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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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Wu DD, Ngowi EE, Zhai YK, Wang YZ, Khan NH, Kombo AF, Khattak S, Li T, Ji XY. Role of Hydrogen Sulfide in Oral Disease. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:1886277. [PMID: 35116090 PMCID: PMC8807043 DOI: 10.1155/2022/1886277] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 11/20/2021] [Accepted: 12/14/2021] [Indexed: 12/13/2022]
Abstract
Oral diseases are among the most common human diseases yet less studied. These diseases affect both the physical, mental, and social health of the patients resulting in poor quality of life. They affect all ages, although severe stages are mostly observed in older individuals. Poor oral hygiene, genetics, and environmental factors contribute enormously to the development and progression of these diseases. Although there are available treatment options for these diseases, the recurrence of the diseases hinders their efficiency. Oral volatile sulfur compounds (VSCs) are highly produced in oral cavity as a result of bacteria activities. Together with bacteria components such as lipopolysaccharides, VSCs participate in the progression of oral diseases by regulating cellular activities and interfering with the immune response. Hydrogen sulfide (H2S) is a gaseous neurotransmitter primarily produced endogenously and is involved in the regulation of cellular activities. The gas is also among the VSCs produced by oral bacteria. In numerous diseases, H2S have been reported to have dual effects depending on the cell, concentration, and donor used. In oral diseases, high production and subsequent utilization of this gas have been reported. Also, this high production is associated with the progression of oral diseases. In this review, we will discuss the production of H2S in oral cavity, its interaction with cellular activities, and most importantly its role in oral diseases.
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Affiliation(s)
- Dong-Dong Wu
- School of Stomatology, Henan University, Kaifeng, Henan 475004, China
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- Kaifeng Municipal Key Laboratory of Cell Signal Transduction, Henan Provincial Engineering Centre for Tumor Molecular Medicine, Henan University, Kaifeng, Henan 475004, China
| | - Ebenezeri Erasto Ngowi
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- Kaifeng Municipal Key Laboratory of Cell Signal Transduction, Henan Provincial Engineering Centre for Tumor Molecular Medicine, Henan University, Kaifeng, Henan 475004, China
- Department of Biological Sciences, Faculty of Science, Dar es Salaam University College of Education, Dar es Salaam 2329, Tanzania
| | - Yuan-Kun Zhai
- School of Stomatology, Henan University, Kaifeng, Henan 475004, China
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
| | - Yi-Zhen Wang
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- Kaifeng Municipal Key Laboratory of Cell Signal Transduction, Henan Provincial Engineering Centre for Tumor Molecular Medicine, Henan University, Kaifeng, Henan 475004, China
| | - Nazeer Hussain Khan
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- School of Life Sciences, Henan University, Kaifeng, Henan 475004, China
| | - Ahmad Fadhil Kombo
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- School of Life Sciences, Henan University, Kaifeng, Henan 475004, China
| | - Saadullah Khattak
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- School of Life Sciences, Henan University, Kaifeng, Henan 475004, China
| | - Tao Li
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- Kaifeng Key Laboratory of Infection and Biological Safety, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
| | - Xin-Ying Ji
- Henan International Joint Laboratory for Nuclear Protein Regulation, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
- Kaifeng Key Laboratory of Infection and Biological Safety, School of Basic Medical Sciences, Henan University, Kaifeng, Henan 475004, China
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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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Kim SR, Nam DH. Reliability, Accuracy, and Use Frequency of Evaluation Methods for Amount of Tongue Coating. Chin J Integr Med 2018; 25:378-385. [PMID: 29700763 DOI: 10.1007/s11655-018-2552-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 07/06/2016] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To classify the evaluation methods for amount of tongue coating (TC) and investigate their reliability, accuracy, and frequency of use. METHODS Articles published from 1985 to 2015 were searched for evaluation methods for the amount of TC in PubMed and the Cochrane Library. Only clinical researches were included except protocol articles. The methods were classified according to their characteristics. RESULTS Finally, 113 articles were selected. The evaluation method for the amount of TC from the articles was classified into 4 types: intuitive, specificative, computerized, and weighing TC. The reliability in the intuitive and specificative methods (κ =0.33-0.92) showed varying levels among the studies. In general, the amount of TC calculated by the specificative method (Spearman's r=0.68-0.80) was more strongly related to the directly measured value than to the value estimated by the computerized method (Pearson's r=0.442). The number of articles published on this topic has increased consistently, and the specificative method was the most frequently used. Despite the higher reliability of the computerized method, it has not been widely used. CONCLUSIONS The high prevalence of the specificative method would continue in clinical practice because of its convenience and accuracy. However, to establish higher reliability, the limitation of the subjectivity of the assessors should be overcome through calibration training. In the computerized method, novel algorithms are needed to obtain a higher accuracy so that it can help the practitioners confidently estimate the amount of TC.
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Affiliation(s)
- Su-Ryun Kim
- Department of Biofunctional Medicine and Diagnosis, College of Korean Medicine, Sangji University, Wonju, 26339, Republic of Korea
| | - Dong-Hyun Nam
- Department of Biofunctional Medicine and Diagnosis, College of Korean Medicine, Sangji University, Wonju, 26339, Republic of Korea.
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Van der Sluijs E, Van der Weijden GA, Hennequin-Hoenderdos NL, Slot DE. The effect of a tooth/tongue gel and mouthwash regimen on morning oral malodour: A 3-week single-blind randomized clinical trial. Int J Dent Hyg 2017; 16:92-102. [PMID: 28544762 DOI: 10.1111/idh.12291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2017] [Indexed: 11/28/2022]
Abstract
AIM To compare the effects of a regimen consisting of a tooth/tongue gel, tongue cleaner and mouthwash with the effects of using standard fluoride dentifrice on the organoleptic oral malodour score (ORG) and volatile sulphur compounds (VSCs). MATERIALS AND METHODS A total, 66 non-dental students participated in a 3-week parallel, single-blind, randomized, controlled clinical trial. The test group used a tongue cleaner, a tooth/tongue gel and mouthwash containing amine fluoride/stannous fluoride and zinc lactate as oral malodour counteractive. The control group used a standard fluoride dentifrice. Measurements were taken in the morning at baseline, at days 1, 7 and 21. The primary outcome was the ORG score. The secondary outcome, the VSC measurement, was assessed using OralChroma™ (H2 S, CH3 SH, (CH3 )2 S) and Halimeter® . Tongue coating thickness and tongue discoloration were scored. At baseline and day 21, the participants' self-perceptions were assessed. RESULTS At day 1 for the ORG, H2 S, CH3 SH and Halimeter® readings, a significant decrease was observed in the test group. At day 21, the decrease in H2 S and the Halimeter® outcomes were maintained for the test group, and a significant increase in tongue surface discoloration was observed. The test group evaluated their "morning breath upon awakening" as significantly better (P=.001) after 21 days. CONCLUSION A significant overnight effect on morning oral malodour was observed for most of the parameters in favour of the test group. At day 21, the effect of prolonged use was significant for H2 S and the Halimeter® readings, although not for the primary ORG outcome parameter.
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Affiliation(s)
- E Van der Sluijs
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - G A Van der Weijden
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - N L Hennequin-Hoenderdos
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - D E Slot
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
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Seemann R, Filippi A, Michaelis S, Lauterbach S, John HD, Huismann J. Duration of effect of the mouthwash CB12 for the treatment of intra-oral halitosis: a double-blind, randomised, controlled trial. J Breath Res 2016; 10:036002. [PMID: 27328808 DOI: 10.1088/1752-7155/10/3/036002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Halitosis occurs in approximately 30% of the adult population and has a negative social and psychological impact on affected individuals. Mouthwashes may be used to prevent unpleasant odour, with long-duration of effect being a desirable attribute. The aim of this study was to assess the long-term efficacy of CB12 (a mixture of 0.3% zinc acetate and 0.025% chlorhexidine) for the treatment of intra-oral halitosis. Thirty-four subjects with confirmed intra-oral halitosis were randomized into a double-blind, controlled, cross-over study to one of 2 groups; (i) CB12-water-water or (ii) water-CB12-CB12. Each group comprised 3 treatments, each given evening and morning (12 h apart) on consecutive study days, with a 5 d washout between treatments. Intra-oral halitosis was assessed objectively by measuring concentrations of hydrogen sulphide, methyl mercaptan, dimethyl sulphide and total volatile sulphur compound (VSC) concentrations and subjectively using organoleptic score (OLS). These were measured at baseline, 12 h after the evening rinse (i.e. 12 h overnight assessment) and 12 h after the daytime rinse (i.e. 12 h day time assessment). CB12 significantly reduced mean hydrogen sulphide, methyl mercaptan, dimethyl sulphide and VSC concentrations, with a duration of effect lasting 12 h, whether assessed overnight (all p ⩽ 0.0003 versus water) or during the day (all p ⩽ 0.0007 versus water). CB12's effect on OLS was also evident for 12 h overnight (p = 0.0043). CB12 was well-tolerated. In conclusion, CB12 showed a clear and durable effect on intra-oral halitosis which lasted at least 12 h, both during the day and overnight, with consistent effect on both objective and subjective variables.
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Affiliation(s)
- Rainer Seemann
- Department of Preventive-, Restorative- and Pediatric Dentistry, zmk bern, University Bern, Freiburgstrasse 7, CH-3010 Bern, Switzerland. www.zmk.unibe.ch
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