation of similar genes of S. sanguinis, were measured 24 h after exposure to blue light. However, in mixed biofilm, a downregulation of those genes in both species was observed, although not significant in S. mutans. In conclusion, blue light seems to effectively alter the bacterial biomass by reducing the viability and virulence characteristics in both bacterial species and may promote the anti-cariogenic balance between them, when grown in a mixed biofilm. Therefore, exposure of oral biofilm to blue light has the potential to serve as a complementary approach in preventive dentistry.

Remediation of adult black dental stains by phototherapy

Introduction and aims

This study investigates the effects of the application of antimicrobial phototherapy on black-stained tooth surfaces. Key variables were area, color and time taken to reappearance of black stain following dental prophylaxis with and without antimicrobial phototherapy. Differences in bacterial composition of black stain (specifically Aggregatibacter actinomycetemcomitans, Tannerella forsythia, and Porphyromonas gingivalis) were analyzed.

Material and methods

The phototherapy device used was GLO™ Science LLC, New York, America, emitting light at 475 nm and a power of 3 W. Light was applied in 2 cycles of 8 min on 31 volunteers. Microbial identification was carried out on DNA extracted from black plaque. This study is registered with ClinicalTrials.gov, number NCT03309748.

Results

Following antimicrobial phototherapy, 64.5% of patients displayed reduced pigmentation area. Plaque color was lighter in 48.4% of subjects. Pigmentation area and depth of color returned to normal levels during the course of the study. Colonization by the three bacterial species decreased, although the changes were not statistically significant. We report a key novel finding showing elevated levels of colonization by Tannerella forsythia (83.9%) in adult black stain.

Conclusions

Application of phototherapy results in a reduction in area, color and bacterial colonization of black plaque in adults. The changes were not found to be statistically significant, perhaps owing to the low illumination power of the home-whitening device. For the first time, we document the elevated presence of Tannerella forsythia in adult black stain. We also demonstrate the potential application of a commercially available home-whitening device for black plaque treatment.

In vitro effectiveness of 455-nm blue LED to reduce the load of Staphylococcus aureus and Candida albicans biofilms in compact bone tissue

The aim of this study was to evaluate the effectiveness of a 455-nm blue light-emitting diode (LED), at different application times, to reduce the load of Staphylococcus aureus and Candida albicans biofilms applied to compact bone tissue. The microorganisms S. aureus (ATCC 25923) and C. albicans (ATCC 18804) were used to form biofilms on 160 specimens of compact bones that had been divided into eight experimental groups (n = 10) for each microorganism, according to the times of application of the 455-nm blue LED (1, 2, 3, 4, 5, 7, and 10 min) with an irradiance of 75 mW/cm2. After LED application, decimal dilutions of microorganisms were performed, plated on BHI or Sabouraud agar and incubated for 24 h/35 °C to obtain CFU/mL counts. The findings were statistically analyzed using a ANOVA 5 %. For the group of S. aureus biofilms, all groups of 455-nm LED application differ compared with the control group (p < 0.05), in which no treatment was given. The largest reduction was obtained in the group receiving LED for 10 min (p = 0.00); within this group, a 3.2 log reduction was observed. For the C. albicans biofilms, only those samples receiving 3, 7, and 10 min of LED application presented a significant difference compared with the control group (p < 0.00), indicating that longer application times are required to achieve efficacy. The results of this study show that 455-nm LED light was effective to reduce the load of S. aureus and C. albicans biofilms, especially during 10 min of application.

Zinc enhances the phototoxic effect of blue light against malodour-producing bacteria in an experimental oral biofilm

Oral malodour is thought to be caused mainly by the production of volatile sulfide compounds (VSCs) by anaerobic Gram-negative oral bacteria. Previous studies have shown that these bacteria are susceptible to blue light (400-500 nm wavelength). In the present study, we tested the effect of blue light in the presence of zinc, erythrosine B or both on malodour production in an experimental oral biofilm. Biofilms were exposed to a plasma-arc light source for 30, 60 and 120 s (equal to energy fluxes of 41, 82 and 164 J cm(-2), respectively) with or without the addition of zinc acetate, erythrosine B or both. After the light exposure, biofilm samples were examined for malodour production (by an odour judge) and VSC production (with a Halimeter), and VSC-producing bacteria were quantified using a microscopy-based sulfide assay (MSA) and in situ confocal laser scanning microscopy (CLSM). Results showed that exposing experimental oral biofilm to both blue light and zinc reduced malodour production, which coincided with a reduction in VSC-producing bacteria in the biofilm. These results suggest that zinc enhances the phototoxicity of blue light against malodour-producing bacteria.

Effect of a variety of Chinese herbs and an herb-containing dentifrice on volatile sulfur compounds associated with halitosis: An in vitro analysis

BACKGROUND

The principal components of halitosis are volatile sulfur compounds (VSCs) such as hydrogen sulfide, methyl mercaptan, and dimethylsulfide or compounds such as butyric acid, propionic acid, putrescine, and cadaverine.

OBJECTIVE

The aim of this study was to evaluate the effect of Chinese herbs on VSCs in vitro.

METHODS

Saliva samples from volunteers were used as the source for the evaluation of bacterial activity and VSC inhibition. Extracted substances from Chinese herbs were identified by VSC inhibition tests with a Halimeter and microbial sensitivity testing. The effectiveness on halitosis was compared between a dentifrice containing one of the effective Chinese herbs (ie, chrysanthemum flower [Chrysanthemum morifolium flos]), 4 commercially available antihalitosis dentifrices, and a positive control that received no treatment.

RESULTS

Ten volunteers provided saliva samples for VSC testing. Of the 40 herbs tested, 14 extracts had percent inhibition rates of VSCs >50%. Ten herbs showed greatest effect against all culturable microorganisms with bacterial inhibition >70%. There was a weak positive correlation between bacteriostasis and the anti-VSC activity of the herbs with a correlation coefficient of 0.2579 (Pearson). The mean (SD) values of the VSC testing were as follows: dentifrice containing chrysanthemum flower, 55.91 (8.16) ppb; Crest Tea Refreshing Dentifrice®, 48.39 (7.48) ppb (P = NS); Cortex Phellodendri Dentifrice®, 139.90 (14.70) ppb (P < 0.01); Colgate Total Plus Whitening®, 120.94 (15.58) ppb (P < 0.01); Zhong Hua Chinese Herbs Dentifrice®, 136.96 (13.06) ppb (P < 0.01); and positive control, 312.38 (28.58) ppb (P < 0.01).

CONCLUSIONS

Of 40 herbs tested, 14 Chinese herbs were found to be effective for VSC inhibition. A dentifrice containing chrysanthemum flower reduced the formation of VSC in vitro, showing a significantly greater effect than the control group and 3 of 4 dentifrices already on the market.

Phototargeting human periodontal pathogens in vivo

The effects of blue light at 455 nm were investigated on the bacterial composition of human dental plaque in vivo. Eleven subjects who refrained from brushing for 3 days before and during phototherapy participated in the study. Light with a power density of 70 mW/cm(2) was applied to the buccal surfaces of premolar and molar teeth on one side of the mouth twice daily for 2 min over a period of 4 days. Dental plaque was harvested at baseline and again at the end of 4 days from eight posterior teeth on both the exposed side and unexposed sides of the mouth. Microbiological changes were monitored by checkerboard DNA probe analysis of 40 periodontal bacteria. The proportions of black-pigmented species Porphyromonas gingivalis and Prevotella intermedia were significantly reduced on the exposed side from their original proportions by 25 and 56 %, respectively, while no change was observed to the unexposed side. Five other species showed the greatest proportional reduction of the light-exposed side relative to the unexposed side. These species were Streptococcus intermedius, Fusobacterium nucleatum ss. vincentii, Fusobacterium nucleatum ss. polymorphum, Fusobacterium periodonticum, and Capnocytophaga sputigena. At the same time, the percentage of gingival areas scored as being red decreased on the side exposed to light from 48 to 42 %, whereas the percentage scored as red increased on the unexposed side from 53 to 56 %. No adverse effects were found or reported in this study. The present study proposes a new method to modify the ecosystem in dental plaque by phototherapy and introduces a new avenue of prophylactic treatment for periodontal diseases.

Oral Malodour and its Management: A Periodontal Perspective

Halitosis is a very common condition which may affect up to 30% of the population. In most cases the aetiology of the condition is from local oral causes (oral malodour). Oral malodour is the result of the action of anaerobic bacteria in producing a range of malodorous molecular species including volatile sulphur compounds. Patients with halitosis may seek treatment from dental clinicians for their perceived oral malodour. Physiologic halitosis, oral pathologic halitosis and pseudo-halitosis would be in the treatment realm of dental practitioners. Management of oral malodour is directed at managing and reducing the bacterial load both in periodontitis and in tongue coatings by instituting proper oral hygiene measures, control of tongue flora by brushing or scraping, and possibly the adjunctive use of antiseptic agents. Treatments have also been proposed to neutralise malodorous compounds by chemical agents to mask the presence of the condition. Further evidence is required to demonstrate the long-term efficacy of therapies for this troublesome condition. The purpose of this article is to review the etiology, diagnosis and treatment of oral malodor from a periodontal perspective. The review will be limited to bad breath odors originating within the mouth.

Effect of green tea on volatile sulfur compounds in mouth air

Many food products are claimed to be effective in controlling halitosis. Halitosis is caused mainly by volatile sulfur compounds (VSCs) such as H(2)S and CH(3)SH produced in the oral cavity. Oral microorganisms degrade proteinaceous substrates to cysteine and methionine, which are then converted to VSCs. Most treatments for halitosis focus on controlling the number of microorganisms in the oral cavity. Since tea polyphenols have been shown to have antimicrobial and deodorant effects, we have investigated whether green tea powder reduces VSCs in mouth air, and compared its effectiveness with that of other foods which are claimed to control halitosis. Immediately after administering the products, green tea showed the largest reduction in concentration of both H(2)S and CH(3)SH gases, especially CH(3)SH which also demonstrated a better correlation with odor strength than H(2)S; however, no reduction was observed at 1, 2 and 3 h after administration. Chewing gum, mints and parsley-seed oil product did not reduce the concentration of VSCs in mouth air at any time. Toothpaste, mints and green tea strongly inhibited VSCs production in a saliva-putrefaction system, but chewing gum and parsley-seed oil product could not inhibit saliva putrefaction. Toothpaste and green tea also demonstrated strong deodorant activities in vitro, but no significant deodorant activity of mints, chewing gum or parsley-seed oil product were observed. We concluded that green tea was very effective in reducing oral malodor temporarily because of its disinfectant and deodorant activities, whereas other foods were not effective.

Specific-wavelength visible light irradiation inhibits bacterial growth of Porphyromonas gingivalis

BACKGROUND AND OBJECTIVE

The effects of laser irradiation on Porphyromonas gingivalis have been reported, but the results are still controversial regarding the efficiency because of the differences of the light sources and irradiation conditions. The aim of this study was to determine the wavelength and irradiation conditions under which the most effective inhibitory effect on P. gingivalis growth was seen without any photosensitizers.

MATERIAL AND METHODS

Using an Okazaki large spectrograph, monochromatic light spectra ranging from 400 to 700 nm were evaluated to determine which spectra effectively inhibited bacterial growth. Moreover, using a monochromatic 405-nm irradiating device, the effects of various irradiating conditions on P. gingivalis growth were examined.

RESULTS

Growth of bacteria irradiated at 400 nm and 410 nm was significantly suppressed compared with a nonirradiated control, whereas wavelengths of 430 nm and longer produced no significant inhibition. A constant energy density of 15 J/cm2 was found to be enough to show an inhibitory effect. Significant inhibition of bacterial growth was found after only 1 min at 50 mW/cm2 irradiation.

CONCLUSION

These results indicate that P. gingivalis growth is specifically suppressed by 405-nm light irradiation, suggesting that visible blue light irradiation is a promising means for eradicating periodontopathogenic bacteria from periodontal lesions.