The capacity of subgingival microbiotas to produce volatile sulfur compounds in human serum

Comparison of halitosis according to herbal mouthwash containing Glycyrrhiza uralensis extract and saline mouthwash: A randomized, double-blind, placebo-controlled study

OBJECTIVES

This study was conducted in order to determine the effect on halitosis and the antibacterial effect against halitosis-causing bacteria of the mouthwash made of the natural material, Glycyrrhiza uralensis (G. uralensis) extract.

MATERIALS AND METHODS

A randomized, double-blind, placebo-controlled study was conducted on 60 patients who visited M dental clinic located in Busan, South Korea, excluding those with systemic disease that may induce halitosis. There were 30 patients classified to the saline gargle group and the remaining 30 patients were classified to the G. uralensis extract gargle group. In addition, their level of halitosis and halitosis-causing bacteria were measured. They visited the dental clinic on a fasted state at baseline before gargle application (Baseline), immediately after gargle application (Treatment) and 5 days after gargle application (After 5 Days). For clinical indicators, participants were tested for halitosis and bacteria immediately after waking up without brushing their teeth and without hydration.

RESULTS

The prevalence of halitosis decreased in the G. uralensis extract gargle group compared to the saline gargle group at Treatment and After 5 Days. In cases with pseudo halitosis, there was a significant decrease in halitosis-causing bacteria when G. uralensis extract gargle was applied (p < 0.05).

CONCLUSIONS

It was identified that using a mouthwash made with G. uralensis extract is effective for halitosis improvement and reduction of halitosis-causing bacteria. Therefore, using a mouthwash containing G. uralensis extract, it will be effective in improving bad breath and oral hygiene will be possible.

Microbial corrosion of metallic biomaterials in the oral environment

A wide variety of microorganisms have been closely linked to metal corrosion in the form of adherent surface biofilms. Biofilms allow the development and maintenance of locally corrosive environments and/or permit direct corrosion including pitting corrosion. The presence of numerous genetically distinct microorganisms in the oral environment poses a threat to the integrity and durability of the surface of metallic prostheses and implants used in routine dentistry. However, the association between oral microorganisms and specific corrosion mechanisms is not clear. It is of practical importance to understand how microbial corrosion occurs and the associated risks to metallic materials in the oral environment. This knowledge is also important for researchers and clinicians who are increasingly concerned about the biological activity of the released corrosion products. Accordingly, the main goal was to comprehensively review the current literature regarding oral microbiologically influenced corrosion (MIC) including characteristics of biofilms and of the oral environment, MIC mechanisms, corrosion behavior in the presence of oral microorganisms and potentially mitigating technologies. Findings included that oral MIC has been ascribed mostly to aggressive metabolites secreted during microbial metabolism (metabolite-mediated MIC). However, from a thermodynamic point of view, extracellular electron transfer mechanisms (EET-MIC) through pili or electron transfer compounds cannot be ruled out. Various MIC mitigating methods have been demonstrated to be effective in short term, but long term evaluations are necessary before clinical applications can be considered. Currently most in-vitro studies fail to simulate the complexity of intraoral physiological conditions which may either reduce or exacerbate corrosion risk, which must be addressed in future studies. STATEMENT OF SIGNIFICANCE: A thorough analysis on literature regarding oral MIC (microbiologically influenced corrosion) of biomedical metallic materials has been carried out, including characteristics of oral environment, MIC mechanisms, corrosion behaviors in the presence of typical oral microorganisms and potential mitigating methods (materials design and surface design). There is currently a lack of mechanistic understanding of oral MIC which is very important not only to corrosion researchers but also to dentists and clinicians. This paper discusses the significance of biofilms from a biocorrosion perspective and summarizes several aspects of MIC mechanisms which could be caused by oral microorganisms. Oral MIC has been closely associated with not only the materials research but also the dental/clinical research fields in this work.

Effect of sleeve gastrectomy on the levels of oral volatile sulfur compounds and halitosis-related bacteria

Background

The association between sleeve gastrectomy and halitosis remains relatively unknown. Therefore, this study aimed to evaluate the effect of sleeve gastrectomy on halitosis and the oral bacterial species associated with halitosis in patients with obesity.

Methods

This was a prospective longitudinal cohort study that examined patients before and after sleeve gastrectomy and followed the patients at three time intervals (1, 3, and 6 months) after sleeve gastrectomy. Clinical periodontal measurements (plaque index [PI], gingival index [GI], and probing depth [PD]) were obtained. In addition, plaque samples were collected for quantification of the periodontopathogenic bacteria: Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, and Fusobacterium nucleatum using real-time quantitative polymerase chain reaction (qPCR). In addition, breath samples were collected to analyze the concentration of volatile sulfur compounds (VSCs), namely hydrogen sulfide (H2S), methyl mercaptan (CH3SH), and dimethyl sulfide (CH3SCH3), via portable gas chromatography (Oral Chroma™).

Results

Of the 43 patients initially included, 39 completed the study, with a mean age of 32.2 ± 10.4 years. For PI and GI repeated measurements one way analysis of variance showed a significant increase (p-value < 0.001 for both) one month after surgery, with mean values of 1.3 and 1.59, respectively, compared to the baseline. During the same period, the number of P. gingivalis increased, with a p-value = 0.04. Similarly, the levels of hydrogen sulfide (H2S) and methyl mercaptan (CH3SH) increased significantly in the first month after surgery (p-value = 0.02 and 0.01, respectively).

Conclusion

This study demonstrated that sleeve gastrectomy may lead to increased halitosis one month post-surgery, attributed to elevated and P. gingivalis counts, contributing to the development of gingivitis in obese patients who underwent sleeve gastrectomy. This emphasizes the importance of including oral health professionals in the multidisciplinary team for the management of patients undergoing bariatric surgery.

Oral microbiome as a co-mediator of halitosis and periodontitis: a narrative review

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.

Microbial metabolites in the pathogenesis of periodontal diseases: a narrative review

The purpose of this narrative review is to highlight the importance of microbial metabolites in the pathogenesis of periodontal diseases. These diseases, involving gingivitis and periodontitis are inflammatory conditions initiated and maintained by the polymicrobial dental plaque/biofilm. Gingivitis is a reversible inflammatory condition while periodontitis involves also irreversible destruction of the periodontal tissues including the alveolar bone. The inflammatory response of the host is a natural reaction to the formation of plaque and the continuous release of metabolic waste products. The microorganisms grow in a nutritious and shielded niche in the periodontal pocket, protected from natural cleaning forces such as saliva. It is a paradox that the consequences of the enhanced inflammatory reaction also enable more slow-growing, fastidious, anaerobic bacteria, with often complex metabolic pathways, to colonize and thrive. Based on complex food chains, nutrient networks and bacterial interactions, a diverse microbial community is formed and established in the gingival pocket. This microbiota is dominated by anaerobic, often motile, Gram-negatives with proteolytic metabolism. Although this alternation in bacterial composition often is considered pathologic, it is a natural development that is promoted by ecological factors and not necessarily a true "dysbiosis". Normal commensals are adapting to the gingival crevice when tooth cleaning procedures are absent. The proteolytic metabolism is highly complex and involves a number of metabolic pathways with production of a cascade of metabolites in an unspecific manner. The metabolites involve short chain fatty acids (SCFAs; formic, acetic, propionic, butyric, and valeric acid), amines (indole, scatole, cadaverine, putrescine, spermine, spermidine) and gases (NH₃, CO, NO, H₂S, H₂). A homeostatic condition is often present between the colonizers and the host response, where continuous metabolic fluctuations are balanced by the inflammatory response. While it is well established that the effect of the dental biofilm on the host response and tissue repair is mediated by microbial metabolites, the mechanisms behind the tissue destruction (loss of clinical attachment and bone) are still poorly understood. Studies addressing the functions of the microbiota, the metabolites, and how they interplay with host tissues and cells, are therefore warranted.

Age-Related Subgingival Colonization of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Parvimonas micra-A Pragmatic Microbiological Retrospective Report

The aim of this study was to compare data about the prevalence and proportions of the bacterial species Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Parvimonas micra in periodontitis pocket samples collected from young, <35 years, and old, >35-year-old patients, YP and OP, respectively. The results from the analyses of a total of 3447 subgingival plaque samples analyzed for clinical diagnosis purposes by cultivation regarding the proportions of these species were collected from a database and elucidated. The prevalence of A. actinomycetemcomitans was found to be more than twice as high (OR = 2.96, 95% CI; 2.50-3.50) in samples from the younger (42.2%) than the older group (20.4%) (p < 0.001). The prevalence of P. micra was significantly lower in samples from the younger age group (OR = 0.43, 95%) (p < 0.001), whereas P. gingivalis was similarly distributed (OR = 0.78, 95%) in the two age groups (p = 0.006). A similar pattern was noticed for A. actinomycetemcomitans and P. gingivalis when high proportions (>50%) of the samples of these bacterial species were elucidated. In contrast, the proportion of samples containing >50% with P. micra was lower compared with the two other bacterial species. Furthermore, it was noted that the proportion of samples from old patients containing A. actinomycetemcomitans in combination with P. micra was almost three times higher than in samples when P. micra was replaced by P. gingivalis. In conclusion, A.actinomycetemcomitans showed an increased presence and proportion in samples from young patients compared with the old patients, while P. gingivalis was similarly distributed in the two age groups. P. micra showed an increased presence and proportion in samples from old patients compared with the young patients.

Concerning perceived and clinically-measured levels of halitosis

The different types of self-reported halitosis complaints include those where one feels that one’s breath smells bad, where one feels that one has bad breath because of the attitudes of others, and where others have pointed out the presence of bad breath. The results of previous studies comparing the objective and subjectives measures of halitosis are inconsistent, and few studies have used gas chromatography (GC) to measure halitosis in a large sample. This study aimed to examine the objectively measured halitosis levels based on the reasons individuals are concerned about halitosis. We included 2063 patients who visited the halitosis clinic at a university dental hospital. Halitosis was assessed using GC, self-administered questionnaires, and oral examinations. Levels of volatile sulphur compounds (VSCs; H2S, CH3SH, and (CH3)2S) were set as objective measures of halitosis. Patients were grouped based on their answers to ‘What made you concerned about bad breath?’ into groups: ‘self-perceived,’ ‘attitudes of others,’ ‘told by others,’ and other reasons. Univariate and multivariable linear regression analyses were performed to examine factors associated with VSCs and objective halitosis levels. Age, sex, oral health status, smoking, drinking, and breakfast habits were used as confounders. Patients who answered ‘told by others’ (n = 691, 33.5%) showed the highest VSCs. Individuals whose halitosis was pointed out by others had higher objectively measured halitosis levels, while those concerned about the attitudes of others or perceived their own halitosis had lower objectively measured halitosis levels. These results suggest that the objective level of halitosis can differ on the basis of the reason underlying an individual’s concern about their bad breath. Categorizing halitosis complaints and comparing them with objective halitosis levels may help reduce the anxiety of those who are concerned about halitosis and confirm the need for intervention for those with objective halitosis.

Supergene origin and maintenance in Atlantic cod

Supergenes are sets of genes that are inherited as a single marker and encode complex phenotypes through their joint action. They are identified in an increasing number of organisms, yet their origins and evolution remain enigmatic. In Atlantic cod, four megabase-scale supergenes have been identified and linked to migratory lifestyle and environmental adaptations. Here we investigate the origin and maintenance of these four supergenes through analysis of whole-genome-sequencing data, including a new long-read-based genome assembly for a non-migratory Atlantic cod individual. We corroborate the finding that chromosomal inversions underlie all four supergenes, and we show that they originated at different times between 0.40 and 1.66 million years ago. We reveal gene flux between supergene haplotypes where migratory and stationary Atlantic cod co-occur and conclude that this gene flux is driven by gene conversion, on the basis of an increase in GC content in exchanged sites. Additionally, we find evidence for double crossover between supergene haplotypes, leading to the exchange of an ~275 kilobase fragment with genes potentially involved in adaptation to low salinity in the Baltic Sea. Our results suggest that supergenes can be maintained over long timescales in the same way as hybridizing species, through the selective purging of introduced genetic variation.

Atlantic cod carries four supergenes linked to migratory lifestyle and environmental adaptations. Using whole-genome sequencing, the authors show that the genome inversions that underlie the supergenes originated at different times and show gene flux between supergene haplotypes.

Interdental and subgingival microbiota may affect the tongue microbial ecology and oral malodour in health, gingivitis and periodontitis

BACKGROUND AND OBJECTIVE

Oral malodour is often observed in gingivitis and chronic periodontitis patients, and the tongue microbiota is thought to play a major role in malodorous gas production, including volatile sulphur compounds (VSCs) such as hydrogen sulphide (H₂ S) and methanethiol (CH₃ SH). This study aimed to examine the link between the presence of VSCs in mouth air (as a marker of oral malodour) and the oral bacterial ecology in the tongue and periodontal niches of healthy, gingivitis and periodontitis patients.

METHODS

Participants were clinically assessed using plaque index, bleeding on probing (BOP) and periodontal probing depths, and VSC concentrations in their oral cavity measured using a portable gas chromatograph. Tongue scrapings, subgingival and interdental plaque were collected from healthy individuals (n = 22), and those with gingivitis (n = 14) or chronic periodontitis (n = 15). The bacterial 16S rRNA gene region V3-V4 in these samples was sequenced, and the sequences were analysed using the minimum entropy decomposition pipeline.

RESULTS

Elevated VSC concentrations and CH₃ SH:H₂ S were observed in periodontitis compared with health. Significant ecological differences were observed in the tongue microbiota of healthy subjects with high plaque scores compared to low plaque scores, suggesting a possible connection between the microbiota of the tongue and the periodontium and that key dysbiotic changes may be initiated in the clinically healthy individuals who have higher dental plaque accumulation. Greater subgingival bacterial diversity was positively associated with H₂ S in mouth air. Periodontopathic bacteria known to be prolific VSC producers increased in abundance on the tongue associated with increased bleeding on probing (BOP) and total percentage of periodontal pockets >6 mm, supporting the suggestion that the tongue may become a reservoir for periodontopathogens.

CONCLUSION

This study highlights the importance of the periodontal microbiota in malodour and has detected dysbiotic changes in the tongue microbiota in periodontitis.

Identification of Salivary Microorganisms and Metabolites Associated with Halitosis

Halitosis is mainly caused by the action of oral microbes. The purpose of this study was to investigate the differences in salivary microbes and metabolites between subjects with and without halitosis. Of the 52 participants, 22 were classified into the halitosis group by the volatile sulfur compound analysis on breath samples. The 16S rRNA gene amplicon sequencing and metabolomics approaches were used to investigate the difference in microbes and metabolites in saliva of the control and halitosis groups. The profiles of microbiota and metabolites were relatively different between the halitosis and control groups. The relative abundances of Prevotella, Alloprevotella, and Megasphaera were significantly higher in the halitosis group. In contrast, the relative abundances of Streptococcus, Rothia, and Haemophilus were considerably higher in the control group. The levels of 5-aminovaleric acid and n-acetylornithine were significantly higher in the halitosis group. The correlation between identified metabolites and microbiota reveals that Alloprevotella and Prevotella might be related to the cadaverine and putrescine pathways that cause halitosis. This study could provide insight into the mechanisms of halitosis.

Characterization of oral bacteria in the tongue coating of patients with halitosis using 16S rRNA analysis

There are many studies on the relationship between the tongue coating and halitosis, but few have evaluated the bacterial community present in the tongue coating. This study identified bacteria in the tongue coating in individuals with and without halitosis using 16S rRNA analysis. Forty subjects (mean age, 46.1 ± 15.8 years) who visited the halitosis clinic at the University Dental Hospital between 2016 and 2017 were divided into halitosis (n = 32) and non-halitosis (n = 8) groups according to results from an organoleptic test (OT). Additional measurements via gas chromatography (GC) and the Breathtron® instrument confirmed the groupings as the H₂S, CH₃SH, (CH₃)₂S, and total volatile sulphur compounds (VSC) levels were significantly higher in the halitosis group than in the non-halitosis group. Bacterial diversity was higher in the halitosis group; the median (quartile) values of the Shannon index were 4.46 (4.21, 4.67) in the halitosis group and 3.80 (3.45, 4.30) in the non-halitosis group. Additionally, the median (quartile) values of the Chao-1 index were 84.0 (77.2, 95.0) in the halitosis group and 71.3 (65.0, 81.5) in the non-halitosis group. These differences in bacterial composition and diversity may further the understanding of causes and treatments for halitosis.

In vitro corrosion studies of stainless-steel dental substrates during Porphyromonas gingivalis biofilm growth in artificial saliva solutions: providing insights into the role of resident oral bacterium

Stainless-steel AISI 321 is an effective material for fabricating dental crowns and other implants utilized dental restorative protocols for elderly and pediatric populations. This unique clinical application is possible through the mechanical stability and corrosion-resistance properties of this metallic material. However, stainless-steel dental implants eventually fail, leading to the creation of surface cavities and cracks within their microstructures during persistent mechanical stresses and biocorrosion. In this study, the in vitro corrosion behaviour of a medical-grade stainless-steel dental substrate was investigated during Porphyromonas gingivalis biofilm growth process in artificial saliva culture suspension (ASCS). Among the causative bioagents of corrosion, P. gingivalis was chosen for this study since it is also responsible for oral periodontitis and a major contributing factor to corrosion in most dental implants. Increased P. gingivalis growth was observed within the incubation period under study as compact cellular clusters fouled the metal surfaces in ASCS media. This led to the corrosion of steel substrates after bacterial growth maturity within 90 days. Corrosion rate increased with higher CFU and bacterial incubation period for all test substrates due to biocorrosion incited by the volatile sulphide products of P. gingivalis metabolism. The presence of some of these volatile compounds has been observed from experimental evidences. Significant anodic degradation in the forms of localized pitting were also recorded by surface analytical techniques. Residual fluorinated ions within the ASCS media also increased the rate of anodic dissolution due to media acidity. This study has provided extensive insights into the fate of stainless-steel dental crown in oral environments infected by a resident oral bacterium. Influences of oral conditions similar to fluoride-enriched mouthwashes were reflected in a view to understanding the corrosion patterns of stainless-steel dental substrates.

A stainless-steel 321 dental substrate significantly corroded within Porphyromonas gingivalis growth culture in artificial saliva culture suspension, with and without NaF additive.

Glutathione catabolism by Treponema denticola impacts its pathogenic potential

Treponema denticola is a spirochete that is etiologic for periodontal diseases. This bacterium is one of two periodontal pathogens that have been shown to have a complete three step enzymatic pathway (GTSP) that catabolizes glutathione to H2S. This pathway may contribute to the tissue pathology seen in periodontitis since diseased periodontal pockets have lower glutathione levels than healthy sites with a concomitant increase in H2S concentration. In order to be able to demonstrate that glutathione catabolism by the GTSP is critical for the pathogenic potential of T. denticola, allelic replacement mutagenesis was used to make a deletion mutant (Δggt) in the gene encoding the first enzyme in the GTSP. The mutant cannot produce H2S from glutathione since it lacks gamma-glutamyltransferase (GGT) activity. The hemolytic and hemoxidation activities of wild type T. denticola plus glutathione are reduced to background levels with the Δggt mutant and the mutant has lost the ability to grow aerobically when incubated with glutathione. The Δggt bacteria with glutathione cause less cell death in human gingival fibroblasts (hGFs) in vitro than do wild type T. denticola and the levels of hGF death correlate with the amounts of H2S produced. Importantly, the mutant spirochetes plus glutathione make significantly smaller lesions than wild type bacteria plus glutathione in a mouse back lesion model that assesses soft tissue destruction, a major symptom of periodontal diseases. Our results are the first to prove that T. denticola thiol-compound catabolism by its gamma-glutamyltransferase can play a significant role in the in the types of host tissue damage seen in periodontitis.

Stable species boundaries despite ten million years of hybridization in tropical eels

Genomic evidence is increasingly underpinning that hybridization between taxa is commonplace, challenging our views on the mechanisms that maintain their boundaries. Here, we focus on seven catadromous eel species (genus Anguilla) and use genome-wide sequence data from more than 450 individuals sampled across the tropical Indo-Pacific, morphological information, and three newly assembled draft genomes to compare contemporary patterns of hybridization with signatures of past introgression across a time-calibrated phylogeny. We show that the seven species have remained distinct for up to 10 million years and find that the current frequencies of hybridization across species pairs contrast with genomic signatures of past introgression. Based on near-complete asymmetry in the directionality of hybridization and decreasing frequencies of later-generation hybrids, we suggest cytonuclear incompatibilities, hybrid breakdown, and purifying selection as mechanisms that can support species cohesion even when hybridization has been pervasive throughout the evolutionary history of clades.

Oral Malodor in Dogs: Measurement Using a Sulfide Monitor

In 28 dogs, oral malodor was assessed organoleptically (0–3 scale) and by measurement of volatile sulfur components (VSC), using two positions ('intraoral' and 'tooth surface') for sampling VSC. Significant correlations were found between: intraoral and tooth surface VSC collection positions (p < 0.0001) and between organoleptic and tooth surface VSC data (p < 0.0001). VSC measurement is a sensitive, repeatable and non-subjective method of assessing oral malodor in dogs.

Potential antibacterial and anti-halitosis activity of medicinal plants against oral bacteria

This study aimed to evaluate the in vitro activity of the crude extracts obtained from Caesalpinia ferrea Mart. (Jucá), Cinnamomum cassia B. (Cinnamon), Mallow sylvestris L. (Mallow), Punica granatum L. (Pomegranate), Rosmarinus officinalis L. (Rosemary), Aeolanthus suaveolens (Als.) Spreng. (Macassá), Sysygium aromaticum L. (Clove), and Tamarindus indica L. (Tamarind) against oral microorganisms (e.g., Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, and Parvimonas micra) that produce volatile sulfur compounds (VSC). The pure extracts were placed in culture medium for the diffusion test in agar. The Minimum Inhibitory Concentration (MIC) was determined by the microdilution method, and microbial growth was assayed with resazurin. Total polyphenols in the extracts were measured by using the Prussian Blue Method. For the salivary sediment test, the sediments were exposed to the Jucá and Pomegranate extracts, which was followed by incubation and organoleptic measurements with a monitor (Halimeter®) at 1-, 2-, 4-, and 24 -h intervals. The diffusion test revealed mixed results for the extracts. When the zone of inhibition was present, it ranged from 1.6-10.3 mm. The Pomegranate extract was the only extract that inhibited all the evaluated microorganisms; the MIC values ranged from 50 to 400 μg/mL. The Pomegranate and Jucá extracts presented higher levels of polyphenols, 7.3 % and 3.9 %, respectively, and less VSC formation as compared to the negative control. In conclusion, the extracts display antimicrobial activity against the tested microorganisms. The investigated plants have the potential to reduce the main substances related to halitosis of oral origin.

Targeted polymerase chain reaction-based expression of putative halitogenic bacteria and volatile sulphur compound analysis among halitosis patients at a tertiary hospital in Nigeria

Halitosis (bad breath) can be a cause of anxiety, depression and psychosocial stress, with pathological changes in the oral microbiota playing an important role in its development. Despite its prevalence, studies on the microbiology of halitosis are rare in Nigeria. This study determines the presence of five putative periodontal pathogens viz: Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia and Treponema denticola on the tongue dorsa of halitosis and non-halitosis patients using a 16S rDNA-directed polymerase chain reaction assay. Furthermore, an association of these bacteria with oral malodour [as assessed by volatile sulphur compounds (VSC) measurements] with a portable sulphide monitor, the Halimeter (Interscan Corp, Chatsworth, California), was performed. The results showed that the prevalence of halitosis in this environment as defined by VSC level above 160 ppb is 14.9%. Halitosis is affected by gender with males having it more than the females. Males also tend to present more with self-reported complaints of halitosis than females. Age does not appear to contribute to the incidence of halitosis. Fusobacterium nucleatum, P. gingivalis, P. intermedia are responsible for increased production of VSCs in halitosis patients while A. actinomycetemcomitans and T. denticola appear to play no part in the production of VSCs. Evaluation of halitogenic bacteria and VSCs may potentially become a surrogate biomarker for monitoring halitosis. Targeted assessment of putative halitogenic bacteria may provide a rapid point-of-care diagnostic tool for halitosis.

Two mechanisms of oral malodor inhibition by zinc ions

The aim of this study was to reveal the mechanisms by which zinc ions inhibit oral malodor. The direct binding of zinc ions to gaseous hydrogen sulfide (H2S) was assessed in comparison with other metal ions. Nine metal chlorides and six metal acetates were examined. To understand the strength of H2S volatilization inhibition, the minimum concentration needed to inhibit H2S volatilization was determined using serial dilution methods. Subsequently, the inhibitory activities of zinc ions on the growth of six oral bacterial strains related to volatile sulfur compound (VSC) production and three strains not related to VSC production were evaluated. Aqueous solutions of ZnCl2, CdCl2, CuCl2, (CH3COO)2Zn, (CH3COO)2Cd, (CH3COO)2Cu, and CH3COOAg inhibited H2S volatilization almost entirely. The strengths of H2S volatilization inhibition were in the order Ag+ > Cd2+ > Cu2+ > Zn2+. The effect of zinc ions on the growth of oral bacteria was strain-dependent. Fusobacterium nucleatum ATCC 25586 was the most sensitive, as it was suppressed by medium containing 0.001% zinc ions. Zinc ions have an inhibitory effect on oral malodor involving the two mechanisms of direct binding with gaseous H2S and suppressing the growth of VSC-producing oral bacteria.

Hydrogen sulfide exposure induces NLRP3 inflammasome-dependent IL-1β and IL-18 secretion in human mononuclear leukocytes in vitro

The aim was to investigate if hydrogen sulfide (H₂S) induces the formation of the NLRP3 inflammasome and subsequent IL‐1β and IL‐18 secretion in human peripheral blood mononuclear cells (PBMCs) and in the human monocyte cell line THP1. Bacterial production of H₂S has been suggested to participate in the inflammatory host response in periodontitis pathogenesis. H₂S is a toxic gas with pro‐inflammatory properties. It is produced by bacterial degradation of sulfur‐containing amino acids, for example, cysteine. We hypothesize that H₂S affects the inflammatory host response by inducing formation of the NLRP3 inflammasome and thereby causes the secretion of IL‐1ß and IL‐18. PBMCs from eight healthy blood donors, the human monocyte cell line THP1 Null, and two variants of the THP1 cell line unable to form the NLRP3 inflammasome were cultured in the presence or absence of 1 mM sodium hydrosulfide (NaHS) in 24‐well plates at 37°C for 24 hr. Supernatants were collected and the IL‐1β and IL‐18 concentrations were measured with DuoSet ELISA Development kit. PBMCs exposed to NaHS produced more IL‐1ß and IL‐18 than unexposed control cells (p = .023 and p = .008, respectively). An increase of extracellular potassium ions (K⁺) inhibited the secretion of IL‐1ß and IL‐18 (p = .008). Further, NaHS triggered the secretion of IL‐1ß and IL‐18 in human THP1‐Null monocytes (p = .0006 and p = .002, respectively), while the NaHS‐dependent secretion was reduced in the monocyte cell lines unable to form the NLRP3 inflammasome. Hence, the results suggest that NaHS induces the formation of the NLRP3 inflammasome and thus the secretion of IL‐1ß and IL‐18. Enhanced NLRP3 inflammasome‐dependent secretion of IL‐1β and IL‐18 in human mononuclear leukocytes exposed to NaHS in vitro is reported. This may be a mode for H₂S to contribute to the inflammatory host response and pathogenesis of periodontal disease.

In vitro effects of Melaleuca alternifolia essential oil on growth and production of volatile sulphur compounds by oral bacteria

Objective

Halitosis can be caused by microorganisms that produce volatile sulphur compounds (VSCs), which colonize the surface of the tongue and subgingival sites. Studies have reported that the use of natural products can reduce the bacterial load and, consequently, the development of halitosis. The aim of this study was to evaluate the antimicrobial activity of the essential oil of Melaleuca alternifolia on the growth and volatile sulphur compound (VSC) production of oral bacteria compared with chlorhexidine.

Material and Methods

The effects of these substances were evaluated by the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) in planktonic cultures of Porphyromonas gingivalis and Porphyromonas endodontalis. In addition, gas chromatography analyses were performed to measure the concentration of VSCs from bacterial cultures and to characterize M. alternifolia oil components.

Results

The MIC and MBC values were as follows: M. alternifolia - P. gingivalis (MIC and MBC=0.007%), P. endodontalis (MIC and MBC=0.007%=0.5%); chlorhexidine - P. gingivalis and P. endodontalis (MIC and MBC=1.5 mg/mL). M. alternifolia significantly reduced the growth and production of hydrogen sulfide (H2S) by P. gingivalis (p<0.05, ANOVA-Dunnet) and the H2S and methyl mercaptan (CH3SH) levels of P. endodontalis (p<0.05, ANOVA-Dunnet). Chlorhexidine reduced the growth of both microorganisms without altering the production of VSC in P. endodontalis. For P. gingivalis, the production of H2S and CH3SH decreased (p<0.05, ANOVA-Dunnet).

Conclusion

M. alternifolia can reduce bacterial growth and VSCs production and could be used as an alternative to chlorhexidine.

Influence of sulfide concentration on the corrosion behavior of titanium in a simulated oral environment

This study assessed the corrosion behavior of titanium in response to sulfide by determining the effects of sulfide concentration and pH over immersion period. Corrosion was evaluated through changes in color, glossiness, surface characterization, and titanium release. Sulfide solutions were prepared in 3 different concentrations with Na2S, each in pH unadjusted (sulfide-alkaline) and pH adjusted to 7.5 (sulfide-neutral). Titanium discoloration increased and glossiness decreased as sulfide concentration and immersion period increased in sulfide-alkaline solutions. Coral-like complexes were observed on the surface of these specimens, which became more pronounced as concentration increased. Small amounts of titanium release were detected in sulfide-alkaline solutions; however, this was not affected by immersion periods. Corrosion was indicated through considerable surface oxidation suggesting the formation of a thick oxide layer. No significant changes in color and glossiness, or titanium release were indicated for titanium specimens immersed in sulfide-neutral solutions indicating that pH had a significant effect on corrosion. Our findings suggest that a thick oxide layer on the titanium surface was formed in sulfide-alkaline solutions due to excessive oxidation.

The Negative Effects of Volatile Sulphur Compounds

Oral malodor has been studied extensively in humans but not necessarily to the same degree in our veterinary patients where malodor constitutes a significant problem. Breath malodor may originate from the mouth, or from an extra oral source, originating from other organ systems such as gastrointestinal, respiratory, or even systemic disease. Oral malodor is a result of microbial metabolism of exogenous and endogenous proteinaceous substrates leading to the production of compounds such as indole, skatole, tyramine, cadaverine, puterescine, mercaptans, and sulphides. Volatile sulphur compounds have been shown to be the main cause of oral malodor. Although most clients perceive oral malodor to be primarily a cosmetic problem, there is an increasing volume of evidence in human dental literature demonstrating that volatile sulphur compounds produced by bacteria, even at low concentrations, are toxic to tissues and play a role in the pathogenesis of periodontitis. This article reviews the current available literature in human dentistry looking at these negative effects. No veterinary studies have been conducted looking at the negative effects of volatile sulphur compounds specifically, but as this article highlights, we should be aware of the potential negative effects of volatile sulphur compounds and consider this an area of future research.

Metabolic fingerprint of dimethyl sulfone (DMSO2) in microbial-mammalian co-metabolism

There is growing awareness that intestinal microbiota alters the energy harvesting capacity of the host and regulates metabolism. It has been postulated that intestinal microbiota are able to degrade unabsorbed dietary components and transform xenobiotic compounds. The resulting microbial metabolites derived from the gastrointestinal tract can potentially enter the circulation system, which, in turn, affects host metabolism. Yet, the metabolic capacity of intestinal microbiota and its interaction with mammalian metabolism remains largely unexplored. Here, we review a metabolic pathway that integrates the microbial catabolism of methionine with mammalian metabolism of methanethiol (MT), dimethyl sulfide (DMS), and dimethyl sulfoxide (DMSO), which together provide evidence that supports the microbial origin of dimethyl sulfone (DMSO2) in the human metabolome. Understanding the pathway of DMSO2 co-metabolism expends our knowledge of microbial-derived metabolites and motivates future metabolomics-based studies on ascertaining the metabolic consequences of intestinal microbiota on human health, including detoxification processes and sulfur xenobiotic metabolism.

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.

Halitosis: From diagnosis to management

Halitosis is formed by volatile molecules which are caused because of pathological or nonpathological reasons and it originates from an oral or a non-oral source. It is very common in general population and nearly more than 50% of the general population have halitosis. Although halitosis has multifactorial origins, the source of 90% cases is oral cavity such as poor oral hygiene, periodontal disease, tongue coat, food impaction, unclean dentures, faulty restorations, oral carcinomas, and throat infections. Halitosis affects a person's daily life negatively, most of people who complain about halitosis refer to the clinic for treatment but in some of the people who can suffer from halitosis, there is no measurable halitosis. There are several methods to determine halitosis. Halitosis can be treated if its etiology can be detected rightly. The most important issue for treatment of halitosis is detection etiology or determination its source by detailed clinical examination. Management may include simple measures such as scaling and root planning, instructions for oral hygiene, tongue cleaning, and mouth rinsing. The aim of this review was to describe the etiological factors, prevalence data, diagnosis, and the therapeutic mechanical and chemical approaches related to halitosis.

Effectiveness of a vegetable dental chew on periodontal disease parameters in toy breed dogs

Sixteen toy breed dogs completed a parallel, 70-day two-period, cross-over design clinical study to determine the effect of a vegetable dental chew on gingivitis, halitosis, plaque, and calculus accumulations. The dogs were randomly assigned into two groups. During one study period the dogs were fed a non-dental dry diet only and during the second study period were fed the same dry diet supplemented by the daily addition of a vegetable dental chew. Daily administration of the dental chew was shown to reduce halitosis, as well as, significantly reduce gingivitis, plaque and calculus accumulation and therefore may play a significant role in the improvement of canine oral health over the long-term.

Evaluation of two mouth rinses in reduction of oral malodor using a spectrophotometric technique

Background:

Various mouth rinses have been used in the treatment of halitosis, but most of the evidence for the efficacy of mouth rinses is anecdotal. In the present study, 0.2% chlorhexidine rinse and an essential oil mouth rinse are compared for their efficacy in reducing the breath mercaptan levels.

Materials and Methods:

Fifteen patients with the chief complaint of oral malodor were randomly divided into 3 groups and were provided with the respective mouth rinses. Pre rinsing measurements were performed on the Day 1 and no other periodontal treatment was instituted. Post rinsing estimation of mercaptan levels was performed after 7 days.

Results:

When comparing chlorhexidine with the essential oil mouth rinse, the reduction in VSCs was highly significant in the chlorhexidine group (P<0.01). However, the reduction in the organoleptic scores was not significant among the two groups. Organoleptic scores showed very highly significant correlations with the VSC concentrations measured by the spectrophotometric method.

Conclusion:

The spectrophotometric technique employed in this study appears to be a promising new method for evaluation of oral malodor. Chlorhexidine still appears to be the agent of choice as a short term regimen in cases of oral malodor.

Vaccines and photodynamic therapies for oral microbial-related diseases

The mouth is a favorable habitat for a great variety of bacteria. Microbial composition of dental plaque is the usual cause of various oral diseases in humans, including dental caries, periodontal disease and halitosis. In general, oral antibacterial agents such as antibiotics are commonly used to treat oral bacterial infection. Traditional periodontal surgery is painful and time-consuming. In addition, bacterial resistance and toxicity of antibiotics have become a global pandemic and unavoidable. Recently, vaccines for dental caries and periodontal disease have been developed and applied. Moreover, the use of photodynamic therapy has become an alternative to antibiotic drugs. The purpose of this article is to highlight the advantages of vaccine therapy and photodynamic therapy for oral microbial-related diseases compared to treatments with antimicrobial agents and traditional periodontal surgery.

A 52-kDa leucyl aminopeptidase from treponema denticola is a cysteinylglycinase that mediates the second step of glutathione metabolism

The metabolism of glutathione by the periodontal pathogen Treponema denticola produces hydrogen sulfide, which may play a role in the host tissue destruction seen in periodontitis. H2S production in this organism has been proposed to occur via a three enzyme pathway, gamma-glutamyltransferase, cysteinylglycinase (CGase), and cystalysin. In this study, we describe the purification and characterization of T. denticola CGase. Standard approaches were used to purify a 52-kDa CGase activity from T. denticola, and high pressure liquid chromatography electrospray ionization tandem mass spectrometry analysis of this molecule showed that it matches the amino acid sequence of a predicted 52-kDa protein in the T. denticola genome data base. A recombinant version of this protein was overexpressed in and purified from Escherichia coli and shown to catalyze the hydrolysis of cysteinylglycine (Cys-Gly) with the same kinetics as the native protein. Surprisingly, because sequence homology indicates that this protein is a member of a family of metalloproteases called M17 leucine aminopeptidases, the preferred substrate for the T. denticola protein is Cys-Gly (k cat/Km of 8.2 microm(-1) min(-1)) not l-Leu-p-NA (k cat/Km of 1.1 microm(-1) min(-1)). The activity of CGase for Cys-Gly is optimum at pH 7.3 and is enhanced by Mn2+, Co2+, or Mg2+ but not by Zn2+ or Ca2+. Importantly, in combination with the two other previously purified T. denticola enzymes, gamma-glutamyltransferase and cystalysin, CGase mediates the in vitro degradation of glutathione into the expected end products, including H2S. These results prove that T. denticola contains the entire three-step pathway to produce H2S from glutathione, which may be important for pathogenesis.

Novel mechanism for conditional aerobic growth of the anaerobic bacterium Treponema denticola

Treponema denticola, a periodontal pathogen, has recently been shown to exhibit properties of a facultative anaerobic spirochete, in contrast to its previous recognition as an obligate anaerobic bacterium. In this study, the capacity and possible mechanism of T. denticola survival and growth under aerobic conditions were investigated. Factors detrimental to the growth of T. denticola ATCC 33405, such as oxygen concentration and hydrogen sulfide (H(2)S) levels as well as the enzyme activities of gamma-glutamyltransferase, cysteinylglycinase, and cystalysin associated with the cells were monitored. The results demonstrated that T. denticola grew only at deeper levels of broth (>or=3 ml in a 10-ml tube), high inoculation ratios (>or=20% of culture in medium), and short cultivation times ( Collapse

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MESH Headings

• Aerobiosis
• Anaerobiosis
• Anti-Bacterial Agents/metabolism
• Culture Media/chemistry
• Cystathionine gamma-Lyase/metabolism
• Dipeptidases/metabolism
• Hydrogen Sulfide/metabolism
• Oxygen/metabolism
• Time Factors
• Treponema denticola/growth & development
• Treponema denticola/metabolism
• gamma-Glutamyltransferase/metabolism

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Grants

• R01 DE013819 NIDCR NIH HHS
• R56 DE013819 NIDCR NIH HHS
• DE-13819 NIDCR NIH HHS

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Affiliation(s)

Yanlai Lai Department of Orthodontics, University of Texas Health Science Center, San Antonio, TX 78229, USA
Lianrui Chu

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