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Shirakawa S, Nagano T, Matsushima Y, Yashima A, Gomi K. Safety and Clinical Evaluation of a Sonic Tongue Brush. Int Dent J 2024; 74:321-327. [PMID: 37985343 PMCID: PMC10988250 DOI: 10.1016/j.identj.2023.10.002] [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: 05/11/2023] [Revised: 09/26/2023] [Accepted: 10/09/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Tongue coating consists of oral bacteria, desquamated epithelium, blood cells, and food residues and is involved in periodontal disease, halitosis, and aspiration pneumonia. Recently, a tongue brush with sonic vibration was developed to clean the tongue. This comparative study examined the extent of tongue coating, its effects on the tongue, bacterial count particularly on the posterior dorsum of the tongue, and the degree of pain using a manual tongue brush and the newly developed sonic tongue brush. MATERIALS AND METHODS Patients' extent of tongue coating and the quantity of bacteria were analysed before and after brushing with a sonic or manual nylon tongue brush. Moreover, the impressions of the dorsum linguae were obtained before and after brushing to establish models that were observed under a stereo microscope to evaluate tongue trauma. Pain caused during the use of these brushes was evaluated based on the numerical rating scale (NRS). RESULTS The extent of tongue coating and number of bacteria decreased in both the sonic and manual nylon brush groups after tongue cleaning; however, no significant differences were noted. Tongue trauma evaluation revealed that the tongue surface was significantly scratched in the manual brush group compared with the sonic brush group. NRS-based pain evaluation revealed no significant differences. CONCLUSIONS The sonic brush was equally effective in removing tongue coating and bacteria compared with the manual brush. As the sonic brush does not cause tongue trauma, it may be considered a safe and effective cleaning tool of the tongue.
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Affiliation(s)
- Satoshi Shirakawa
- Department of Dental Hygiene, Tsurumi Junior College, Kanagawa, Japan
| | - Takatoshi Nagano
- Department of Periodontology, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Yuji Matsushima
- Department of Periodontology, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Akihiro Yashima
- Department of Periodontology, School of Dental Medicine, Tsurumi University, Yokohama, Japan
| | - Kazuhiro Gomi
- Department of Periodontology, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
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2
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Hammouri EH, Mustafa AT, Jaradat TF, Ghozlan MM, Bani Salman MY, Ersheidat AA, Nawasra IM. Exploring Jordanian children and parents' awareness, behavior, and perception of pediatric oral health. BMC Oral Health 2024; 24:64. [PMID: 38195480 PMCID: PMC10777652 DOI: 10.1186/s12903-023-03838-7] [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: 09/12/2023] [Accepted: 12/27/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND To evaluate children's and parents' practice and attitude toward oral hygiene and their knowledge about oral hygiene. METHODS This cross-sectional questionnaire-based study was conducted on randomly selected children who were seen in the Pediatric dentistry clinic in different Royal Medical Services hospitals. A modified questionnaire was used to gather information from the child or parents to gather the child's demographic data and evaluate the children's and parents' practice and attitude toward oral hygiene, their knowledge about oral hygiene, information about the parent and family, and oral examination, the questionnaire questions' reliability and validity were assessed by test-retest and Cronbach's Alpha test. RESULTS Three hundred seventy four patients were included, and the average age was 5.06 ± 3.58 SD years. Children's and parents' practice toward oral hygiene was inadequate where the majority (83.3%) brush their teeth occasionally, change their toothbrushes infrequently, apply toothpaste inappropriately, and less than half (47.2%) clean their tongue after teeth brushing. A significant number (73%) of candidates were aware that oral health has a significant role in their general health and can prevent dental problems. Participants agreed that maintaining a healthy mouth is an individual responsibility. The majority of participants came from large family size (the average family members 6.1 ± 1.7 SD) who live below the poverty line. CONCLUSION Our study demonstrated that awareness of oral health status in children below the age of 12 was poor. Although their oral knowledge was good their attitude and behavior were inadequate. These findings urge the need for expanded, well-organized, preventive educational programs that include school's syllabus, house visits, and hospitals for parents and children alike.
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3
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Souza JPDV, Romero GDA, Melo Neto CLDM, Piacenza LT, Monteiro RV, Silva EVFD, Santos DMD, Goiato MC. Halitosis and Pain Threshold of Peri-Implant Tissues: An Observational Cohort Study. Braz Dent J 2023; 34:1-9. [PMID: 38133082 PMCID: PMC10742358 DOI: 10.1590/0103-6440202305527] [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: 04/18/2023] [Accepted: 10/11/2023] [Indexed: 12/23/2023] Open
Abstract
In this study, we aimed to evaluate the halitosis and pain threshold of the peri-implant soft tissues in individuals rehabilitated with implant-supported prostheses. Forty-eight subjects were divided into four groups (n = 12) according to their prosthetic rehabilitation: single-tooth fixed prosthesis, multi-tooth fixed prosthesis, overdentures, and the Brånemark protocol. Halitosis was measured using a halimeter, whereas the pain threshold was measured using Von Frey monofilaments. Measurements were taken before (t0) and 30 days after (t1) placement of healing caps, and at the time of (t2) and 30 days after (t3) prosthetic placement. Halitosis data were analyzed using the chi-square test and Bonferroni correction (p < 0.05). Two-way ANOVA and Tukey's test (p < 0.05) were used to analyze pain threshold data. We noted an association between halitosis and time for the Brånemark protocol [X2(6) = 18.471; p = 0.005] and overdenture groups [X2(6) = 17.732; p = 0.007], and between halitosis and type of prosthesis only at t0 [X2(6) = 12.894; p = 0.045]. The interaction between time and the type of prosthesis significantly interfered with the mean pain threshold values (p = 0.001). At most time points, the majority of participants in each group had clinically unacceptable halitosis. After 30 days of using the prostheses, the overdenture group had a lower pain threshold compared to the Brånemark protocol group.
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Affiliation(s)
- João Paulo do Vale Souza
- Departamento de Materiais Dentários e Prótese, Universidade Estadual Paulista "Júlio de Mesquita Filho", Araçatuba, Brasil
| | | | | | - Lucas Tavares Piacenza
- Departamento de Materiais Dentários e Prótese, Universidade Estadual Paulista "Júlio de Mesquita Filho", Araçatuba, Brasil
| | | | | | - Daniela Micheline Dos Santos
- Departamento de Materiais Dentários e Prótese, Universidade Estadual Paulista "Júlio de Mesquita Filho", Araçatuba, Brasil
| | - Marcelo Coelho Goiato
- Departamento de Materiais Dentários e Prótese, Universidade Estadual Paulista "Júlio de Mesquita Filho", Araçatuba, Brasil
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4
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Lee YH, Hong JY. Oral microbiome as a co-mediator of halitosis and periodontitis: a narrative review. FRONTIERS IN ORAL HEALTH 2023; 4:1229145. [PMID: 37719278 PMCID: PMC10500072 DOI: 10.3389/froh.2023.1229145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/18/2023] [Indexed: 09/19/2023] Open
Abstract
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.
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Affiliation(s)
- Yeon-Hee Lee
- Department of Orofacial Pain and Oral Medicine, Kyung Hee University School of Dentistry, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Ji-Youn Hong
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, School of Dentistry, Kyung Hee University, Seoul, Republic of Korea
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5
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Veeray JM, Gupta KK, Soni S, Kothari D. Comparison of clinical indices with halitosis grading in chronic periodontitis: A randomized control trial. J Indian Soc Periodontol 2023; 27:422-427. [PMID: 37593549 PMCID: PMC10431231 DOI: 10.4103/jisp.jisp_197_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 02/05/2023] [Accepted: 03/05/2023] [Indexed: 08/19/2023] Open
Abstract
Background Oral malodor is a major periodontal complaint, but the best method for assessing the halitosis grade is still undefined. The primary objective of the study was to detect the halitosis grade in the exhaled breath using the three distinct techniques and to compare the readings with different clinical indices to find out the best method of halitosis grading. Materials and Methods A total of 90 patients with chronic periodontitis having oral malodor were included in the study. The subjective assessment of the exhaled breath (halitosis grading) was done by three different methods; using a handheld portable Tanita FitScan sulfide monitor, by Halitox toxin assay, and by organoleptic (Sniff test) method. The findings were then compared with the clinical parameters of poor oral hygiene like plaque index (PI), gingival index (GI), gingival bleeding index (BI), and pocket depth (PD) to detect the best method of halitosis grading. Results The mean age of the patients included was 38.23 ± 8.83 (mean ± standard deviation) years. The median value of halitosis grading as obtained by Tanita FitScan was 3.0 (95% confidence interval as 2 and 4) which was then compared with clinical indices (PI, GI, BI, and PD) and the results were statistically significant (P < 0.05), whereas the other two techniques of halitosis grading gave insignificant results. Conclusion The results confirmed that the halitosis grading done using Tanita FitScan sulfide monitor is more appropriate with respect to clinical indices when compared with the other two techniques.
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Affiliation(s)
- Junaid Mushtaq Veeray
- Department of Periodontology and Oral Implantology, Vyas Dental College and Hospital, Jodhpur, Rajasthan, India
| | - K. K. Gupta
- Department of Periodontology and Oral Implantology, Vyas Dental College and Hospital, Jodhpur, Rajasthan, India
| | - Sweta Soni
- Department of Periodontology and Oral Implantology, Vyas Dental College and Hospital, Jodhpur, Rajasthan, India
| | - Divya Kothari
- Department of Periodontics, Pacific Dental College and Research Centre, Udaipur, Rajasthan, India
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6
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Izidoro C, Botelho J, Machado V, Reis AM, Proença L, Alves RC, Mendes JJ. Revisiting Standard and Novel Therapeutic Approaches in Halitosis: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11303. [PMID: 36141577 PMCID: PMC9516975 DOI: 10.3390/ijerph191811303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 06/16/2023]
Abstract
Halitosis, or bad breath, is an oral health problem characterized by an unpleasant malodor emanating from the oral cavity. This condition can have different origins and causes a negative burden in social interactions, communication and quality of life, and can in uncommon cases be indicative of underlying non-oral non-communicable diseases. Most cases of halitosis are due to inadequate oral hygiene, periodontitis and tongue coating, yet the remaining proportion of cases are due to ear-nose-throat-associated (10%) or gastrointestinal/endocrine (5%) disorders. For this reason, the diagnosis, treatment and clinical management of halitosis often require a multidisciplinary team approach. This comprehensive review revisits the etiology of halitosis as well as standard and novel treatment that may contribute to higher clinical success.
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Affiliation(s)
- Catarina Izidoro
- Periodontology Department, Egas Moniz Dental Clinic (EMDC), Egas Moniz, CRL, 2829-511 Monte de Caparica, Portugal
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Monte de Caparica, Portugal
| | - João Botelho
- Periodontology Department, Egas Moniz Dental Clinic (EMDC), Egas Moniz, CRL, 2829-511 Monte de Caparica, Portugal
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Monte de Caparica, Portugal
| | - Vanessa Machado
- Periodontology Department, Egas Moniz Dental Clinic (EMDC), Egas Moniz, CRL, 2829-511 Monte de Caparica, Portugal
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Monte de Caparica, Portugal
| | - Ana Mafalda Reis
- Instituto de Ciências Biomédicas Abel Salazar, School of Health and Life Sciences, University of Porto, 4099-002 Porto, Portugal
- Neuroradiology Department, Hospital Pedro Hispano, 4464-513 Matosinhos, Portugal
| | - Luís Proença
- Quantitative Methods for Health Research Unit (MQIS), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz, CRL, 2829-511 Monte de Caparica, Portugal
| | - Ricardo Castro Alves
- Periodontology Department, Egas Moniz Dental Clinic (EMDC), Egas Moniz, CRL, 2829-511 Monte de Caparica, Portugal
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Monte de Caparica, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Egas Moniz—Cooperativa de Ensino Superior, CRL, 2829-511 Monte de Caparica, Portugal
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7
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The Effect of Mechanical Tongue Cleaning on Oral Malodor and Tongue Coating. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010108. [PMID: 35010368 PMCID: PMC8751028 DOI: 10.3390/ijerph19010108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/23/2021] [Accepted: 12/20/2021] [Indexed: 11/17/2022]
Abstract
Background: Mechanical tongue cleaning is an important oral hygiene procedure; it is known that a significant cause of volatile sulfur compounds (VSCs), a major component of bad breath, is due to the bacteria coating the tongue. This study was conducted to identify the effect of mechanical tongue cleaning on reducing bad breath and tongue coating. Methods: Various mechanical tongue-cleaning methods were studied, including removing tongue coating using a toothbrush, removing tongue coating using a tongue scraper, and removing tongue coating using a toothbrush and a tongue scraper together. The results were as follows. Results: First, the organic bad breath measurement value after cleaning the tongue significantly decreased in the group using only the toothbrush, the group using only the tongue scraper, and the group using both the toothbrush and the tongue scraper. However, there was no difference between the groups. Second, after cleaning the tongue, the measured values of the tongue coating in the values of WTCI (Winkel’s tongue coating index) and Qray view were significantly reduced in all three groups, and there was no difference between the groups. Third, the gas measurement value in the oral cavity using a machine significantly decreased only the H2S value of the group using the tongue scraper immediately after the mechanical tongue cleaning. Conclusions: From these results, it can be confirmed that mechanical tongue cleaning is effective at reducing bad breath and tongue coating. However, in this study, there was no difference in the reduction effect according to the tools (groups) used for mechanical tongue cleaning. It can therefore be seen that wiping accurately from the rear of the tongue to the front is more effective at reducing bad breath and tongue coating.
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8
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Sônego MV, de Moraes Melo Neto CL, Dos Santos DM, de Melo Moreno AL, de Magalhães Bertoz AP, Goiato MC. Quality of Life, Satisfaction, Occlusal Force, and Halitosis after Direct and Indirect Relining of Inferior Complete Dentures. Eur J Dent 2021; 16:215-222. [PMID: 34428849 PMCID: PMC8890934 DOI: 10.1055/s-0041-1731838] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Objective
The aim of this study was to compare the direct relining technique with the indirect relining technique in relation to quality of life, satisfaction with the relining, occlusal force, and halitosis of users of acrylic complete dentures.
Materials and Methods
Twenty bimaxillary edentulous individuals were selected. They had to use the same pair of complete dentures for a minimum of 1 year and a maximum of 5 years. The subjects were randomly divided in groups of direct relining and indirect relining of the inferior denture (
n
= 10). Both groups received the same silicone-based relining. The clinical tests verified the quality of life (Oral Health Impact Profile in edentulous individuals), the satisfaction with the relining, the occlusal force, and halitosis. The tests (halitosis and occlusal force) were performed initially (before the relining), immediately after the relining, and 30, 60, 90, and 180 days after the relining. The questionnaires (quality of life and satisfaction with the relining) were performed initially (before the relining), and 30, 60, 90, and 180 days after the relining.
Statistical Analysis
Analysis of variance and the Tukey test were used (
p
< 0.05).
Results
There was no statistical difference comparing the two techniques in all the evaluations (
p
< 0.05). There was a significant statistical difference for the factor of time in all clinical tests for each relining technique (
p
< 0.05). The quality of life and satisfaction with the relining increased significantly 30 days after the relining when compared with the initial time point, for both techniques (
p
< 0.05). The occlusal force increased significantly after 90 and 180 days when compared with the initial time point, for both techniques (
p
< 0.05). Halitosis decreased significantly immediately after the relining when compared with the initial time point, for both techniques (
p
< 0.05).
Conclusion
Independent of the relining technique used, there was an increase in the quality of life, satisfaction with the relining, and occlusal force, as well as a reduction in the level of halitosis. Both techniques generated similar results and therefore can be options in clinical practice.
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Affiliation(s)
- Mariana Vilela Sônego
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University, Araçatuba, São Paulo, Brazil
| | | | - Daniela Micheline Dos Santos
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University, Araçatuba, São Paulo, Brazil.,Oral Oncology Center, School of Dentistry, São Paulo State University, São Paulo, Brazil
| | - André Luiz de Melo Moreno
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University, Araçatuba, São Paulo, Brazil
| | | | - Marcelo Coelho Goiato
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University, Araçatuba, São Paulo, Brazil.,Oral Oncology Center, School of Dentistry, São Paulo State University, São Paulo, Brazil
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9
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Teshome A, Derese K, Andualem G. The Prevalence and Determinant Factors of Oral Halitosis in Northwest Ethiopia: A Cross-Sectional Study. Clin Cosmet Investig Dent 2021; 13:173-179. [PMID: 34007216 PMCID: PMC8123970 DOI: 10.2147/ccide.s308022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 04/22/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Oral halitosis, unpleasant or offensive odor to others, has become a major health concern among the general population, ranking the third most common reason for seeking a dentist behind dental caries and periodontal disease. Even though there have been repeated cases of halitosis in Ethiopia, there is no documented evidence. OBJECTIVE The purpose of this study was to determine the prevalence of halitosis in Northwest Ethiopia and to examine the relationship between halitosis and sociodemographic factors, oral habits, and health practices. METHODS From December 2019 to March 30, 2020, a hospital-based cross-sectional study was conducted. A systematic random sampling method was used to select study participants. Following informed consent, sociodemographic characteristics were collected using structured questionnaires, and two qualified dental surgeons performed the oral examination. The organoleptic test was used to assess the presence of halitosis. RESULTS Six hundred sixty-one people took part in the study, with a mean age of 30.0 ±14.76 years. The prevalence of oral halitosis was 44.2% (95% CI: 40.39-47.96) among the study participants. Participants with no formal education were more prone to oral halitosis. Oral halitosis was common in students (18.5%), low-income individuals (22.2%), rural residents (12.3%), mouth breathers (19.1%), and participants with poor oral hygiene practices (15.3%). Independent factors of halitosis included rural residency (AOR=1.40, 95% CI: 1.18, 1.67), low economic status (AOR=1.81, 95% CI: 1.06,3.09), poor tooth brushing habit (AOR=1.85 (1.31, 2.61), smoking (AOR=2.69 (1.39, 5.21) and dental caries (AOR=8.74 (5.57, 13.71). CONCLUSION The prevalence of oral halitosis was 44.2% among the study participants. Rural residency, low monthly income, poor tooth-brushing habit, smoking, and dental caries were independent factors of halitosis.
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Affiliation(s)
- Amare Teshome
- Department of Dentistry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Kirubel Derese
- Department of Dentistry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Getaneh Andualem
- Department of Dentistry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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10
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Araujo CB, Ribeiro AB, Fortes CV, Bueno FL, De Wever B, Oliveira VC, Macedo AP, Paranhos HFO, da Silva CHL. Effect of local hygiene protocols on denture-related stomatitis, biofilm, microbial load, and odor: A randomized controlled trial. J Prosthet Dent 2021; 128:664-673. [PMID: 33736863 DOI: 10.1016/j.prosdent.2020.12.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 12/20/2022]
Abstract
STATEMENT OF PROBLEM Denture stomatitis affects complete denture wearers and is frequently treated with antifungals drugs, as well as treating the denture with sodium hypochlorite. Whether the limitations of these treatments can be overcome with local hygiene protocols that do not damage the denture materials or adversely affect the patient is unclear. PURPOSE The purpose of this randomized controlled trial was to evaluate the effect of denture hygiene protocols on complete denture wearers with denture stomatitis. MATERIAL AND METHODS For this randomized, double-blind controlled clinical trial, 108 participants were assigned to parallel groups: 0.25% sodium hypochlorite (positive control) 0.15% Triclosan, denture cleaning tablets, or denture cleaning tablets plus gingival cleaning tablets. The participants were instructed to brush the dentures and the palate and immerse the denture in the solutions. The outcomes of denture stomatitis remission, biofilm removal, decrease of microbial load (colony-forming units), and odor level of the mouth and denture were measured at baseline and after 10 days. Descriptive analyses were used for sociodemographic characterization of the participants; the Pearson chi-square test was used to compare participant frequency with different degrees of denture stomatitis. The data were not normally distributed (Shapiro-Wilks test) or homogeneous (Levene test). So, the Kruskal-Wallis and Dunn post hoc tests and Wilcoxon test were used to compare the effects of solutions and time on the variables (α=.05). RESULTS The frequency of the highest to lowest denture stomatitis scores was significantly different for the 0.15% Triclosan and denture cleaning tablets groups. No significant difference was found among the groups in terms of denture stomatitis scores, biofilm, or colony-forming unit count of Candida spp. or C. albicans and S. mutans; a significant reduction was found in these parameters. The 0.25% sodium hypochlorite and 0.15% Triclosan treatments caused a significant reduction in Gram-negative microorganisms; these 2 protocols, and the denture cleaning tablets showed a significant reduction in Staphylococcus spp.; all protocols had similar effects. Only the S. mutans count of the palate decreased after 10 days. The odor level of the mouth and the denture was not significantly different (P=.778). CONCLUSIONS The evaluated protocols can be recommended for the hygiene of complete dentures, since they were effective for all the variables studied.
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Affiliation(s)
- Camila B Araujo
- Master student, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Adriana B Ribeiro
- Collaboration Professor, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Caroline V Fortes
- Master student, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Frank L Bueno
- Doctoral student, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Bart De Wever
- Chief Scientific Officer, bonyf AG, Vaduz, Liechtenstein
| | - Viviane C Oliveira
- Specialized Laboratory Technician, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Ana P Macedo
- Specialized Laboratory Technician, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Helena F O Paranhos
- Titular professor, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Claudia Helena Lovato da Silva
- Titular professor, Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirao Preto, University of Sao Paulo (USP), Ribeirão Preto, SP, Brazil.
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11
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Llanos do Vale K, Ratto Tempestini Horliana AC, Romero Dos Santos S, Oppido Schalch T, Melo de Ana A, Agnelli Mesquita Ferrari R, Kalil Bussadori S, Porta Santos Fernandes K. Treatment of halitosis with photodynamic therapy in older adults with complete dentures: A randomized, controlled, clinical trial. Photodiagnosis Photodyn Ther 2020; 33:102128. [PMID: 33276115 DOI: 10.1016/j.pdpdt.2020.102128] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/04/2020] [Accepted: 11/23/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Halitosis of oral origin is mainly caused by the release of H2S (hydrogen sulfide) by bacteria lodged on the tongue. Antimicrobial photodynamic therapy (aPDT) has been evaluated for the treatment of halitosis, but there are no previous reports of the use of this treatment modality in older people with dentures. The aim of the present study was to compare the effect of aPDT and tongue scraping (standard treatment) in older people with complete dentures diagnosed with halitosis (H2S gas concentration>112 ppb). METHODS The participants were divided into two groups: G1- treatment with a tongue scraper (n = 20); G2- treatment with aPDT (n = 20). Halimeter testing was performed before and after treatments using gas chromatography and was repeated after seven days. RESULTS After treatment, the group treated with aPDT had a lower mean concentration of H2S gas (18.5 ppb) than the tongue scraping group (185.3 ppb). After one week, the mean concentration of H2S increased to 218.2 ppb in the tongue scraping group and 39 ppb in the PDT group. CONCLUSIONS Both treatments were able to reduce the concentration of H2S but only treatment with aPDT was able to decrease halitosis to socially unnoticeable levels. Moreover, this normal breath condition remained for seven days only in the aPDT group.
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Affiliation(s)
- Katia Llanos do Vale
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil; Dentistry School, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil.
| | - Anna Carolina Ratto Tempestini Horliana
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil; Dentistry School, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil.
| | - Sergio Romero Dos Santos
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil; Dentistry School, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil.
| | - Tania Oppido Schalch
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil.
| | - Alessandro Melo de Ana
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil.
| | - Raquel Agnelli Mesquita Ferrari
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil; Postgraduate Program in Rehabilitation Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil.
| | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil; Dentistry School, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil; Postgraduate Program in Rehabilitation Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil.
| | - Kristianne Porta Santos Fernandes
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil; Dentistry School, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, 01504-001, São Paulo, Brazil.
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12
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Guedes CC, Bussadori SK, Garcia ACM, Motta LJ, Gomes AO, Weber R, Amancio OMS. Accuracy of a portable breath meter test for the detection of halitosis in children and adolescents. Clinics (Sao Paulo) 2020; 75:e1764. [PMID: 32935823 PMCID: PMC7470429 DOI: 10.6061/clinics/2020/e1764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 05/04/2020] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES This study aimed to determine the accuracy of the Breath-Alert™ portable breath meter (BA) for the detection of halitosis in children and adolescents, considering the organoleptic test (OT) as the gold standard in this assessment. METHODS A cross-sectional study was conducted on 150 children (aged 6-12 years). OT was performed by three independent examiners on a single occasion, obtaining three scores of 0-5 points on the Rosenberg's organoleptic scale. The median of the three evaluations for each child was used for analysis. BA was used according to the manufacturer's instructions, with breath odor scored from 0-5 points. Scores ≥2 on both tests were considered indicative of halitosis. RESULTS A total of 26 (17.3%) and 23 (15.3%) children were detected with halitosis on the OT and BA tests, respectively. The sensitivity and specificity of the BA scores for the detection of halitosis were 80.76% and 98.38%, respectively. The positive and negative predictive values for BA were 91.3% and 96.06%, respectively. CONCLUSION In the present study involving children, who require fast, practical examinations, BA proved to be an auxiliary tool to OT for the detection of halitosis in the practice of pediatric dentistry, demonstrating high sensitivity and specificity.
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Affiliation(s)
| | | | | | | | | | - Raimar Weber
- Departamento de Otorrinolaringologia, Hospital Infantil Sabara, Sao Paulo, SP, BR
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Kumbargere Nagraj S, Eachempati P, Uma E, Singh VP, Ismail NM, Varghese E. Interventions for managing halitosis. Cochrane Database Syst Rev 2019; 12:CD012213. [PMID: 31825092 PMCID: PMC6905014 DOI: 10.1002/14651858.cd012213.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Halitosis or bad breath is a symptom in which a noticeably unpleasant breath odour is present due to an underlying oral or systemic disease. 50% to 60% of the world population has experienced this problem which can lead to social stigma and loss of self-confidence. Multiple interventions have been tried to control halitosis ranging from mouthwashes and toothpastes to lasers. This new Cochrane Review incorporates Cochrane Reviews previously published on tongue scraping and mouthrinses for halitosis. OBJECTIVES The objectives of this review were to assess the effects of various interventions used to control halitosis due to oral diseases only. We excluded studies including patients with halitosis secondary to systemic disease and halitosis-masking interventions. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 8 April 2019), the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 3) in the Cochrane Library (searched 8 April 2019), MEDLINE Ovid (1946 to 8 April 2019), and Embase Ovid (1980 to 8 April 2019). We also searched LILACS BIREME (1982 to 19 April 2019), the National Database of Indian Medical Journals (1985 to 19 April 2019), OpenGrey (1992 to 19 April 2019), and CINAHL EBSCO (1937 to 19 April 2019). The US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (8 April 2019), the World Health Organization International Clinical Trials Registry Platform (8 April 2019), the ISRCTN Registry (19 April 2019), the Clinical Trials Registry - India (19 April 2019), were searched for ongoing trials. We also searched the cross-references of included studies and systematic reviews published on the topic. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomised controlled trials (RCTs) which involved adults over the age of 16, and any intervention for managing halitosis compared to another or placebo, or no intervention. The active interventions or controls were administered over a minimum of one week and with no upper time limit. We excluded quasi-randomised trials, trials comparing the results for less than one week follow-up, and studies including advanced periodontitis. DATA COLLECTION AND ANALYSIS Two pairs of review authors independently selected trials, extracted data, and assessed risk of bias. We estimated mean differences (MDs) for continuous data, with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS We included 44 trials in the review with 1809 participants comparing an intervention with a placebo or a control. The age of participants ranged from 17 to 77 years. Most of the trials reported on short-term follow-up (ranging from one week to four weeks). Only one trial reported long-term follow-up (three months). Three studies were at low overall risk of bias, 16 at high overall risk of bias, and the remaining 25 at unclear overall risk of bias. We compared different types of interventions which were categorised as mechanical debridement, chewing gums, systemic deodorising agents, topical agents, toothpastes, mouthrinse/mouthwash, tablets, and combination methods. Mechanical debridement: for mechanical tongue cleaning versus no tongue cleaning, the evidence was very uncertain for the outcome dentist-reported organoleptic test (OLT) scores (MD -0.20, 95% CI -0.34 to -0.07; 2 trials, 46 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Chewing gums: for 0.6% eucalyptus chewing gum versus placebo chewing gum, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.10, 95% CI -0.31 to 0.11; 1 trial, 65 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Systemic deodorising agents: for 1000 mg champignon versus placebo, the evidence was very uncertain for the outcome patient-reported visual analogue scale (VAS) scores (MD -1.07, 95% CI -14.51 to 12.37; 1 trial, 40 participants; very low-certainty evidence). No data were reported for dentist-reported OLT score or adverse events. Topical agents: for hinokitiol gel versus placebo gel, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.27, 95% CI -1.26 to 0.72; 1 trial, 18 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Toothpastes: for 0.3% triclosan toothpaste versus control toothpaste, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -3.48, 95% CI -3.77 to -3.19; 1 trial, 81 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Mouthrinse/mouthwash: for mouthwash containing chlorhexidine and zinc acetate versus placebo mouthwash, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.20, 95% CI -0.58 to 0.18; 1 trial, 44 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Tablets: no data were reported on key outcomes for this comparison. Combination methods: for brushing plus cetylpyridium mouthwash versus brushing, the evidence was uncertain for the outcome dentist-reported OLT scores (MD -0.48, 95% CI -0.72 to -0.24; 1 trial, 70 participants; low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. AUTHORS' CONCLUSIONS We found low- to very low-certainty evidence to support the effectiveness of interventions for managing halitosis compared to placebo or control for the OLT and patient-reported outcomes tested. We were unable to draw any conclusions regarding the superiority of any intervention or concentration. Well-planned RCTs need to be conducted by standardising the interventions and concentrations.
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Affiliation(s)
- Sumanth Kumbargere Nagraj
- Faculty of Dentistry, Melaka‐Manipal Medical College, Manipal Academy of Higher Education (MAHE), ManipalDepartment of Oral Medicine and Oral RadiologyJalan Batu HamparBukit BaruMelakaMalaysia75150
| | - Prashanti Eachempati
- Faculty of Dentistry, Melaka‐Manipal Medical College, Manipal Academy of Higher Education (MAHE)Department of ProsthodonticsJalan Batu HamparBukit BaruMelakaMalaysia75150
| | - Eswara Uma
- Faculty of Dentistry, Melaka‐Manipal Medical College, Manipal Academy of Higher Education (MAHE)Department of Paediatric DentistryJalan Batu HamparBukit BaruMelakaMalaysia75150
| | - Vijendra Pal Singh
- Faculty of Dentistry, Melaka‐Manipal Medical College, Manipal Academy of Higher Education (MAHE)Department of Periodontology and ImplantologyJalan Batu HamparBukit BaruMelakaMalaysia75150
| | - Noorliza Mastura Ismail
- Faculty of Dentistry, Melaka‐Manipal Medical College, Manipal Academy of Higher Education (MAHE)Department of Community DentistryJalan Batu HamparBukit BaruMelakaMelakaMalaysia75150
| | - Eby Varghese
- Melaka‐Manipal Medical College, Manipal Academy of Higher Education (MAHE)Department of Paediatric Dentistry, Faculty of DentistryMelakaMalaysia75150
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Ribeiro AB, de Araújo CB, Silva LEV, Fazan-Junior R, Salgado HC, Ribeiro AB, Fortes CV, Bueno FL, de Oliveira VC, de F O Paranhos H, Watanabe E, da Silva-Lovato CH. Hygiene protocols for the treatment of denture-related stomatitis: local and systemic parameters analysis - a randomized, double-blind trial protocol. Trials 2019; 20:661. [PMID: 31783777 PMCID: PMC6884795 DOI: 10.1186/s13063-019-3854-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 10/25/2019] [Indexed: 12/15/2022] Open
Abstract
Background Denture-related stomatitis (DS) is chronic multifactorial inflammation, strongly related to the presence of the biofilm that is the complex structure formed by microorganisms held together by a mucus-like matrix of carbohydrate that adheres to different surfaces, including the denture surface. DS has recently been correlated with deleterious cardiovascular alterations. The potential effect of hygiene protocols in the control of DS and randomized clinical trials that address this oral condition with cardiovascular complications are important in clinical decision-making. Material/design A clinical trial, randomized, double-blind, and with parallel groups, will be conducted in Brazil The sample will consist of 100 patients without teeth in both arches, users of at least maxillary complete dentures, and diagnosed with DS, who will be allocated to groups (n = 25 per group) according to the different hygiene protocols: (1) brushing of the palate and immersion of the prosthesis in 0.25% sodium hypochlorite solution (positive control); (2) brushing of the palate and immersion of the prosthesis in 0.15% triclosan solution; (3) brushing of the palate and immersion of the prosthesis in lactose monohydrate; or (4) brushing the palate with citric acid and immersing the prosthesis in lactose monohydrate. The response variables will be heart rate variability and alteration of blood pressure (systemic level), remission of DS, removal of biofilm, reduction of microbial load (colony-forming units (CFU)), mouth and prosthesis odor level, expression of MUC1, proinflammatory cytokines, C-reactive protein (CRP), viscosity, pH and salivary flow (locally); patient-centred qualitative analysis will also be undertaken. Measurements will be performed at baseline and 10 days after the interventions. The results obtained will be statistically analyzed as pertinent, with a level of significance of 0.05. Discussion This study will provide a guideline for clinical practice regarding the use of hygiene protocols in the treatment of oral diseases (DS) mediated by biofilm. Also, it may provide evidence of correlation of oral manifestation with cardiac risk. Trial registration Brazilian Registry of Clinical Trials, RBR-4hhwjb. Registered on 9 November 2018.
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Affiliation(s)
- Adriana B Ribeiro
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Camila B de Araújo
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Luiz Eduardo V Silva
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Rubens Fazan-Junior
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Helio C Salgado
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Aline B Ribeiro
- Department of Physiology, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Caroline V Fortes
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Frank L Bueno
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Viviane C de Oliveira
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Helena de F O Paranhos
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil
| | - Evandro Watanabe
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Cláudia H da Silva-Lovato
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, Brazil.
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Amaechi BT, Abdul Azees PA, Menon S, Kasundra H. In vitro evaluation of the effects of Ultrasound Tongue Scraper on bacteria and biofilm formation. ACTA ACUST UNITED AC 2019; 10:e12471. [PMID: 31541515 DOI: 10.1111/jicd.12471] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/08/2019] [Accepted: 08/20/2019] [Indexed: 11/26/2022]
Abstract
AIM Oral malodor is a common condition caused by some Gram-negative oral bacteria, among which are the 3 red complex bacteria (RCB). The present study investigated the effectiveness of the Ultrasound Tongue Scraper (UTS) to disrupt the structural morphology of the bacteria and their biofilm. METHODS While developing over 72 hours, multispecies biofilms of RCB (Porphromonas gingivalis, Tryponema denticola, Tannerella forsythia) were treated every 24 hours with 1.6-MHz ultrasound waves generated with UTS. An untreated group served as controls. Confocal laser scanning microscopy was used to determine the biofilm thickness, biomass and live : dead cell ratio at each time point (24, 48 and 72 hours). Biofilm morphology and bacteria ultrastructure were viewed using scanning/transmission electron microscopy, respectively. Data were analyzed using ANOVA and Tukey tests. RESULTS At each time point, the 3 variables were significantly lower in treated samples than the untreated. Significant biofilm disruption was observed in treated samples at each time period while the untreated had intact biofilm morphology. Cells in treated samples showed disrupted cell wall, cytoplasmic material, huge vacuoles and heterogeneity in electron density, while these cell organelles remained intact in untreated samples. CONCLUSION The UTS has an inhibitory effect on RCB and could be useful for oral malodor management.
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Affiliation(s)
- Bennett T Amaechi
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health, San Antonio, USA
| | - Parveez Ahamed Abdul Azees
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health, San Antonio, USA
| | - Suchitra Menon
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health, San Antonio, USA
| | - Hariyali Kasundra
- Department of Comprehensive Dentistry, School of Dentistry, University of Texas Health, San Antonio, USA
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do Vale KL, Horliana ACRT, Romero SDS, Deana ADM, Gonçalves MLL, Ferrari RAM, Bussadori SK, Fernandes KPS. Evaluation of the treatment of halitosis with photodynamic therapy in older patients with complete denture: Protocol for a randomized, controlled trial. Medicine (Baltimore) 2019; 98:e16275. [PMID: 31277154 PMCID: PMC6635224 DOI: 10.1097/md.0000000000016275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 06/10/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Halitosis is the term used to define an unpleasant odor emanating from the mouth. However, no studies have evaluated the causes and treatment of halitosis in the population of older adults with denture. METHODS A randomized, controlled trial is proposed. The patients will be divided into 2 groups: G1: older adults who wear complete dentures and will be treated with tongue scraper (n = 20); G2 older adults who wear complete dentures and will be treated with PDT (n = 20). If the halitosis persists, the participants will be submitted to hygiene procedures for the mucosa and dentures. The evaluation of halitosis will be made before and after treatments, with OralChroma. If the halitosis is solved, the participants will return after 1 week for an additional evaluation. Oral Health Impact Profile (OHIP-14) will be administered by a calibrated examiner on the day the patient history is taken (baseline) and 1 week after treatment for halitosis. DISCUSSION This protocol will determine the effectiveness of photodynamic therapy regarding the reduction of halitosis in older adults with complete denture. TRIAL REGISTRATION This protocol was registered in ClinicalTrial.gov, under number NCT03960983. It was first posted and last updated in May 23, 2019. https://clinicaltrials.gov/ct2/show/NCT03960983.
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Affiliation(s)
- Katia Llanos do Vale
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho
| | | | | | | | | | | | - Sandra Kalil Bussadori
- Postgraduate program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho
- Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho, UNINOVE, São Paulo, Brazil
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17
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Jervøe-Storm PM, Schulze H, Jepsen S. A randomized cross-over short-term study on the short-term effects of a zinc-lactate containing mouthwash against oral malodour. J Breath Res 2019; 13:026005. [PMID: 30523908 DOI: 10.1088/1752-7163/aaf401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIM This randomized controlled cross-over-design-study investigated short-term effects on oral malodour of a zinc-lactate-containing mouthwash. MATERIALS AND METHODS Sixteen subjects (18-65 years) with an organoleptic score (OLS) ≥2 were included. Following rinses were used: (A) a zinc-lactate-containing mouthwash (10 ml/30 s); (B) a zinc-lactate-containing mouthwash (15 ml/60 s); (C) a rinse without zinc-lactate (3 droplets/10 ml tap water/30 s) and (D) tap water (10 ml/30 s). Each formulation was evaluated by two blinded examiners comparing OLS and three volatile-sulphur-compounds (VSC; H2S (hydrogen sulphide), CH3SH (methyl mercaptan) and (CH3)2S (dimethyl sulphide)) before, 1 and 3 h after rinsing. Subject's perception was investigated with a visual-analogue-scale. Linear mixed models were used to compare all parameters simultaneously with respect to the four treatment groups with a significance level α < 0.05. RESULTS OLS was significantly reduced by A and B compared to C and D after 3 h (p < 0.006). The sum of the 3 VSCs as well as H2S alone were significantly reduced by rinses A and B after 1 and 3 h compared to rinses C and D (p < 0.05). Significant differences were found between the four rinses for 'Taste' (p = 0.003), for 'Change of mouth feeling' (p = 0.001), for 'Feeling of freshness' (p = 0.002) and for 'Effectiveness' (p = 0.002) in favour of A & B. CONCLUSION A zinc-lactate-containing mouthwash reduced OLS and VSC over a period of 3 h with favourable patient reported outcomes.
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Affiliation(s)
- Pia-Merete Jervøe-Storm
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Germany
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Acar B, Berker E, Tan Ç, İlarslan YD, Tekçiçek M, Tezcan İ. Effects of oral prophylaxis including tongue cleaning on halitosis and gingival inflammation in gingivitis patients—a randomized controlled clinical trial. Clin Oral Investig 2018; 23:1829-1836. [DOI: 10.1007/s00784-018-2617-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 09/04/2018] [Indexed: 10/28/2022]
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Fedorowicz Z, Aljufairi H, Nasser M, Outhouse TL, Pedrazzi V. WITHDRAWN: Mouthrinses for the treatment of halitosis. Cochrane Database Syst Rev 2016; 2016:CD006701. [PMID: 27228022 PMCID: PMC7388864 DOI: 10.1002/14651858.cd006701.pub3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Cochrane Oral Health withdrew this review as of Issue 5, 2016.
This review is being updated and replaced following the publication of a new expanded protocol on the effects of different interventions for the management of halitosis (Pedrazzi V, do Nascimento C, Mardegan Issa JP, Fedorowicz Z. Interventions for managing halitosis (Protocol). Cochrane Database of Systematic Reviews 2016, Issue 5. Art. No.: CD012213. DOI: 10.1002/14651858.CD012213.). It will remain withdrawn when the new review is published.
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Affiliation(s)
| | - Hamad Aljufairi
- Royal College of Surgeons in Ireland ‐ BahrainSchool of MedicineP.O. Box 15503AdliyaBahrain
| | - Mona Nasser
- Plymouth University Peninsula Schools of Medicine and DentistryPeninsula Dental SchoolThe John Bull Building, Tamar Science Park,PlymouthUKPL6 8BU
| | | | - Vinícius Pedrazzi
- School of Dentistry of Ribeirão Preto, University of São PauloDepartment of Dental Materials and ProsthesisAv do Café s/nºRibeirão PretoSão PauloBrazil14040‐904
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Abstract
Cochrane Oral Health withdrew this review as of Issue 5, 2016.
This review is being updated and replaced following the publication of a new expanded protocol on the effects of different interventions for the management of halitosis (Pedrazzi V, do Nascimento C, Mardegan Issa JP, Fedorowicz Z. Interventions for managing halitosis (Protocol). Cochrane Database of Systematic Reviews 2016, Issue 5. Art. No.: CD012213. DOI: 10.1002/14651858.CD012213 .). It will remain withdrawn when the new review is published. The editorial group responsible for this previously published document have withdrawn it from publication.
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Affiliation(s)
| | - Rashad Al‐Alawi
- Ministry of Health BahrainPeriodontologyMinistry Of HealthBox 12ManamaBahrain
| | | | - James V Keenan
- US NavyBranch Dental Clinic London4 Netherwood RoadBeaconsfieldBucksUKHP9 2BE
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Pedrazzi V, do Nascimento C, Mardegan Issa JP, Fedorowicz Z. Interventions for managing halitosis. Hippokratia 2016. [DOI: 10.1002/14651858.cd012213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Vinícius Pedrazzi
- School of Dentistry of Ribeirão Preto, University of São Paulo; Department of Dental Materials and Prosthesis; Av do Café s/nº Ribeirão Preto São Paulo Brazil 14040-904
| | - Cássio do Nascimento
- School of Dentistry of Ribeirão Preto, University of São Paulo; Av do Café s/nº Ribeirão Preto São Paulo Brazil 14040-904
| | - Joao Paulo Mardegan Issa
- School of Dentistry of Ribeirão Preto, University of São Paulo; Av do Café s/nº Ribeirão Preto São Paulo Brazil 14040-904
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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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Kapoor U, Sharma G, Juneja M, Nagpal A. Halitosis: Current concepts on etiology, diagnosis and management. Eur J Dent 2016; 10:292-300. [PMID: 27095913 PMCID: PMC4813452 DOI: 10.4103/1305-7456.178294] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Halitosis or oral malodor is an offensive odor originating from the oral cavity, leading to anxiety and psychosocial embarrassment. A patient with halitosis is most likely to contact primary care practitioner for the diagnosis and management. With proper diagnosis, identification of the etiology and timely referrals certain steps are taken to create a successful individualized therapeutic approach for each patient seeking assistance. It is significant to highlight the necessity of an interdisciplinary method for the treatment of halitosis to prevent misdiagnosis or unnecessary treatment. The literature on halitosis, especially with randomized clinical trials, is scarce and additional studies are required. This article succinctly focuses on the development of a systematic flow of events to come to the best management of the halitosis from the primary care practitioner's point of view.
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Affiliation(s)
| | - Gaurav Sharma
- Department of Oral Medicine and Radiology, Sudha Rustagi College of Dental Sciences and Research, Faridabad, Haryana, India
| | - Manish Juneja
- Advanced Standing DMD Candidate, Henry M. Goldman School of Dental Medicine, Boston University, MA, USA
| | - Archna Nagpal
- Department of Oral Medicine and Radiology, P.D.M. Dental College and Research Institute, Bahadurgarh, Haryana, India
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Beekmans DG, Slot DE, Van der Weijden GA. User perception on various designs of tongue scrapers: an observational survey. Int J Dent Hyg 2016; 15:e1-e8. [DOI: 10.1111/idh.12204] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2015] [Indexed: 11/28/2022]
Affiliation(s)
- DG Beekmans
- Academic Center for Dentistry at the University of Groningen (RuG); Groningen The Netherlands
| | - DE Slot
- Department of Periodontology; Academic Center for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
| | - GA Van der Weijden
- Department of Periodontology; Academic Center for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
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Grover HS, Blaggana A, Jain Y, Saini N. Detection and measurement of oral malodor in chronic periodontitis patients and its correlation with levels of select oral anaerobes in subgingival plaque. Contemp Clin Dent 2015; 6:S181-7. [PMID: 26604572 PMCID: PMC4632221 DOI: 10.4103/0976-237x.166825] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Oral malodor is generally ascribable to oral microbial putrefaction generating malodorous volatile sulfur compounds. The aim of the present study is to correlate organoleptic recordings with a small handheld portable volatile sulfide monitor and periodontal clinical parameters and correlate the levels of halitosis causing bacteria in plaque between baseline, 1-week, and 1-month. Materials and Methods: A total of 20 systemically healthy subjects with self-reported halitosis were subjected to organoleptic examination and FitScan®. Subgingival plaque samples for anaerobic culturing were harvested followed by an assessment of plaque index (PI), gingival bleeding index (GBI), and pocket probing depth. Data derived were subjected to statistical analysis using Wilcoxon signed rank test and Spearman's rank test (P < 0.05). Results: No correlation was seen between organoleptic measurements and portable volatile sulfide monitor at any time interval. There was a statistically significant (P < 0.05) correlation between the scores of PI, gingival index, GBI, and myeloproliferative disease with organoleptic readings at all-time intervals. Anaerobic culture has shown to identify Fusobacterium species, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia. However, no correlation could be established in between total microbial load with organoleptic and FitScan® reading at any time interval (P < 0.05). Conclusion: Significant correlation could be established between organoleptic readings and periodontal parameters.
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Affiliation(s)
- H S Grover
- Department of Periodontology, Faculty of Dental Sciences, S. G. T. University, Gurgaon, Haryana, India
| | - Anshu Blaggana
- Department of Periodontology, Faculty of Dental Sciences, S. G. T. University, Gurgaon, Haryana, India
| | - Yashika Jain
- Department of Periodontology, Faculty of Dental Sciences, S. G. T. University, Gurgaon, Haryana, India
| | - Neha Saini
- Department of Periodontology, Faculty of Dental Sciences, S. G. T. University, Gurgaon, Haryana, India
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Peker I, Akarslan Z, Basman A, Haciosmanoglu N. Knowledge and behavior of dentists in a dental school regarding toothbrush disinfection. Braz Oral Res 2015; 29:48. [PMID: 25789506 DOI: 10.1590/1807-3107bor-2015.vol29.0048] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 12/18/2014] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the knowledge and behavior of dentists regarding toothbrush disinfection. This study included 147 dentists (88 women and 59 men) who were actively employed at a dental school in Ankara, Turkey. Participants were asked to fill out a standard questionnaire, which contained questions regarding their demographics, brushing habits, toothbrush storage and disinfection habits, toothpaste use, knowledge about toothbrush disinfection, and whether they advised their patients about toothbrush storage. Descriptive statistics were calculated, and statistical analyses were performed with t-tests, chi-squared tests, and Fisher exact tests, where appropriate. Among the 147 surveyed dentists, 62.6% and 85.7% reported that they did not have any knowledge about toothbrush disinfection and did not disinfect their toothbrushes, respectively. However, approximately two thirds of surveyed dentists thought that toothbrush disinfection should be performed by everyone, including healthy individuals. Significant associations were found between knowledge about toothbrush disinfection and the professional title of dentists, how they stored their toothbrushes, and whether their toothbrushes were in contact with each other during storage (p < 0.05). A minority of dentists reported that they disinfected their toothbrushes.
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Affiliation(s)
- Ilkay Peker
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Zuhre Akarslan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Adil Basman
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Nur Haciosmanoglu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
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Effectiveness of alternative methods for toothbrush disinfection: an in vitro study. ScientificWorldJournal 2014; 2014:726190. [PMID: 24971388 PMCID: PMC4058182 DOI: 10.1155/2014/726190] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 05/04/2014] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the effectiveness of alternative methods for toothbrush disinfection. METHODS Two-hundred eighty toothbrushes were included in the study. The toothbrushes were divided into 7 groups and were contaminated by standardized suspensions of Lactobacillus rhamnosus (L. rhamnosus), Streptococcus mutans (S. mutans), Staphylococcus aureus (S. aureus), and Escherichia coli (E. coli). The following disinfectants were tested: 1% sodium hypochlorite (NaOCl), 100% and 50% white vinegar, microwave (MW) oven, ultraviolet (UV) sanitizer, and mouth rinse-containing propolis (MCP). Data were analyzed with Kruskal Wallis and Dunn's tests. RESULTS Statistically significant differences were found between different methods and control group for all tested bacteria. There were statistically significant differences between all test groups for all microorganisms. MW was the most effective for L. rhamnosus and 100% white vinegar was the most effective method for S. mutans and S. aureus. NaOCl was the most effective for E. coli. CONCLUSION This study showed that 100% white vinegar was considered to be effective for tested microorganisms. Similarly, 1% NaOCl is cost-effective, easily accessible, and comparatively effective for toothbrush disinfection. Because these agents are nontoxic, cost-effective and easily accessible, they may be appropriate for household use.
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Oliveira-Neto JM, Sato S, Pedrazzi V. How to deal with morning bad breath: A randomized, crossover clinical trial. J Indian Soc Periodontol 2014; 17:757-61. [PMID: 24554886 PMCID: PMC3917206 DOI: 10.4103/0972-124x.124497] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 07/18/2013] [Indexed: 11/17/2022] Open
Abstract
Context: The absence of a protocol for the treatment of halitosis has led us to compare mouthrinses with mechanical oral hygiene procedures for treating morning breath by employing a hand-held sulfide monitor. Aims: To compare the efficacy of five modalities of treatment for controlling morning halitosis in subjects with no dental or periodontal disease. Settings and Design: This is a five-period, randomized, crossover clinical trial. Materials and Methods: Twenty volunteers were randomly assigned to the trial. Testing involved the use of a conventional tongue scraper, a tongue scraper joined to the back of a toothbrush's head, two mouthrinses (0.05% cetylpyridinium chloride and 0.12% chlorhexidine digluconate) and a soft-bristled toothbrush and fluoride toothpaste for practicing oral hygiene. Statistical Analysis Used: Data analysis was performed using SPSS version 17 for Windows and NCSS 2007 software (P < 0.05). The products and the periods were compared with each other using the Friedman's test. When significant differences (P < 0.05) were determined, the products and periods were compared in pairs by using the Wilcoxon's test and by adjusting the original significance level (0.05) for multiple comparisons by using the Bonferroni's method. Results: The toothbrush's tongue scraper was able to significantly reduce bad breath for up to 2 h. Chlorhexidine reduced bad breath only at the end of the second hour, an effect that lasted for 3 h. Conclusions: Mechanical tongue cleaning was able to immediately reduce bad breath for a short period, whereas chlorhexidine and mechanical oral hygiene reduced bad breath for longer periods, achieving the best results against morning breath.
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Affiliation(s)
- Jeronimo M Oliveira-Neto
- Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, Brazil
| | - Sandra Sato
- Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, Brazil
| | - Vinícius Pedrazzi
- Department of Dental Materials and Prosthodontics, Faculty of Dentistry of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, Brazil
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Toothbrushing Versus Toothbrushing Plus Tongue Cleaning in Reducing Halitosis and Tongue Coating. Nurs Res 2013; 62:422-9. [DOI: 10.1097/nnr.0b013e3182a53b3a] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Dupim Souza AC, Franco CF, Pataro AL, Guerra T, de Oliveira Costa F, da Costa JE. Halitosis in obese patients and those undergoing bariatric surgery. Surg Obes Relat Dis 2013; 9:315-21. [DOI: 10.1016/j.soard.2011.10.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2011] [Revised: 09/27/2011] [Accepted: 10/19/2011] [Indexed: 12/24/2022]
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Erovic Ademovski S, Lingström P, Winkel E, Tangerman A, Persson GR, Renvert S. Comparison of different treatment modalities for oral halitosis. Acta Odontol Scand 2012; 70:224-33. [PMID: 22149929 DOI: 10.3109/00016357.2011.635601] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To assess the effects on intra-oral halitosis by a mouth rinse containing zinc acetate (0.3%) and chlorhexidine diacetate (0.025%) with and without adjunct tongue scraping. MATERIALS AND METHODS Twenty-one subjects without a diagnosis of periodontitis were randomized in a cross-over clinical trial. Organoleptic scores (OLS) were assessed to define intra-oral halitosis by total volatile sulfur compound (T-VSC) measurements and by gas chromatography. RESULTS Twenty-one subjects with a mean age of 45.7 years (SD: ±13.3, range: 21-66). The OLS were significantly lower following active rinse combined with tongue scraping (p < 0.001) at all time points. Immediately after, at 30 min, and at day 14, the T-VSC values were lower in the active rinse sequence than in the negative rinse sequence (p < 0.001, p < 0.001 and p < 0.05, respectively). At 30 min and at day 14, the hydrogen sulfide (H(2)S) and methyl mercaptan (MM) values were lower in the active rinse sequence compared to the inactive rinse sequence (p < 0.001). The inactive rinse sequence with tongue scraping reduced T-VSC at 30 min (p < 0.001) but not at 14 days. Similar reductions in T-VSC, H(2)S and MM were found in the active rinse sequence with or without tongue scraping. CONCLUSION The use of a tongue scraper did not provide additional benefits to the active mouth rinse, but reduced OLS and tongue coating index.
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Affiliation(s)
- Seida Erovic Ademovski
- Department of Oral Health Science, Section for Health and Society, Kristianstad University, Sweden
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Nohno K, Yamaga T, Kaneko N, Miyazaki H. Tablets containing a cysteine protease, actinidine, reduce oral malodor: a crossover study. J Breath Res 2012; 6:017107. [PMID: 22368260 DOI: 10.1088/1752-7155/6/1/017107] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Tongue coating (TC) mainly consists of protein mostly from exfoliated epithelial cells. Until now, to reduce TC accumulation, only mechanical measures have been available, and the procedure involves unpleasant side effects, such as gagging reflex or carcinogenesis related to mechanical stimulation. We expected that protease might be effective in reducing the accumulation of TC causing oral malodor. The purpose of this study was to determine the effect of long-term use of candy tablets containing protease, actinidine, on both TC accumulation and concentration of volatile sulfur compounds (VSCs) in mouth air. We employed 14 subjects aged 24 to 54 years old for this study, and conducted a double-blind randomized crossover trial. The subjects sucked the tablets containing actinidine three times a day until the sixth day after starting the study. The tablets without actinidine were utilized as a placebo. Measurements of VSC concentration and TC accumulation were carried out before and after chewing tablets on the first day, and also on the seventh day. The levels of VSC and TC significantly (p < 0.05) decreased after tablets were taken on the first day in both the test and placebo groups. There was a statistically significant decrease (p < 0.05) in VSC after seven days of use only in the test group. The results of the study suggest that the tablets containing actinidine had an accumulative effect in reducing VSC in mouth air with long-term use.
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Affiliation(s)
- K Nohno
- Division of Preventive Dentistry, Graduate School of Medical and Dental Sciences, Niigata University,Gakko-Cho, Cho-ku, Niigata City, Niigata, Japan.
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Pham TAV, Ueno M, Zaitsu T, Takehara S, Shinada K, Lam PH, Kawaguchi Y. Clinical trial of oral malodor treatment in patients with periodontal diseases. J Periodontal Res 2011; 46:722-9. [DOI: 10.1111/j.1600-0765.2011.01395.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Spolidorio DMP, Tardivo TA, dos Reis Derceli J, Neppelenbroek KH, Duque C, Spolidorio LC, Pires JR. Evaluation of two alternative methods for disinfection of toothbrushes and tongue scrapers. Int J Dent Hyg 2011; 9:279-83. [PMID: 21356033 DOI: 10.1111/j.1601-5037.2011.00503.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effectiveness of two alternatives methods for the disinfection of oral cleaning devices. METHODS One type of toothbrush and two types of tongue scrapers (steel and plastic) were tested in this study. Sixteen specimens of each group were cut with standardized dimensions, contaminated separately with Candida albicans, Streptococcus mutans and Staphylococcus aureus and incubated for 24 h. After this, oral cleaning devices were washed in saline solution to remove non-adhered cells and divided into two groups (n = 8), one irradiated in microwave and other immersed in 3.78% sodium perborate solution, and evaluated for microbial recovery. The values of cfu of each group of microorganism after disinfection were compared by Kruskal-Wallis and Dunn non-parametric test, considering 95% of confidence. RESULTS The toothbrush harboured a significant larger number of viable organisms than the tongue scrapers. The steel tongue scraper was less susceptible to adhesion of the three oral microorganisms. The time required to inactivate all contaminating microorganisms using microwave oven was 1 min and, for the immersion in 3.78% sodium perborate solution, was 2 and 3 h, respectively, for C. albicans and S. mutans/S. aureus. CONCLUSION Microwave irradiation proved to be an effective alternative method to the disinfection of tongue cleaners and toothbrushes.
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Affiliation(s)
- D M P Spolidorio
- Department of Physiology and Pathology, Dental School of Araraquara, State University of São Paulo, Araraquara, SP, Brazil.
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Van der Sleen MI, Slot DE, Van Trijffel E, Winkel EG, Van der Weijden GA. Effectiveness of mechanical tongue cleaning on breath odour and tongue coating: a systematic review. Int J Dent Hyg 2010; 8:258-68. [PMID: 20961381 DOI: 10.1111/j.1601-5037.2010.00479.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The objective of this review was to summarize the available evidence regarding the effects of mechanical tongue cleaning compared with no mechanical tongue cleaning on breath odour and tongue coating (TC). METHODS PubMed-MEDLINE, EMBASE and Cochrane-CENTRAL were searched to identify potentially relevant studies. The inclusion criteria included the following: randomized controlled clinical trials (RCTs) or controlled clinical trials (CCTs) conducted in humans in good general health (no systemic disorders) and a patient age of ≥17 years. For the intervention, we considered tongue cleaning [the use of a tongue scraper (TS) or tongue brush (TB)] and for the control, brushing only (B) groups. Clinical parameters such as volatile sulphur compound concentration, organoleptic scores and TC were the outcome variables of interest. Study selection, quality assessment and data extraction were carried out by two independent reviewers. RESULTS After screening of the titles and abstracts and subsequent full text reading of the potential papers, we identified five publications that met the eligibility criteria and provided seven experiments. The five studies consisted of three RCTs and two CCTs. All experiments show a positive effect of mechanical tongue cleaning in addition to toothbrushing on various parameters of oral malodour. CONCLUSIONS This review demonstrated that mechanical approaches, such as tongue brushing or tongue scraping to clean the dorsum of the tongue, have the potential to successfully reduce breath odour and TC. However, data concerning the effect of mechanical tongue cleaning on chronic oral malodour (halitosis) are insufficient.
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Affiliation(s)
- M I Van der Sleen
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Centre, University of Amsterdam, The Netherlands
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Lourith N, Kanlayavattanakul M. Review Article: Oral malodour and active ingredients for treatment. Int J Cosmet Sci 2010; 32:321-9. [DOI: 10.1111/j.1468-2494.2010.00585.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
BACKGROUND Halitosis is an unpleasant odour emanating from the oral cavity. Mouthwashes, which are commonly used for dealing with oral malodour, can be generally divided into those that neutralize and those that mask the odour. OBJECTIVES To investigate the effects of mouthrinses in controlling halitosis. SEARCH STRATEGY We searched the following databases: Cochrane Oral Health Group Trials Register (to August 2008); the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 3); MEDLINE (1950 to August 2008); EMBASE (1980 to August 2008); and CINAHL (1982 to August 2008). There were no language restrictions. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing mouthrinses to placebo in adults over the age of 18 with halitosis and without significant other comorbidities or health conditions.The primary outcomes considered were self expressed and organoleptic (human nose) assessments of halitosis, and the secondary outcomes included assessment of halitosis as measured by a halimeter, portable sulphide monitor or by gas chromatography coupled with flame-photometric detection. DATA COLLECTION AND ANALYSIS Two independent review authors screened and extracted information from, and independently assessed the risk of bias in the included trials. MAIN RESULTS Five RCTs, involving 293 participants who were randomised to mouthrinses or placebo, were included in this review.In view of the clinical heterogeneity between the trials, pooling of the results and meta-analysis of the extracted data was not feasible and therefore only a descriptive summary of the results of the included trials is provided.0.05% chlorhexidine + 0.05% cetylpyridinium chloride + 0.14% zinc lactate mouthrinse significantly reduced the mean change (standard deviation (SD)) of organoleptic scores from baseline compared to placebo (-1.13 (1.1) P < 0.005 versus -0.2 (0.7)) and also caused a more significant reduction in the mean change (SD) in peak level of volatile sulphur compounds (VSC) (-120 (92) parts per billion (ppb) versus 8 (145) ppb in placebo). The chlorhexidine cetylpyridinium chloride zinc lactate mouthrinse showed significantly more tongue (P < 0.001) and tooth (P < 0.002) staining compared to placebo.However, in view of the incomplete reporting of results in three of the trials and the sole use of the halimeter for assessment of VSC levels as outcomes in two further trials, caution should be exercised in interpreting these results. AUTHORS' CONCLUSIONS Mouthrinses containing antibacterial agents such as chlorhexidine and cetylpyridinium chloride may play an important role in reducing the levels of halitosis-producing bacteria on the tongue, and chlorine dioxide and zinc containing mouthrinses can be effective in neutralisation of odouriferous sulphur compounds.Well designed randomised controlled trials with a larger sample size, a longer intervention and follow-up period are still needed.
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Affiliation(s)
- Zbys Fedorowicz
- UKCC (Bahrain Branch), Ministry of Health, Bahrain, Box 25438, Awali, Bahrain.
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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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Mumghamba EGS, Manji KP, Michael J. Oral hygiene practices, periodontal conditions, dentition status and self-reported bad mouth breath among young mothers, Tanzania. Int J Dent Hyg 2006; 4:166-73. [PMID: 17038053 DOI: 10.1111/j.1601-5037.2006.00186.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine the oral hygiene practices, periodontal conditions, dentition status and self-reported bad mouth breath (S-BMB) among young mothers. STUDY PARTICIPANTS AND METHODS This was a cross-sectional descriptive study conducted at Muhimbili National Hospital, Dar es Salaam, Tanzania. A total of 302 postpartum mothers, aged 14-44 years, were interviewed on oral hygiene practices and S-BMB using structured questionnaire. Oral hygiene, dentition and periodontal status were assessed using the Community Periodontal Index probe and gingival recessions (GR) using Williams Periodontal probe. RESULTS Tooth brushing practice was 99%; tongue brushing (95%), plastic toothbrush users (96%), chewing stick (1%), wooden toothpicks (76%), dental floss (<1%); and toothpaste (93%). The prevalence of plaque and gingival bleeding on probing was 100%, gum bleeding during tooth brushing (33%), calculus (99%), probing periodontal pocket depth (PPD) 4-5 mm (27%), PPD 6+ mm (3%), GR 1+ mm (27%) and tooth decay (55%). The prevalence of S-BMB was 14%; the S-BMB had higher mean number of sites with plaque compared to the no S-BMB group (P=0.04). Factors associated with S-BMB were gum bleeding on tooth brushing (OR=2.4) and PPD 6+ mm (OR=5.4). CONCLUSION Self-reported bad mouth breath is a cause of concern among young mothers, and associated significant factors were gum bleeding on tooth brushing and deep periodontal pockets of 6+ mm. Further research involving clinical diagnosis of bad mouth breath and intervention through oral health promotion and periodontal therapy are recommended. CLINICAL RELEVANCE This study provides baseline information on oral health status and the complaint on bad mouth breath which necessitates in the future need for objective assessment, diagnosis and management of bad mouth breath for enhanced social and professional interaction without embarrassment.
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Affiliation(s)
- E G S Mumghamba
- Department of Restorative Dentistry, School of Dentistry, Muhimbili University College of Health Sciences, and Dental Department, Muhimbili National Hospital, Dar es Salaam, Tanzania.
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Faveri M, Hayacibara MF, Pupio GC, Cury JA, Tsuzuki CO, Hayacibara RM. A cross-over study on the effect of various therapeutic approaches to morning breath odour. J Clin Periodontol 2006; 33:555-60. [PMID: 16899098 DOI: 10.1111/j.1600-051x.2006.00955.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the effect of tongue scraping and inter-dental flossing on morning bad breath in periodontally healthy subjects. METHODS A four-step blind, cross-over study was conducted in 19 volunteers, divided into four groups: Group I: tooth brushing; Group II: tooth brushing and inter-dental flossing; Group III: tooth brushing and tongue scraping; and Group IV: tooth brushing, inter-dental flossing and tongue scraping. The volunteers performed these oral hygiene procedures three times a day for 7 days. Seven-day wash-out intervals were observed. Morning mouth breath was assessed organoleptically and by volatile sulphur compound concentrations. RESULTS The highest mean organoleptic and volatile sulphur compound measurement values were found in the treatment groups in which tongue scraping was not performed and there were statistical differences between the two groups (p < 0.05). In the organoleptic evaluation (p > 0.05), inter-dental flossing did not show any statistical improvement in the effect of tongue hygiene on morning bad breath, but it significantly reduced the concentration of volatile sulphur compounds (p < 0.05). CONCLUSION The findings suggest that tongue scraping appears to be the most important hygienic procedure to reduce morning bad breath in periodontally healthy subjects.
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Abstract
BACKGROUND Halitosis is used to describe any disagreeable odour of expired air regardless of its origin. Mouthwashes which disguise oral malodor are more socially acceptable and generally more popular than tongue scrapers. OBJECTIVES To provide reliable evidence regarding the effectiveness of tongue scraping versus other interventions (including mouthwashes) to control halitosis. SEARCH STRATEGY We searched the following databases: Cochrane Oral Health Group Trials Register (to 15th September 2005); the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3 2005); MEDLINE 1966 to September Week 1 2005; EMBASE 1974 to September 2005 (searched September 19th 2005). SELECTION CRITERIA Randomized controlled trials comparing different methods of tongue cleaning to reduce mouth odour in adults with halitosis. DATA COLLECTION AND ANALYSIS Clinical heterogeneity between the two included trials precluded pooling of data, therefore a descriptive summary is presented. MAIN RESULTS This review included two trials involving 40 participants. Both trials were methodologically sound but included no data for the primary outcomes specified in this review. Secondary outcomes expressed as volatile sulfur compound (VSC) levels were assessed by a portable sulfide monitor in both trials. One trial showed reductions of VSC levels of 42% with the tongue cleaner, 40% with the tongue scraper and 33% with the toothbrush. Reduced VSC levels persisted longer with the tongue cleaner than the toothbrush and could not be detected for more than 30 minutes after the intervention in any of the groups. Differences were assessed by the Friedman and Wilcoxon signed rank tests with the level of significance set at P < 0.05. The second trial, in which differences in totaled rank values between groups were compared by the Dunn method alpha = 0.01, showed a reduction of VSC levels compared with baseline measurements of 75% with the tongue scraper and 45% with the toothbrush. Adverse effects in one trial were nausea (60%) and trauma (10%) with the toothbrush and all participants receptive to using the tongue scraper. Based on the independent data from these two trials there was a statistically significant difference between the effectiveness of either the tongue cleaner or the tongue scraper in reducing VSC levels when compared with the toothbrush. AUTHORS' CONCLUSIONS There is weak and unreliable evidence to show that there is a small but statistically significant difference in reduction of VSC levels when tongue scrapers or cleaners rather than toothbrushes are used to reduce halitosis in adults. We found no high level evidence comparing mechanical with other forms of tongue cleaning.
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Affiliation(s)
- T L Outhouse
- United States Navy, Dental Corps, Comprehensive Dentistry, Box 25438, Awali, Bahrain.
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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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