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HOKKYO A, KAKIYAMA S, SHIWA Y, KAGA C, KOBAYASHI T, NOMOTO K, HARIMA-MIZUSAWA N. Continuous intake of galacto-oligosaccharides containing syrup contributes to maintaining the health of household dogs by modulating their gut microbiota. BIOSCIENCE OF MICROBIOTA, FOOD AND HEALTH 2024; 43:204-212. [PMID: 38966045 PMCID: PMC11220336 DOI: 10.12938/bmfh.2023-062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/22/2024] [Indexed: 07/06/2024]
Abstract
Interest is growing in the relationship of the microbiota and intestinal environment with health in companion animals. Galacto-oligosaccharides (GOS), typical prebiotics, are expected to provide benefits in dogs. Previous studies of GOS in dogs have involved dogs with similar rearing conditions and diets, which may have biased the results. We conducted an open study of 26 healthy dogs kept in households with diverse rearing environments in order to evaluate how the intake of a GOS-containing syrup affects the intestinal microbiota and its metabolites. Each dog was fed 1.2-4.8 g of the GOS-containing syrup (GOS 0.5-2.0 g equivalent) for 8 weeks. Fecal microbiota, fecal concentrations of organic acids and putrefactive products, fecal odor, and serum uremic toxin concentrations were evaluated before intake (0 weeks), during the 8-week intake period (4 and 8 weeks), and 4 weeks after intake (12 weeks). The activity of N-benzoyl-DL-arginine peptidase in dental plaque, which may be associated with periodontal disease, was evaluated at 0 and 8 weeks. Continuous intake of GOS resulted in changes in fecal microbiota, with a particularly marked increase in the abundance of Megamonas, which produces propionic acid. Other findings included a significant increase in the fecal acetic, propionic, and n-butyric acid concentrations. Additionally, significant decreases in fecal odor, fecal phenol concentration, and serum indoxyl sulfate concentration. Intake of GOS was also associated with a significant decrease in N-benzoyl-DL-arginine peptidase activity in dental plaques. These results suggest that continuous intake of GOS may contribute to canine health.
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Affiliation(s)
- Atsuko HOKKYO
- Yakult Honsha Co., Ltd., Central Research Institute, 5-11
Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - Sayaka KAKIYAMA
- Yakult Honsha Co., Ltd., Central Research Institute, 5-11
Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - Yuh SHIWA
- Department of Molecular Microbiology, Tokyo University of
Agriculture, 1-1-1 Sakuragaoka, Setagaya-ku, Tokyo 156-8502, Japan
- NODAI Genome Research Center, Tokyo University of
Agriculture, 1-1-1 Sakuragaoka, Setagaya-ku, Tokyo 156-8502, Japan
| | - Chiaki KAGA
- Yakult Honsha Co., Ltd., Central Research Institute, 5-11
Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - Toshihide KOBAYASHI
- Yakult Honsha Co., Ltd., Central Research Institute, 5-11
Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
| | - Koji NOMOTO
- Department of Molecular Microbiology, Tokyo University of
Agriculture, 1-1-1 Sakuragaoka, Setagaya-ku, Tokyo 156-8502, Japan
| | - Naomi HARIMA-MIZUSAWA
- Yakult Honsha Co., Ltd., Central Research Institute, 5-11
Izumi, Kunitachi-shi, Tokyo 186-8650, Japan
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Aslan BI, Uzuner FD, Taskaldıran ES, Tuter G, Gulsen A, Güngör K, Ucuncu N. Evaluation of the Change in Halitosis with the Improvement in Oral Health in Cleft Lip and Palate Patients. Cleft Palate Craniofac J 2023:10556656231212033. [PMID: 37926978 DOI: 10.1177/10556656231212033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
AIM This study aimed to assess the effects of hygiene education on periodontal health and mouth/nasal halitosis in patients with cleft. MATERIALS AND METHODS 39 patients with cleft who were accepted for orthodontic treatment divided into two groups as with (Group1; n = 24) and without braces (Group2; n = 15). Plaque Index (PI), Gingival Index (GI), and Tongue coating Index (TCI) values were recorded. The BANA test microbiological kit, was used to determine the amount of anaerobic bacteria. Values of volatile sulfur components (VSC) for the measurement of oral and nasal halitosis were measured with a Halimeter device. After the initial measurements, oral hygiene instructions were given to eliminate the plaque production on teeth, periodontal structure, tongue and palate. All measurements were repeated 4 weeks after the hygiene instructions. Wilcoxon and Mann-Whitney U test were used for statistical analysis. RESULTS In both groups, the PI, GI, values were significantly decreased (P < .05). Tongue coating area, thickness and TCI were significantly reduced (P < .05). Oral halitosis values decreased significantly (P < .05). The PI values decreased significantly more in the Group 1 (P < .05). Non significant difference was detected in nasal halitosis in both groups. In unilateral cleft lip and palate cases cases (n = 23), no significant difference was found in nasal halitosis values between the cleft and the healthy sides (P > 0.05). CONCLUSION In patients with clet cases, periodontal health was improved and oral halitosis was reduced by the given hygiene education; brushing the teeth, especially the tongue and palate. However, hygiene education did not have a significant effect on nasal halitosis. Key Words: Cleft lip and palate, Halitosis, BANA test, Periodontal index.
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Affiliation(s)
- Belma Isık Aslan
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Fatma Denız Uzuner
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Ezgi Sila Taskaldıran
- Department of Periodontology, Dentistry Faculty, Istanbul Aydin University, Istanbul, Turkey
| | - Gulay Tuter
- Department of Periodontolgy, Gazi University, Ankara, Turkey
| | - Ayse Gulsen
- Department of Plastic Reconstructive and Estethic Surgery, Faculty of Medicine, University of Gazi, Ankara, Turkey
| | - Kahraman Güngör
- Department of Dentomaxillofacial Radiology, Gazi Universitesi, Ankara, Turkey
| | - Neslihan Ucuncu
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Ankara, Turkey
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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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Gurpinar B, Kumral TL, Sari H, Tutar B, Uyar Y. A new halitosis screening tool: halitosis finding score derivation and validation. Acta Odontol Scand 2022; 80:44-50. [PMID: 34102953 DOI: 10.1080/00016357.2021.1936162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The lack of a valid and appropriate halitosis screening survey prompted us to develop and validate a simple, 15-item questionnaire to be used as a screening tool to score halitosis for the daily practise. METHODS After calculating the sample size, 200 participants were included in the study. All participants filled a 15-item questionnaire with the subsequent measurements of halitosis through the organoleptic scoring system and a halimeter. The application of questionnaire and the halitosis measurements were repeated 15 days after the first control. RESULTS Mann-Whitney's U test was statistically significant between the halimeter measurements and Halfins scores (p=.000, p<.05). ROC curve is drawn due to halitometer analyses. The cut-off point was determined such as Halfins scores greater than 14 indicated halitosis (65.75 sensitivity, 66.04 specificity). The content validation and concurrent validity were proven successful. CONCLUSIONS A new halitosis-specific screening tool called Halfins was proven as a valid diagnostic tool for measuring halitosis in the present study. Nevertheless, we believe this questionnaire could be used as complementary tool for the diagnosis of halitosis, seeing as its use alone is not able to firmly conclude the presence of halitosis in all cases, an organoleptic test or VSC assessment would still be necessary.
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Affiliation(s)
- Berk Gurpinar
- Department of Otolaryngology, Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Tolgar Lutfi Kumral
- Department of Otolaryngology, Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Huseyin Sari
- Department of Otolaryngology, Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Belgin Tutar
- Department of Otolaryngology, Cemil Tascioglu City Hospital, Istanbul, Turkey
| | - Yavuz Uyar
- Department of Otolaryngology, Cemil Tascioglu City Hospital, Istanbul, Turkey
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Musić L, Par M, Peručić J, Badovinac A, Plančak D, Puhar I. Relationship Between Halitosis and Periodontitis: a Pilot Study. Acta Stomatol Croat 2021; 55:198-206. [PMID: 34248153 PMCID: PMC8255038 DOI: 10.15644/asc55/2/9] [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] [Accepted: 04/27/2021] [Indexed: 11/10/2022] Open
Abstract
Objective Halitosis, or oral malodour, is an unpleasant smell emanating from the oral cavity. It is a common complaint among patients with periodontitis, however, their relationship is not fully elucidated. This study aimed to evaluate the association between halitosis measures, clinical indicators of periodontitis and tongue coating, as well as a novel measure, periodontal inflamed surface area (PISA). Material and methods Data of 10 patients with periodontitis and halitosis were included in this study. Halitosis was assessed by the organoleptic method and the portable sulphide monitor, measuring volatiles sulphur compounds. A comprehensive periodontal examination was conducted, and the parameters of probing depth, gingival recession, clinical attachment level, bleeding on probing, plaque and tongue coating were registered. The PISA was calculated using clinical attachment level, gingival recession and bleeding on probing. Results A correlation between organoleptic score and tongue coating (r=0.554) and plaque (r=0.614) could be observed. No correlation between measures of halitosis and probing depth or the PISA could be detected. A significant correlation was found between organoleptic scores and volatiles sulphur compounds values (r=0.931). Conclusion This pilot study has shown and further reiterated a complex interplay between different factors causative to halitosis in patients affected by periodontitis. The results suggest that tongue coating and oral hygiene may have an important role in halitosis in patients with periodontitis.
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Affiliation(s)
- Larisa Musić
- 1Department of Periodontology, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
2Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
3Undergraduate student, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Matej Par
- 1Department of Periodontology, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
2Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
3Undergraduate student, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Jasna Peručić
- 1Department of Periodontology, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
2Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
3Undergraduate student, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Ana Badovinac
- 1Department of Periodontology, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
2Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
3Undergraduate student, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Darije Plančak
- 1Department of Periodontology, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
2Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
3Undergraduate student, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
| | - Ivan Puhar
- 1Department of Periodontology, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
2Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
3Undergraduate student, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb, Croatia
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Wu J, Cannon RD, Ji P, Farella M, Mei L. Halitosis: prevalence, risk factors, sources, measurement and treatment - a review of the literature. Aust Dent J 2019; 65:4-11. [PMID: 31610030 DOI: 10.1111/adj.12725] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2019] [Indexed: 11/29/2022]
Abstract
Halitosis, an offensive breath odour, has multiple sources and negative impacts on people's social interactions and quality of life. It is important for health care professionals, including general physicians and dental professionals, to understand its aetiology and risk factors in order to diagnose and treat patients appropriately. In this study, we have reviewed the current literature on halitosis regarding its prevalence, classification, risk factors, sources, measurement and treatment.
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Affiliation(s)
- J Wu
- Department of Oral Sciences, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - R D Cannon
- Department of Oral Sciences, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - P Ji
- Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - M Farella
- Department of Oral Sciences, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
| | - L Mei
- Department of Oral Sciences, Faculty of Dentistry, Sir John Walsh Research Institute, University of Otago, Dunedin, New Zealand
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Rams TE, van Winkelhoff AJ. Introduction to Clinical Microbiology for the General Dentist. Dent Clin North Am 2017; 61:179-197. [PMID: 28317561 DOI: 10.1016/j.cden.2016.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Clinical oral microbiology may help dental professionals identify infecting pathogenic species and evaluate their in vitro antimicrobial susceptibility. Saliva, dental plaque biofilms, mucosal smears, abscess aspirates, and soft tissue biopsies are sources of microorganisms for laboratory testing. Microbial-based treatment end points may help clinicians better identify patients in need of additional or altered dental therapies before the onset of clinical treatment failure, and help improve patient oral health outcomes. Microbiological testing appears particularly helpful in periodontal disease treatment planning. Further research and technological advances are likely to increase the availability and clinical utility of microbiological analysis in modern dental practice.
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Affiliation(s)
- Thomas E Rams
- Department of Periodontology and Oral Implantology, Oral Microbiology Testing Service Laboratory, Temple University School of Dentistry, 3223 North Broad Street, Philadelphia, PA 19140, USA; Department of Microbiology and Immunology, Temple University School of Medicine, 3500 North Broad Street, Philadelphia, PA 19140, USA.
| | - Arie J van Winkelhoff
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen, Faculty of Medical Sciences, University of Groningen, Antonius Deusinglaan 1, Groningen 9713 AV, The Netherlands; Department of Medical Microbiology, University Medical Center Groningen, Faculty of Medical Sciences, University of Groningen, Hanzeplein 1, Groningen GZ 9713, The Netherlands
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8
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Sterer N, Bar-Ness Greenstein R, Rosenberg M. β-Galactosidase Activity in Saliva is Associated with Oral Malodor. J Dent Res 2017. [DOI: 10.1177/0810182] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Deglycosylation of oral mucins may be a critical initial step leading to their subsequent proteolysis and putrefaction. The present study was undertaken to determine whether activity in saliva of a major glycosidic enzyme (β–galactosidase) is associated with oral malodor in a group of 64 subjects. Enzyme activity was detected by the use of a chromogenic substrate (X-Gal) impregnated on paper discs. Malodor-related measurements included two odor judges' assessments of whole-mouth and tongue malodor, and volatile sulfide levels measured by a portable sulfide monitor (Interscan Corp.). β–galactosidase assay scores were significantly associated with both odor judges' scores for whole-mouth (p ≤ 0.002; Spearman) and tongue malodor (p ≤ 0.001; Spearman). β–galactosidase activity and sulfide monitor measurements both factored significantly into multiple regression equations for odor judge scores, yielding multiple r-values ranging from 0.47 (p = 0.0007) to 0.60 (p < 0.0001). Analysis of the data presented indicates that β–galactosidase activity in saliva is correlated with oral malodor.
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Affiliation(s)
- N. Sterer
- Department of Oral Biology, The Maurice and Gabriela Goldschleger School
of Dental Medicine, Tel-Aviv University, Ramat-Aviv, Israel, 69978
| | - R. Bar-Ness Greenstein
- Department of Oral Biology, The Maurice and Gabriela Goldschleger School
of Dental Medicine, Tel-Aviv University, Ramat-Aviv, Israel, 69978
| | - M. Rosenberg
- Department of Oral Biology, The Maurice and Gabriela Goldschleger School
of Dental Medicine, Tel-Aviv University, Ramat-Aviv, Israel, 69978
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Rosenberg M, Knaan T, Cohen D. Association among Bad Breath, Body Mass Index, and Alcohol Intake. J Dent Res 2016; 86:997-1000. [PMID: 17890678 DOI: 10.1177/154405910708601015] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Bad breath is a common condition, difficult to assess in the general population. In the present study, we tested the hypothesis that a self-administered questionnaire can help identify factors associated with greater risk of oral malodor. Persons (n = 88) undergoing routine medical check-ups completed a questionnaire including 38 questions on general and oral health, dietary habits, and their own oral malodor levels. Oral malodor assessments included odor judge scores, volatile sulfide levels ( via a Halimeter®, Interscan Corp.), and salivary β-galactosidase. Among the questionnaire results, 9 responses were significantly associated with odor judge scores (p < 0.05, unpaired t test), including questions on alcohol intake and body mass index (BMI). Predictions of odor judge scores based on these 9 questions (linear multiple regression analysis) yielded R = 0.601; when introduced together with Halimeter® and β-galactosidase scores, the correlation rose to R = 0.843. The results suggest that alcohol intake and BMI may be factors that help predict oral malodor.
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Affiliation(s)
- M Rosenberg
- Department of Oral Biology, Goldschleger School of Dental Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
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De Geest S, Laleman I, Teughels W, Dekeyser C, Quirynen M. Periodontal diseases as a source of halitosis: a review of the evidence and treatment approaches for dentists and dental hygienists. Periodontol 2000 2016; 71:213-27. [DOI: 10.1111/prd.12111] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2015] [Indexed: 11/28/2022]
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Singh VP, Malhotra N, Apratim A, Verma M. Assessment and management of halitosis. ACTA ACUST UNITED AC 2015; 42:346-8, 351-3. [DOI: 10.12968/denu.2015.42.4.346] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Vijendra P Singh
- Assistant Professor, Department of Periodontics, Faculty of Dentistry, Melaka Manipal Medical College, Melaka, Malaysia
| | - Neeraj Malhotra
- Reader, Department of Conservative Dentistry and Endodontics, ITS Dental College, Hospital and Research Centre, Greater Noida, UP, India
| | - Abhishek Apratim
- Assistant Professor, Department of Prothodontics, Faculty of Dentistry, Melaka Manipal Medical College, Melaka, Malaysia
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Hammad MM, Darwazeh AM, Al-Waeli H, Tarakji B, Alhadithy TT. Prevalence and awareness of halitosis in a sample of Jordanian population. J Int Soc Prev Community Dent 2015; 4:S178-86. [PMID: 25625076 PMCID: PMC4304056 DOI: 10.4103/2231-0762.149033] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives: This study was conducted to estimate the prevalence and awareness of halitosis among the subjects of a population, and also to compare the results of Halimeter® readings to self-estimation of halitosis and to assess the relationship between halitosis and oral health. Materials and Methods: A sample of 205 employees from the Jordan University for Science and Technology (JUST) were selected as study subjects. A standardized questionnaire focusing on dental hygiene, self-reported halitosis, and smoking was filled by all participants. In the clinical examination, the objective values for assessment of oral health and the presence of halitosis were gathered through an organoleptic test (OLT) and the measurement of volatile sulfur compound (VSC) level by Halimeter for each participant. Results: The prevalence of halitosis was 78%, with low rate of awareness (20.5%). The amount of TC played the most important role in increasing the concentration of VSCs in mouth air (P < 0.001). Conclusion: A statistically significant correlation was found between OLT and Halimeter values (P < 0.001). Subjective patients’ opinion did not correlate with the objective evaluation of halitosis. TC scores and smoking were the factors significantly associated to halitosis. The Halimeter showed promising characteristics regarding diagnosis of halitosis for clinical setting and field surveys.
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Affiliation(s)
- Mohammad M Hammad
- Department of Preventive Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Azmi Mg Darwazeh
- Department of Oral Medicine and Surgery, Jordan University of Science and Technology, Irbid, Jordan
| | - Haider Al-Waeli
- Department of Restorative, School of Dentistry, International Medical University, Malaysia
| | - Bassel Tarakji
- Department of Oral and Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Kingdom of Saudi Arabia
| | - Teeb T Alhadithy
- Department of Oral and Maxillofacial Sciences, Al-Farabi College of Dentistry and Nursing, Riyadh, Kingdom of Saudi Arabia
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Lee SH, Baek DH. Effects of Streptococcus thermophilus on volatile sulfur compounds produced by Porphyromonas gingivalis. Arch Oral Biol 2014; 59:1205-10. [DOI: 10.1016/j.archoralbio.2014.07.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 07/16/2014] [Accepted: 07/16/2014] [Indexed: 11/28/2022]
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Effect of a variety of Chinese herbs and an herb-containing dentifrice on volatile sulfur compounds associated with halitosis: An in vitro analysis. Curr Ther Res Clin Exp 2014; 71:129-40. [PMID: 24683259 DOI: 10.1016/j.curtheres.2010.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2010] [Indexed: 11/20/2022] Open
Abstract
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.
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Laleman I, Dadamio J, De Geest S, Dekeyser C, Quirynen M. Instrumental assessment of halitosis for the general dental practitioner. J Breath Res 2014; 8:017103. [PMID: 24566293 DOI: 10.1088/1752-7155/8/1/017103] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
At the moment there are no clear protocols for the assessment of bad breath. An organoleptic evaluation is still the reference. To date there are several tools available to detect and quantify specific compounds related to halitosis. This paper reviews the available information on three sulphur monitors (OralChroma™ (CHM-1), Halimeter® and Breathtron®), in order to suggest guidance for the general dental practitioner. All three devices showed an acceptable correlation with organoleptic scores. The Halimeter® and Breathtron® seem the most appropriate devices for a general dental practitioner, because they are easy to handle. Because of its capacity of distinguishing between different sulphur compounds and due to its time-consuming and complicated use, the OralChroma™ (CHM-1) seems more suitable in a research environment.
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Affiliation(s)
- I Laleman
- Catholic University Leuven, Department of Periodontology Kapucijnenvoer 33, B-3000 Leuven, Belgium
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Kamaraj R D, Bhushan KS, K L V. An evaluation of microbial profile in halitosis with tongue coating using PCR (polymerase chain reaction)- a clinical and microbiological study. J Clin Diagn Res 2014; 8:263-7. [PMID: 24596791 DOI: 10.7860/jcdr/2014/6213.3856] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 09/29/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Medline search using key words halitosis, tongue coating, polymerase chain reaction, microbial profile did not reveal any study. Hence, the purpose of the present investigation was to assess the malodor using the organoleptic method and tanita device; to quantify odoriferous microorganisms using Polymerase Chain Reaction technique in chronic periodontitis patients. MATERIALS AND METHODS The study included 30 chronic periodontitis patients. Halitosis was detected using organoleptic assessment & tanita breath alert. Microbial analysis of Pg, Tf & Fn was done using PCR. Plaque index (PI), gingival index (GI), gingival bleeding index (GBI) were recorded. RESULT The maximum score of 3 for tongue coating was found in 60% of selected subjects. The tanita breath alert measured VSC level of score 2 in 60% of selected subjects while organoleptic score of 4 was found in 50% of subjects. The maximum mean value of 31.1±36.5 was found to be of F. nucleatum (Fn) followed by P. gingivalis (Pg) (13±13.3) & T. forsythia (Tf) (7.16±8.68) in tongue samples of selected patients. A weak positive correlation was found between VSC levels (tanita score & organoleptic score) and clinical parameters. CONCLUSION The halitosis assessment by measuring VSC levels using organoleptic method and tanita breath alert are clinically feasible. Maximum tongue coating was found in 60% of patients. Fn was found comparatively more than the Pg & Tf. A weak positive correlation was found between VSC levels and clinical parameters such as PI, GI & GBI. Thus,the dentist/ periodontist should emphasise on tongue cleaning measures that would reduce the odoriferous microbial load.
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Affiliation(s)
- Dinesh Kamaraj R
- M.D.S, Department of Periodontics, College of Dental Sciences , Davangere, Karnataka, India
| | - Kala S Bhushan
- Student, Department of Periodontics, College of Dental Sciences , Davangere, Karnataka, India
| | - Vandana K L
- Senior Professor, Department of Periodontics, College of Dental Sciences , Davangere, Karnataka, India
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Setia S, Pannu P, Gambhir RS, Galhotra V, Ahluwalia P, Sofat A. Correlation of oral hygiene practices, smoking and oral health conditions with self perceived halitosis amongst undergraduate dental students. J Nat Sci Biol Med 2014; 5:67-72. [PMID: 24678201 PMCID: PMC3961956 DOI: 10.4103/0976-9668.127291] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE The present study was undertaken to determine the prevalence of oral hygiene practices, smoking habits and halitosis among undergraduate dental students and correlating the oral hygiene practices, oral health conditions to the prevalence of self perceived oral malodour. MATERIALS AND METHODS A self-administered questionnaire was distributed among 277 male and female students. A questionnaire was developed to assess the self-reported perception of oral breath, awareness of bad breath, timing of bad breath, oral hygiene practices, caries and bleeding gums, dryness of the mouth, smoking and tongue coating. RESULTS The results indicate female students had better oral hygiene practices. Significantly less self-reported oral bad breath (P = 0.007) was found in female dental students (40%) as compared to their male counterparts (58%). It was found that smoking and dryness of mouth had statistically significant correlation with halitosis (P = 0.026, P = 0.001). Presence of other oral conditions such as tongue coating and dental caries and bleeding gums also showed higher prevalence of halitosis in dental students. CONCLUSION A direct correlation exists between oral hygiene practices and oral health conditions with halitosis. Females exhibited better oral hygiene practices and less prevalence of halitosis as compared to male students.
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Affiliation(s)
- Saniya Setia
- Intern, Gian Sagar Dental College and Hospital, Rajpura, Punjab, India
| | - Parampreet Pannu
- Department of Pedodontics and Preventive Dentistry, Gian Sagar Dental College and Hospital, Rajpura, Punjab, India
| | - Ramandeep Singh Gambhir
- Department of Public Health Dentistry, Gian Sagar Dental College and Hospital, Rajpura, Punjab, India
| | - Virat Galhotra
- Department of Pedodontics and Preventive Dentistry, Gian Sagar Dental College and Hospital, Rajpura, Punjab, India
| | - Pooja Ahluwalia
- Department of Pedodontics and Preventive Dentistry, Gian Sagar Dental College and Hospital, Rajpura, Punjab, India
| | - Anjali Sofat
- Department of Prosthodontics, Gian Sagar Dental College and Hospital, Rajpura, Punjab, India
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Abstract
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.
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Affiliation(s)
- Bahadır Uğur Aylıkcı
- Department of Periodontology, Kirikkale University Dental Faculty, Kirikkale, Turkey
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Pham TAV, Ueno M, Shinada K, Kawaguchi Y. Factors affecting oral malodor in periodontitis and gingivitis patients. ACTA ACUST UNITED AC 2013; 3:284-90. [PMID: 23129143 DOI: 10.1111/j.2041-1626.2012.00155.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM To examine the associations between oral health status, the presence of N-benzoyl-DL-arginine-2-naphthylamide-positive bacteria, and oral malodor in periodontal patients. METHODS A total of 137 periodontitis and 80 gingivitis patients were included in the study. Oral malodor was measured by an organoleptic test and the OralChroma. An oral examination was conducted, including the assessment of decayed teeth, periodontal status, and tongue coating. The presence of N-benzoyl-DL-arginine-2-naphthylamide-positive bacteria in the subgingiva, tongue coating, and saliva was evaluated by the N-benzoyl-DL-arginine-2-naphthylamide test. RESULTS In the periodontitis group, oral malodor was significantly correlated with decayed teeth, periodontal parameters, and tongue coating. Among the N-benzoyl-DL-arginine-2-naphthylamide test parameters, the highest correlation of oral malodor was found with N-benzoyl-DL-arginine-2-naphthylamide subgingiva, followed by N-benzoyl-DL-arginine-2-naphthylamide tongue coating and N-benzoyl-DL-arginine-2-naphthylamide saliva. In the gingivitis group, oral malodor was significantly correlated with the plaque index, bleeding on probing, and tongue coating. Among the N-benzoyl-DL-arginine-2-naphthylamide test parameters, the highest correlation of oral malodor was found with N-benzoyl-DL-arginine-2-naphthylamide tongue coating, followed by N-benzoyl-DL-arginine-2-naphthylamide saliva and N-benzoyl-DL-arginine-2-naphthylamide subgingiva. CONCLUSION Dental plaque, bleeding on probing, tongue coating, and N-benzoyl-DL-arginine-2-naphthylamide-positive bacteria contribute to oral malodor, but with different degrees in periodontitis and gingivitis patients.
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Affiliation(s)
- Thuy A V Pham
- Department of Periodontology, University of Medicine and Pharmacy, Ho Chi Minh, Vietnam.
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20
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Apatzidou AD, Bakirtzoglou E, Vouros I, Karagiannis V, Papa A, Konstantinidis A. Association between oral malodour and periodontal disease-related parameters in the general population. Acta Odontol Scand 2013; 71:189-95. [PMID: 22339235 DOI: 10.3109/00016357.2011.654259] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM To determine the association between halitosis detection and periodontal status in systemically healthy non-smokers and to assess whether halitosis was related to quantities of Fusobacterium nucleatum and Porphyromonas gingivalis on the tongue dorsum. METHODS Periodontal examinations, tongue coating determination, Halimeter® readings and organoleptic assessments of mouth odour were performed in 28 chronic periodontitis patients, 23 chronic gingivitis patients and 27 healthy individuals. The quantities of P. gingivalis and F. nucleatum were determined in tongue specimens by real-time PCR. RESULTS Halitosis was more likely to be detected in patients with periodontitis (OR = 9.2) and gingivitis (OR = 4.6) than in healthy subjects. The posterior tongue odour was similar for all groups; had the highest score of all organoleptic assessments and was significantly correlated with Halimeter® scores and the odour of the whole mouth air. Periodontitis patients harboured significantly greater amounts of P. gingivalis on their tongue, yet similar quantities of F. nucleatum compared to gingivitis patients and healthy subjects. The amount of P. gingivalis residing on the tongue dorsum of periodontitis patients was significantly associated with halitosis recordings, while the amount of F. nucleatum was related to tongue coating in healthy controls, which corroborates its role in biofilm formation. CONCLUSIONS Patients with periodontal disease were at higher risk for halitosis detection than healthy individuals. The posterior portion of the tongue dorsum seems to be an important source of odourous compounds, regardless of periodontal condition. P. gingivalis residing on the tongue of periodontitis patients may play a key role in oral malodour production.
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Affiliation(s)
- A D Apatzidou
- Department of Preventive Dentistry, Medical School, Aristotle University of Thessaloniki,Thessaloniki, Greece.
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Dadamio J, Tornout M, Vancauwenberghe F, Federico R, Dekeyser C, Quirynen M. Clinical utility of a novel colorimetric chair side test for oral malodour. J Clin Periodontol 2012; 39:645-50. [DOI: 10.1111/j.1600-051x.2012.01901.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Jesica Dadamio
- Department of Periodontology; Catholic University of Leuven; Leuven; Belgium
| | - Marie Tornout
- Department of Periodontology; Catholic University of Leuven; Leuven; Belgium
| | | | | | - Christel Dekeyser
- Department of Periodontology; Catholic University of Leuven; Leuven; Belgium
| | - Marc Quirynen
- Department of Periodontology; Catholic University of Leuven; Leuven; Belgium
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Rösing CK, Loesche W. Halitosis: an overview of epidemiology, etiology and clinical management. Braz Oral Res 2011; 25:466-71. [DOI: 10.1590/s1806-83242011000500015] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2011] [Accepted: 09/01/2011] [Indexed: 01/01/2023] Open
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Dadamio J, Van Tornout M, Van den Velde S, Federico R, Dekeyser C, Quirynen M. A novel and visual test for oral malodour: first observations. J Breath Res 2011; 5:046003. [DOI: 10.1088/1752-7155/5/4/046003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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24
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Kawamoto A, Sugano N, Motohashi M, Matsumoto S, Ito K. Relationship between oral malodor and the menstrual cycle. J Periodontal Res 2010; 45:681-7. [DOI: 10.1111/j.1600-0765.2010.01285.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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Romano F, Pigella E, Guzzi N, Aimetti M. Patients' self-assessment of oral malodour and its relationship with organoleptic scores and oral conditions. Int J Dent Hyg 2010; 8:41-6. [PMID: 20096081 DOI: 10.1111/j.1601-5037.2009.00368.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this study was to compare patients' self-rating of oral malodour with organoleptic evaluation and to relate them to oral conditions. METHODS One hundred and eighty systemically healthy patients with a primary complaint of oral malodour participated in this cross-sectional study. They were asked to complete a questionnaire regarding family and social discomfort and type of halitosis complaint, and to score the degree of their own oral malodour. The quality of the mouth air was assessed organoleptically by a calibrated odour judge. Odour-judge scores and self-assessments of bad breath were compared with one another as well as with clinical parameters (plaque index, bleeding index, probing depth and tongue coating score). RESULTS The organoleptic test revealed that 93.9% of the subjects were found actually to have halitosis. The self-rating of oral malodour varied widely among patients. In 37.8% of patients, there was a correspondence between subjective and organoleptic measurements. The better correspondence was evident at 2-3 scores. The organoleptic ratings were significantly related to clinical parameters, whereas patients' self-measurements did not. The bleeding index had the highest correlation coefficient among the periodontal parameters examined (r = 0.665, P < 0.001). CONCLUSIONS Self-estimation of bad breath correlated well with the presence of oral malodour as determined by organoleptic examination. Patients with slight or moderate oral halitosis presented the highest correlation rate between self- and odour-judge assessment.
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Affiliation(s)
- F Romano
- Section of Periodontology, Department of Biomedical Sciences and Human Oncology, University of Torino, Torino, Italy
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26
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Alagirisamy N, Hardas SS, Jayaraman S. Novel colorimetric sensor for oral malodour. Anal Chim Acta 2010; 661:97-102. [DOI: 10.1016/j.aca.2009.11.064] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2009] [Revised: 11/13/2009] [Accepted: 11/30/2009] [Indexed: 11/17/2022]
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Hartley MG, El-Maaytah MA, McKenzie C, Greenman J. The Tongue Microbiota of Low Odour and Malodorous Individuals. MICROBIAL ECOLOGY IN HEALTH AND DISEASE 2009. [DOI: 10.3109/08910609609166462] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- M. Gillian Hartley
- Bristol Oral Microbiology Unit, Faculty of Applied Sciences, University of the West of England, Bristol, UK
| | - M. A. El-Maaytah
- Bristol Oral Microbiology Unit, Faculty of Applied Sciences, University of the West of England, Bristol, UK
| | - C. McKenzie
- Bristol Oral Microbiology Unit, Faculty of Applied Sciences, University of the West of England, Bristol, UK
| | - J. Greenman
- Bristol Oral Microbiology Unit, Faculty of Applied Sciences, University of the West of England, Bristol, UK
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Waer SM. The Effect of Some Metal Ions on Volatile Sulfur-Containing Compounds Originating from the Oral Cavity. Acta Odontol Scand 2009. [DOI: 10.3109/00016359709115425] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
ABSTRACT
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.
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Woodall GM, Smith RL, Granville GC. Proceedings of the Hydrogen Sulfide Health Research and Risk Assessment Symposium October 31-November 2, 2000. Inhal Toxicol 2008; 17:593-639. [PMID: 16033755 DOI: 10.1080/08958370591000618] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The Hydrogen Sulfide Health Research and Risk Assessment Symposium came about for several reasons: (1) increased interest by the U.S. Environmental Protection Agency (EPA) and several state agencies in regulating hydrogen sulfide (H2S); (2) uncertainty about ambient exposure to H2S; (3) confusion and disagreement in the literature about possible health effects at low-level exposures; and (4) presentation of results of a series of recent animal bioassays. The American Petroleum Institute (API) proposed this symposium and the EPA became an early co-sponsor, with the Chemical Industry Institute of Toxicology (CIIT) and the American Forest & Paper Association (AF&PA) contributing expertise and funding assistance. The topics covered in this symposium included Animal Research, Human Research, Mode-of-Action and Dosimetry Issues, Environmental Exposure and Monitoring, Assessment and Regulatory Issues, and closed with a panel discussion. The overall goals of the symposium were to: gather together experts in H2S health effects research and individuals from governmental agencies charged with protecting the public health, provide a venue for reporting of recent research findings, identify gaps in the current information, and outline new research directions and promote research collaboration. During the course of the symposium, presenters provided comprehensive reviews of the state of knowledge for each topic. Several new research proposals discussed at the symposium have subsequently been initiated. This report provides a summary of the talks, poster presentations, and panel discussions that occurred at the Hydrogen Sulfide Health and Risk Assessment Symposium.
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Peruzzo DC, Salvador SL, Sallum AW, Nogueira-Filho GDR. Flavoring agents present in a dentifrice can modify volatile sulphur compounds (VSCs) formation in morning bad breath. Braz Oral Res 2008; 22:252-7. [DOI: 10.1590/s1806-83242008000300011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2007] [Accepted: 09/03/2007] [Indexed: 11/22/2022] Open
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Coelho Dal Rio AC, Danielli Nicola EM, Franchi Teixeira AR. Halitosis--an assessment protocol proposal. Braz J Otorhinolaryngol 2008; 73:835-842. [PMID: 18278230 PMCID: PMC9450685 DOI: 10.1016/s1808-8694(15)31180-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2005] [Accepted: 09/08/2005] [Indexed: 11/25/2022] Open
Abstract
UNLABELLED Halitosis is an embarrassing symptom with a significant social impact. Halitosis affects millions of people worldwide and many resources are spent annually in products to improve halitus, unsuccessfully. The study of halitosis in a scientific basis is justified once halitosis causes social restriction, decreases life quality and may be an indication of serious diseases. AIM To elaborate a protocol for halitosis assessment in order to minimize costs, avoid unnecessary tests and provide a guideline for diagnosis. METHODS The protocol was created based on the literature and on the authors personal experiences, adopting an evidence-based anamnesis. RESULTS There are many causes of halitosis and most of them are related to the oral cavity; others are related to otolaryngologic and respiratory diseases. Gastrointestinal diseases, liver/renal impairment and other metabolic syndromes are less frequent, but also important causes of halitosis. CONCLUSION There are important costs involved in halitosis assessment and treatment, including medical appointments, specialist assessment, and complementary tests. Such costs would be minimized by adopting a protocol of evidence-based anamnesis and a flowchart for a rational clinical investigation.
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Affiliation(s)
| | - Ester Maria Danielli Nicola
- PhD. Professor of Otolaryngology and Head and Neck Surgery - Dept. of OPHT / ENT - FCM - UNICAMP, Coordinator of the Graduate Course - Medical Sciences - FCM-UNICAMP, Coordinator of the Laser Medicine Multidisciplinary Unit - HC-UNICAMP
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Kara C, Demir T, Orbak R, Tezel A. Effect of Nd: YAG laser irradiation on the treatment of oral malodour associated with chronic periodontitis. Int Dent J 2008; 58:151-8. [DOI: 10.1111/j.1875-595x.2008.tb00191.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Kurata H, Awano S, Yoshida A, Ansai T, Takehara T. The prevalence of periodontopathogenic bacteria in saliva is linked to periodontal health status and oral malodour. J Med Microbiol 2008; 57:636-642. [DOI: 10.1099/jmm.0.47706-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This study investigated whether an improvement in periodontal health resulted in changes in the prevalence of periodontopathogenic bacteria in saliva and tongue coatings and a reduction in volatile sulfur compounds (VSCs: H2S and CH3SH) linked to oral malodour. The subjects were 35 patients who visited the breath odour clinic of Kyushu Dental College, Japan. Their mean age was 51.2±18.3 years (mean±sd). A clinical examination performed at baseline and 2 months after periodontal treatment assessed VSCs in mouth air using gas chromatography, periodontal probing depth and bleeding on probing (BOP) in all subjects; saliva and tongue coatings were also collected. Genomic DNA was isolated from the samples, and the proportions of five periodontopathogenic bacteria (Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, Prevotella intermedia and Prevotella nigrescens) were investigated using quantitative real-time PCR. The subjects were classified into four groups based on the presence of a periodontal pocket of more than 4 mm (PD) and VSCs above the organoleptic threshold level (VSCT) as follows: –PD/–VSCT group, subjects without PD or VSCT; –PD/+VSCT group, those without PD but with VSCT; +PD/–VSCT group, those with PD but without VSCT; and +PD/+VSCT group, those with PD and VSCT. Although the mean PD values in the +PD/–VSCT and +PD/+VSCT groups, BOP in the +PD/+VSCT group, and H2S and CH3SH concentrations in the –PD/+VSCT and +PD/+VSCT groups were greater than in the other groups at baseline, we found no significant difference among the four groups after periodontal treatment. The proportion of periodontopathogenic bacteria in saliva was higher in the +PD/–VSCT and +PD/+VSCT groups than in the –PD/–VSCT and –PD/+VSCT groups at baseline and after treatment, but the proportions of bacteria in saliva after treatment were reduced compared to the baseline. Furthermore, the differences in the proportions of the five target bacteria in the tongue coating were not as apparent as those in saliva at baseline or after treatment. The prevalence of periodontopathogenic bacteria in saliva may reflect periodontal health status and influence VSC levels in mouth air.
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Affiliation(s)
- Hiroshi Kurata
- Division of Community Oral Health Science, Department of Health Promotion, Kyushu Dental College, 2-6-1 Manazuru, Kokurakitaku, Kitakyushu 803-8580, Japan
| | - Shuji Awano
- Division of Community Oral Health Science, Department of Health Promotion, Kyushu Dental College, 2-6-1 Manazuru, Kokurakitaku, Kitakyushu 803-8580, Japan
| | - Akihiro Yoshida
- Division of Community Oral Health Science, Department of Health Promotion, Kyushu Dental College, 2-6-1 Manazuru, Kokurakitaku, Kitakyushu 803-8580, Japan
| | - Toshihiro Ansai
- Division of Community Oral Health Science, Department of Health Promotion, Kyushu Dental College, 2-6-1 Manazuru, Kokurakitaku, Kitakyushu 803-8580, Japan
| | - Tadamichi Takehara
- Division of Community Oral Health Science, Department of Health Promotion, Kyushu Dental College, 2-6-1 Manazuru, Kokurakitaku, Kitakyushu 803-8580, Japan
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Nogueira-Filho GR, Peruzzo D, Sallum AW. Relationship between the formation of volatile sulfur compounds (VSC) and the severity of the periodontal disease: a pilot study. J Breath Res 2008; 2:017005. [DOI: 10.1088/1752-7155/2/1/017005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Kurata H, Awano S, Yoshida A, Ansai T, Takehara T. Volatile sulphide compound levels in mouth air with plaque-related periodontal disease are associated with a change in the proportion of periodontopathic bacteria in saliva. J Breath Res 2008; 2:017006. [DOI: 10.1088/1752-7155/2/1/017006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abstract
A Halitose é um sintoma constrangedor com significativo impacto social. Ela afeta milhões de pessoas ao redor do mundo e muitos recursos são investidos em produtos para a melhora do hálito, sem sucesso. O estudo da halitose com uma abordagem científica se justifica, uma vez que a halitose é causa de restrição social, diminui a qualidade de vida e pode ser indicativo da presença de doenças mais graves. OBJETIVO: Elaborar um protocolo de avaliação da halitose com o objetivo de minimizar custos, evitar exames desnecessários e orientar o diagnóstico causal. MÉTODO: O protocolo foi elaborado baseado na literatura e na experiência pessoal dos autores, adotando uma anamnese baseada em evidências. RESULTADO: Existem muitas causas da halitose e a maioria delas está relacionada com a cavidade oral, outras estão relacionadas com doenças otorrinolaringológicas e respiratórias. Doenças gastrointestinais, alterações das funções renais e hepáticas e outras síndromes metabólicas são causas menos freqüentes, porém importantes de halitose. CONCLUSÃO: Existem custos importantes envolvidos no diagnóstico e tratamento da halitose, incluindo consultas ambulatoriais, avaliação de especialistas e exames complementares. Estes custos poderiam ser minimizados adotando uma anamnese baseada em evidências e um organograma para uma investigação clínica racional.
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van den Broek AMWT, Feenstra L, de Baat C. A review of the current literature on aetiology and measurement methods of halitosis. J Dent 2007; 35:627-35. [PMID: 17555859 DOI: 10.1016/j.jdent.2007.04.009] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2007] [Revised: 04/05/2007] [Accepted: 04/27/2007] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES This work reviews the current knowledge of aetiology and measurement methods of halitosis. DATA Halitosis is an unpleasant or offensive odour emanating from the breath. The condition is multifactorial and may involve both oral and non-oral conditions. SOURCES A private, monthly with keywords halitosis, malodo(u)r, (a)etiology, measurement, and management from Medline and Pubmed updated database of literature was reviewed. CONCLUSIONS In approximately 80-90% of all cases, halitosis is caused by oral conditions, defined as oral malodour. Oral malodour results from tongue coating, periodontal disease, peri-implant disease, deep carious lesions, exposed necrotic tooth pulps, pericoronitis, mucosal ulcerations, healing (mucosal) wounds, impacted food or debris, imperfect dental restorations, unclean dentures, and factors causing decreased salivary flow rate. The basic process is microbial degradation of organic substrates. Non-oral aetiologies of halitosis include disturbances of the upper and lower respiratory tract, disorders of the gastrointestinal tract, some systemic diseases, metabolic disorders, medications, and carcinomas. Stressful situations are predisposing factors. There are three primary measurement methods of halitosis. Organoleptic measurement and gas chromatography are very reliable, but not very easily clinically implemented methods. The use of organoleptic measurement is suggested as the 'gold standard'. Gas chromatography is the preferable method if precise measurements of specific gases are required. Sulphide monitoring is an easily used method, but has the limitation that important odours are not detected. The scientific and practical value of additional or alternative measurement methods, such as BANA test, chemical sensors, salivary incubation test, quantifying beta-galactosidase activity, ammonia monitoring, ninhydrin method, and polymerase chain reaction, has to be established.
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Affiliation(s)
- Annemiek M W T van den Broek
- Department of Oral and Maxillofacial Surgery and Special Dental Care, Erasmus University Medical Centre, Rotterdam, The Netherlands
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Krespi YP, Shrime MG, Kacker A. The relationship between oral malodor and volatile sulfur compound-producing bacteria. Otolaryngol Head Neck Surg 2006; 135:671-6. [PMID: 17071291 DOI: 10.1016/j.otohns.2005.09.036] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2005] [Accepted: 09/21/2005] [Indexed: 11/30/2022]
Abstract
Halitosis can be a crippling social problem, and standard dental treatments and mouthwashes often provide only temporary relief. The mouth is home to hundreds of bacterial species that produce several fetid substances as a result of protein degradation. Volatile sulfur compound (VSC)-producing bacteria colonizing the lingual dorsum have recently been implicated in the generation of halitosis. Detection of VSCs, such as methylmercaptan and hydrogen sulfite, via organoleptic and objective methods, can aid in the identification of their source. Following comprehensive evaluation for possible causes, most halitosis in patients seen in an ENT practice can be localized to the tongue. We review methods of diagnosis and treatment of oral malodor from the overgrowth of proteolytic, anaerobic, gram-negative bacteria on the crevices of the lingual dorsum. Bacteriologic analysis of biofilm and scraped specimens obtained from the lingual dorsum and other oral sites, primarily gingival pockets and tonsillar crypts, can identify VSC-producing bacteria. Porphyromonas, Prevotella, Actinobacillus, and Fusobacterium species are the most common organisms identified. Halitosis is an oral phenomenon, with almost no cases originating distal to the tonsils. Halitosis arising from the lingual dorsum secondary to overpopulated VSC-producing bacteria can be successfully managed with a combination of mechanical cleansing using tongue brushes or scrapes and chemical solutions containing essential oils, zinc chloride, and cetylpyridinium chloride.
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Affiliation(s)
- Yosef P Krespi
- Department of Otolaryngology, St Luke's / Roosevelt Hospital, New York, New York, USA
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Yoneda M, Naito T, Suzuki N, Yoshikane T, Hirofuji T. Oral malodor associated with internal resorption. J Oral Sci 2006; 48:89-92. [PMID: 16858138 DOI: 10.2334/josnusd.48.89] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
We report a case of oral malodor associated with internal resorption. A 39-year-old male attended our hospital complaining of oral malodor. Utilizing organoleptic measurement, the halimeter test and gas chromatography, it was diagnosed as a strong halitosis caused by oral origin. The pocket probing depth of tooth 21 was 10 mm, and X-ray examination revealed a vertical bone loss around this tooth. The patient had received periodontal treatment at two dental offices previously, but the periodontal conditions and oral malodor persisted. We performed an initial periodontal preparation, however a deep pocket remained. We therefore performed a surgical inspection including flap reflection, and found that the tooth had a large perforating defect in the distal surface. The extracted tooth had multiple perforating defects covered with granulation tissues on all root surfaces including the root apex. Taking into consideration the anamnesis and X-ray examination of the extracted tooth, internal absorption was considered to have been the cause of the multiple perforating defects. After extraction of the causative tooth, oral malodor dramatically decreased. To our knowledge, this is the first report of an oral malodor associated with internal resorption.
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Affiliation(s)
- Masahiro Yoneda
- Section of General Dentistry, Department of General Dentistry, Fukuoka Dental College, Japan.
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Monteiro-Amado F, Chinellato LEM, de Rezende MLR. Evaluation of oral and nasal halitosis parameters in patients with repaired cleft lip and/or palate. ACTA ACUST UNITED AC 2005; 100:682-7. [PMID: 16301148 DOI: 10.1016/j.tripleo.2005.03.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2005] [Revised: 03/07/2005] [Accepted: 03/23/2005] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this study was to investigate the relationship between halitosis parameters in patients with and without cleft lip and/or palate. STUDY DESIGN Forty-two subjects were examined. They were divided into group I, postgraduate students of Bauru Dental School (FOB); and group II, individuals with repaired cleft lip and/or palate. The concentration of volatile sulfur compounds (VSC) was assessed with a portable sulfide monitor and the values were correlated to the salivary flow rate and weight of tongue coating. RESULTS There was a relationship between the presence of tongue coating and VSC levels, as well as between salivary flow rate and VSC levels in group II. The same group also revealed a significant correlation between weight of tongue coating and salivary flow rate. There were no significant differences between groups as regards the Halimeter oral measurement. CONCLUSIONS Individuals with repaired cleft lip and/or palate can have the same VSC levels as subjects without clefts.
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Affiliation(s)
- Flávio Monteiro-Amado
- Hospital for Rehabilitation of Craniofacial Anomalies, Universidade of São Paulo, and Master of Science in Stomatology by Bauru Dental School, Universidade of São Paulo, Bauru, Brazil.
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Stamou E, Kozlovsky A, Rosenberg M. Association between oral malodour and periodontal disease-related parameters in a population of 71 Israelis. Oral Dis 2005; 11 Suppl 1:72-4. [PMID: 15752105 DOI: 10.1111/j.1601-0825.2005.01097.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of the present study was to determine whether oral malodour and periodontal disease parameters are associated with one another in 71 Israeli subjects (mean age 36.2 +/- 18.4; ages ranging from 15 to 65). Parameters measured included whole mouth odour judge scoring, Halimeter, OK to Kiss test, gingival index, plaque index and probing depth. Odour judge scores were significantly associated with Halimeter (r = 0.55; P < 0.001), as well as the OK to Kiss test (r = 0.52; P < 0.001). However, neither gingival index, plaque index nor probing depth was significantly associated with odour judge scores or Halimeter scores. Logistic regression analysis showed that both Halimeter and OK to Kiss scores factored significantly (P = 0.005 and 0.018, respectively, odds ratios 14.9 and 2.7, respectively) in predicting the severity of oral malodour. Results suggest that in the population studied, periodontal health and oral malodour are not associated with one another.
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Affiliation(s)
- E Stamou
- Department of Orthodontics, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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Ohmori M, Miyazaki A, Sato H, Katano S, Tanabe S, Masatsuki N, Imade S, Sano A. A Study on the Effects of Tongue Cleaning. ACTA ACUST UNITED AC 2005. [DOI: 10.2329/perio.47.36] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Tanaka M, Yamamoto Y, Kuboniwa M, Nonaka A, Nishida N, Maeda K, Kataoka K, Nagata H, Shizukuishi S. Contribution of periodontal pathogens on tongue dorsa analyzed with real-time PCR to oral malodor. Microbes Infect 2004; 6:1078-83. [PMID: 15380777 DOI: 10.1016/j.micinf.2004.05.021] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2004] [Accepted: 05/28/2004] [Indexed: 11/17/2022]
Abstract
Oral malodor is considered to originate primarily from tongue microbiota populations. However, the relationship between oral malodor and tongue microbiota remains unclear. In this study, tongue periodontal pathogens were analyzed via real-time PCR, and the association between oral malodor and tongue periodontal pathogens, including Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia, Prevotella nigrescens and Treponema denticola, was examined. The subject population consisted of 29 individuals with and 10 healthy persons without oral malodor. Oral malodor was assessed by organoleptic test and volatile sulfur compound (VSC) levels as measured by gas chromatography. Real-time PCR was conducted for anaerobes in tongue biofilm samples employing a LightCycler system; furthermore, bacterial proportion served as a quantitative parameter. Among the five anaerobes, only T. forsythia displayed higher proportions in malodor subjects than corresponding values in healthy controls. Proportions of P. intermedia and P. nigrescens correlated strongly with hydrogen sulfide concentration. Proportions of P. gingivalis and P. nigrescens also exhibited strong correlation with methyl mercaptan concentration. The correlation coefficient between the proportion of the total of the five anaerobes and total VSC level (r = 0.88) was greater than that between bacterial proportion and organoleptic score (r = 0.29). When a linear regression analysis was performed utilizing the proportion of each of the five periodontal pathogens as an independent variable, the explanatory power of these independent variables revealed 81% for total VSC level and 16% for organoleptic score. These results suggest that these five periodontal pathogens on tongue dorsa may contribute greatly to VSC production.
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Affiliation(s)
- Muneo Tanaka
- Department of Preventive Dentistry, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
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Tanaka M, Anguri H, Nonaka A, Kataoka K, Nagata H, Kita J, Shizukuishi S. Clinical assessment of oral malodor by the electronic nose system. J Dent Res 2004; 83:317-21. [PMID: 15044506 DOI: 10.1177/154405910408300409] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A recently developed electronic nose has not yet been clinically applied to evaluations of oral malodor. This investigation sought to determine whether an electronic nose could clinically assess oral malodor. Twenty-nine healthy adults and 49 patients were assessed by results of an actual organoleptic test, a score representing malodor strength with an electronic nose in "top-note" mode (top-note score), and measurements of volatile sulfur compound (VSC) concentrations. The correlation coefficient between top-note and actual organoleptic scores (r = 0.71) was comparable with the log VSC and actual organoleptic scores (r = 0.63). However, the area under the receiver-operating characteristic plots for top-note score was significantly larger than that for log VSC. In logistic regression analyses with top-note score as a dependent variable, probing depth, tongue coating, and plaque control record each had independent associations. Our findings suggest that the top-note score from an electronic nose examination may be useful for the clinical evaluation of oral malodor.
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Affiliation(s)
- M Tanaka
- Department of Preventive Dentistry, Graduate School of Dentistry, Osaka University, 1-8, Yamadaoka, Suita, Osaka 565-0871, Japan.
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Carvalho MD, Tabchoury CM, Cury JA, Toledo S, Nogueira-Filho GR. Impact of mouthrinses on morning bad breath in healthy subjects. J Clin Periodontol 2004; 31:85-90. [PMID: 15016031 DOI: 10.1111/j.0303-6979.2004.00452.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND During sleep, a proliferation of oral bacteria is responsible for the release of offending gases in morning breath even in healthy people. Thus, the aim of this study was to evaluate the bad breath-inhibiting effect of four commercially available mouthrinses (0.03% triclosan, 0.12% chlorhexidine gluconate, 0.05% cetylpyridinium chloride and essential oils) on morning breath when compared with a positive and a negative control. METHOD A six-step double-blind, crossover, randomised study was conducted in 12 dental students with healthy periodontium, who refrained from mechanical plaque control during a 4-day period. The subjects were instructed to rinse twice daily with the assigned product during each period. Fifteen-day washout intervals were used. Before professional plaque and tongue coating removal (baseline), the morning breath was scored through volatile sulphur compounds (VSCs) level measured by a sulphide monitor. After 4 days, VSCs and plaque index (PI) were recorded. RESULTS Even in the absence of mechanical plaque control, there was a decrease in VSC level with the use of all mouthrinses, with the exception of an increase with the use of the negative control. The VSC formation was inhibited in descending order, by positive control (0.2% chlorhexidine), 0.12% chlorhexidine, triclosan and essential oils and cetylpyridinium chloride. Plaque formation was inhibited by chlorhexidine mouthrinses and essential oils. CONCLUSIONS These findings suggest that mouthrinses can reduce morning bad breath, and that such a reduction is not attributable only to the reduction of supragingival plaque formation.
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Affiliation(s)
- M D Carvalho
- Department of Prosthodontics and Periodontics, Faculty of Dentistry of Piracicaba, University of Campinas, Piracicaba, SP, Brazil
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Quirynen M, Zhao H, Avontroodt P, Soers C, Pauwels M, Coucke W, van Steenberghe D. A salivary incubation test for evaluation of oral malodor: a pilot study. J Periodontol 2003; 74:937-44. [PMID: 12931755 DOI: 10.1902/jop.2003.74.7.937] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Breath odor is scored by different techniques, each with its own shortcomings. Organoleptic ratings are uncomfortable for the patient, subjective, influenced by external parameters including food and cosmetics, and especially lack international calibration. Portable sulphide monitors are relatively expensive and neglect several major malodorous molecules (e.g., butyric and propionic acids, putrescine, and cadaverine). Gas chromatography necessitates expensive devices and experienced technicians. This pilot study explored the applicability of a new technique (saliva incubation) by comparing its discrimination power, in a morning bad breath inhibition study of antiseptics, to those of hydrogen sulphide (H2S) measurement devices and organoleptic ratings. METHODS After a professional cleaning, 8 periodontally healthy students abstained from all means of mechanical plaque control for 5 experimental periods of 7 days, with intervening washout periods of at least 2 weeks. During each experimental period, the students rinsed only twice daily with different antiseptics. At day 7, morning breath was scored clinically (volatile sulphide compound [VSC] level and organoleptic ratings), and 1.5 ml of saliva was collected and divided between 3 glass tubes that were sealed and incubated (37 degrees C, anaerobic chamber). Immediately after collection and after 3 and 6 hours of incubation, the headspace air in one of the tubes was examined for VSC production and organoleptic measurements. RESULTS The investigations of the incubated saliva correlated well with the 7-day intraoral VSC recordings and organoleptic ratings (P < or = 0.005). Moreover, evaluations showed a similar interproduct ranking for their efficacy in malodor control. The power analyses indicated a higher discrimination power for the saliva incubation test than for the intraoral registrations. CONCLUSIONS The strong correlation between odor production of incubated saliva and clinical assessments suggests that the saliva incubation test may be used as an indirect method to measure oral malodor and can be employed to investigate the antimalodor effectiveness of oral hygiene products.
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Affiliation(s)
- Marc Quirynen
- Department of Periodontology, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium.
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Abstract
The many thousands of individuals who experience oral malodor that stems from the overgrowth of proteolytic, anaerobic bacteria on their tongue surfaces can be successfully treated by a regimen that includes tongue brushing and tooth brushing, often in combination with a mouthrinse containing an antibacterial agent. Several candidate mouthrinses containing essential oils (Listerine; Warner-Lambert, Morris Plains, NJ), ZnCl(2), chlorine dioxide, or an oil:water-cetylpyridium chloride mouthrinse have reduced the organoleptic scores of individuals with moderate levels of oral malodor in the absence of tongue brushing. Very little long-term data beyond 6 weeks of use are available.
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Affiliation(s)
- Walter J. Loesche
- University of Michigan School of Dentistry, 1011 N. University, Ann Arbor MI, 48109, USA.
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Roldán S, Winkel EG, Herrera D, Sanz M, Van Winkelhoff AJ. The effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc lactate on the microflora of oral halitosis patients: a dual-centre, double-blind placebo-controlled study. J Clin Periodontol 2003; 30:427-34. [PMID: 12716335 DOI: 10.1034/j.1600-051x.2003.20004.x] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM This study evaluated the microbial effects of a newly formulated mouthwash (Halita) on oral halitosis patients. METHODS Forty subjects were included in this dual-centre, double-blind, placebo-controlled parallel study. Inclusion and exclusion criteria were used to select patients. At baseline and at 2 weeks post-treatment, full-mouth organoleptic odor scores, level of volatile sulphur compounds (VSC) and the Winkel Tongue Coating Index were recorded. Standardized samples of tongue coating, saliva and subgingival plaque were microbiologically investigated. Participants were randomly assigned to the test or placebo groups. RESULTS High prevalences were observed for Fusobacterium nucleatum, Prevotella intermedia and Porphyromonas gingivalis in tongue coating, saliva and subgingival plaque samples. A significant positive correlation between baseline total counts of P. gingivalis in saliva samples and organoleptic and VSC scores was found. Two weeks post-treatment there was a reduction in total anaerobic counts in all samples in the test group. A significant positive correlation was observed between the reduction in total counts in saliva samples and the reduction in organoleptic scores in the test group. Significant reductions in total counts and proportions of F. nucleatum and total counts of P. intermedia in tongue coating samples were observed in the test group. CONCLUSIONS The test mouthwash demonstrated efficacy in reducing the microbiological parameters in three oral niches in moderate to severe halitosis patients without periodontitis, and this was correlated with the improvements in organoleptic and VSC scores but not with the tongue coating scores.
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Affiliation(s)
- S Roldán
- Universidad Complutense de Madrid, Spain.
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