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Szalai E, Tajti P, Szabó B, Kói T, Hegyi P, Czumbel LM, Varga G, Kerémi B. ORGANOLEPTIC AND HALITOMETRIC ASSESSMENTS DO NOT CORRELATE WELL IN INTRA-ORAL HALITOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2023; 23:101862. [PMID: 37689445 DOI: 10.1016/j.jebdp.2023.101862] [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: 10/18/2022] [Revised: 03/12/2023] [Accepted: 03/25/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND The gold standard method for diagnosing oral halitosis is the subjective organoleptic measurement. Device-supported methods are also widespread worldwide. The challenges and safety concerns around performing organoleptic measurements during pandemics and the diversity of measuring device alternatives raised our clinical question: which halitometer is the most suitable for diagnosing halitosis? METHODS This systematic review was registered in PROSPERO (ID CRD42022320024). The search was performed on March 23, 2022 in the following electronic databases: MEDLINE, Embase, Scopus, Web of Science, and CENTRAL. Adult populations with or without halitosis were included, and patients with systemic diseases were excluded. Organoleptic (subjective) measurement and the device-supported (objective) methods were compared; the primary outcome was the correlation coefficient, and the secondary was the specificity and sensitivity of the devices. QUADAS-2 and QUADAS-C were used to evaluate the risk of bias in the studies. Random-effects meta analyses were performed on the outcomes, and the secondary outcomes were plotted on a common ROC plot. RESULTS A total of 1231 records were found in the 5 databases. After the selection process, 76 articles were eligible for the systematic review, and 14,635 patients were involved in the qualitative analysis. The pooled Spearman's correlation coefficient (c.c.) for sulfide monitors was 0.65; 95% CIs: [0.53-0.74]; I2 = 95%, P < .01. The pooled Spearman's c.c. for portable gas chromatographs was 0.69; 95% CIs: [0.63-0.74]; I2 = 12%, P < .01. The pooled Spearman's c.c. for gas chromatographs was 0.76; 95% CIs: [0.67-0.83]; I2 = 0%, P < .01. DISCUSSION None of the most commonly used halitometers proved to be significantly superior to the others. Halimeter and OralChroma measurements did not correlate well with the organoleptic level of oral halitosis in adults. Therefore, better halitometers need to be developed as an alternative to organoleptic measurements.
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Affiliation(s)
- Eszter Szalai
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Tajti
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Tamás Kói
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Stochastics, Institute of Mathematics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - László Márk Czumbel
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Oral Biology, 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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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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Memon MA, Memon HA, Faizan-E-Muhammad, Fahad S, Siddiqui A, Lee KY, Tahir MJ, Yousaf Z. The aetiology and associations of halitosis: a systematic review. Oral Dis 2022; 29:1432-1438. [PMID: 35212093 DOI: 10.1111/odi.14172] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 02/15/2022] [Accepted: 02/19/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Halitosis is a term that refers to an unpleasant or foul odour originating from the oral cavity that can be caused by either intra-oral or extra-oral factors. Despite the fact that halitosis has multifactorial aetiology, intra-oral factors play a significant role in the majority of cases. AIM This systematic review assesses halitosis's intra-oral and extra-oral associations. METHODS An electronic search through MEDLINE (PubMed), Google Scholar, and the Wiley Online Library was conducted to identify relevant manuscripts. A keywords-based search was performed, using the terms "halitosis," "bad-breath," and "oral malodour causes and aetiology." Articles published from January 2014 to December 2020 were included. We selected studies evaluating the intra-oral and extra-oral factors that induce oral malodour, as well as the factors associated with systemic diseases. RESULTS Eighty to ninety percent of halitosis is caused by intra-oral factors, with coated tongue, periodontal diseases, and poor oral hygiene practices being the principal factors. Ten to twenty percent of halitosis is induced by extra-oral factors associated with systemic diseases. CONCLUSIONS Multiple factors can cause halitosis, but most of the aetiology is intra-oral. Increased medical awareness is needed to determine the actual pathophysiological process of oral malodour in otherwise healthy individuals.
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Affiliation(s)
| | - Hifza Anwer Memon
- Dow University of Health Sciences, Ul Ebad Institute of Oral Health Sciences, Dr. Ishrat, Karachi, Pakistan
| | | | | | - Amna Siddiqui
- Karachi Medical and Dental College, Karachi, Pakistan
| | - Ka Yiu Lee
- Swedish Winter Sports Research Centre, Department of Health Sciences, Mid Sweden University, Sweden
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Efficacy of a Zinc Lactate Mouthwash and Tongue Scraping in the Reduction of Intra-Oral Halitosis: A Single-blind, Controlled, Crossover Clinical Trial-A Pilot Study. J Clin Med 2021; 10:jcm10235532. [PMID: 34884234 PMCID: PMC8658071 DOI: 10.3390/jcm10235532] [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] [Received: 10/30/2021] [Revised: 11/22/2021] [Accepted: 11/25/2021] [Indexed: 11/17/2022] Open
Abstract
Intra-oral halitosis is defined as an unpleasant odor that comes out of the mouth. The aim of this study was to investigate the effect of zinc lactate mouthwash and tongue scraping on intra-oral halitosis. The study was conducted on 60 volunteers that were divided into two groups and fol-lowed two types of 14-day oral hygiene protocols on a cross-over basis after a 7-day wash-out period. One protocol was based on tooth brushing only, while the other was based on additional mouth rinsing with a zinc lactate product and tongue scraping. Morning mouth breath was as-sessed organoleptic and by volatile sulfur compound concentrations. The highest mean organo-leptic and volatile sulfur compound measurement values were found in the tooth brushing without mouth washing and tongue scraping oral hygiene protocol (p < 0.05). The zinc lactate mouthwash combined with tongue scraping appears to be an important hygienic procedure to reduce breath odor.
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Takaesu Y, Suzuki N, Naito M, Watanabe T, Shimazu A, Yatabe N, Yoneda M, Hirofuji T, Hanioka T. Novel oral biomarkers predicting oral malodor. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:667-674. [PMID: 33077409 DOI: 10.1016/j.oooo.2020.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/31/2020] [Accepted: 09/09/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We sought new markers to predict oral malodor. STUDY DESIGN Seventy-five adults complaining of oral malodor were classified into 3 groups clinically: no oral malodor, physiologic oral malodor, and periodontitis-derived oral malodor. In addition to conventional clinical parameters, 7 salivary components, occlusal force, and lip-closing force were compared among the groups. RESULTS Concerning the salivary components, cariogenic bacteria, occult blood, leukocytes, and ammonia differed significantly among the groups. Multiple logistic regression analyses indicated that tongue-coating scores and ammonia levels were significantly associated with genuine oral malodor, including physiologic oral malodor and periodontitis-derived oral malodor, and the tongue-coating score, plaque index, and occult blood level were significantly associated with periodontitis-derived oral malodor. Occlusal force and lip-closing force did not differ among the groups. However, there was a statistically significant interaction between occlusal force and lip-closing force in oral malodor in women (P = .019). CONCLUSIONS Novel salivary markers, ammonia levels, and occult blood levels may predict genuine oral malodor and periodontitis-derived oral malodor, respectively. An interaction effect between occlusal force and lip-closing force on oral malodor was identified in women.
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Affiliation(s)
- Yu Takaesu
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Nao Suzuki
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan; Oral Medical Research Center, Fukuoka Dental College, Fukuoka, Japan.
| | - Marie Naito
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Takeshi Watanabe
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Atsushi Shimazu
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Naoko Yatabe
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Masahiro Yoneda
- Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Takao Hirofuji
- Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Takashi Hanioka
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
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Gonçalves ACDS, Martins MCN, Paula BLD, Weckwerth PH, Franzolin SDOB, Silveira EMV. A new technique for tongue brushing and halitosis reduction: the X technique. J Appl Oral Sci 2019; 27:e20180331. [PMID: 30970113 PMCID: PMC6442830 DOI: 10.1590/1678-7757-2018-0331] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 10/05/2018] [Indexed: 11/23/2022] Open
Abstract
The tongue is one of the primary sources of halitosis. The manual or mechanical removal of biofilm is known to decrease oral malodor.
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