Two mechanisms of oral malodor inhibition by zinc ions

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

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

ABSTRACT Objective Halitosis can be caused by microorganisms that produce volatile sulphur compounds (VSCs), which colonize the surface of the tongue and subgingival sites. Studies have reported that the use of natural products can reduce the bacterial load and, consequently, the development of halitosis. The aim of this study was to evaluate the antimicrobial activity of the essential oil of Melaleuca alternifolia on the growth and volatile sulphur compound (VSC) production of oral bacteria compared with chlorhexidine. Material and Methods The effects of these substances were evaluated by the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) in planktonic cultures of Porphyromonas gingivalis and Porphyromonas endodontalis. In addition, gas chromatography analyses were performed to measure the concentration of VSCs from bacterial cultures and to characterize M. alternifolia oil components. Results The MIC and MBC values were as follows: M. alternifolia - P. gingivalis (MIC and MBC=0.007%), P. endodontalis (MIC and MBC=0.007%=0.5%); chlorhexidine - P. gingivalis and P. endodontalis (MIC and MBC=1.5 mg/mL). M. alternifolia significantly reduced the growth and production of hydrogen sulfide (H2S) by P. gingivalis (p<0.05, ANOVA-Dunnet) and the H2S and methyl mercaptan (CH3SH) levels of P. endodontalis (p<0.05, ANOVA-Dunnet). Chlorhexidine reduced the growth of both microorganisms without altering the production of VSC in P. endodontalis. For P. gingivalis, the production of H2S and CH3SH decreased (p<0.05, ANOVA-Dunnet). Conclusion M. alternifolia can reduce bacterial growth and VSCs production and could be used as an alternative to chlorhexidine.

Site-specific mouth rinsing can improve oral odor by altering bacterial counts. blind crossover clinical study

To determine whether site-specific mouth rinsing with oral disinfectants can improve oral odor beyond the traditional panoral mouth disinfection with mouth rinses by targeting specifically oral malodor implicated anaerobic bacteria. Twenty healthy fasting subjects volunteered for a blinded prospective, descriptive correlational crossover cross-section clinical trial conducted during the month of Ramadan between July and August 2013 in Albaha province in Saudi Arabia involving the application of Listerine[R] Cool Mint[R] mouth rinse by either the traditional panoral rinsing method, or a site-specific disinfection method targeting the subgingival and supragingival plaque and the posterior third of the tongue dorsum, while avoiding the remaining locations within the oral cavity. The viable anaerobic and aerobic bacterial counts, volatile sulfur compounds [VSCs] levels, organoleptic assessment of oral odor, and the tongue-coating index were compared at baseline, one, 5, and 9 hours after the treatment. The site-specific disinfection method reduced the VSCs and anaerobic bacterial loads while keeping the aerobic bacterial numbers higher than the traditional panoral rinsing method. Site-specific disinfection can more effectively maintain a healthy oral cavity by predominantly disinfecting the niches of anaerobic bacteria within the oral cavity

Efeito do tratamento periodontal full-mouth e convencional na redução da halitose / Effect of periodontal treatment full-mouth and conventional in the reduction of halitosis

A halitose se caracterizada pela emanação de um odor desagradável onde cerca de 90% de se origina dentro da cavidade oral. Estudos têm demonstrado uma relação direta entre a doença periodontal e o odor ofensivo do hálito. O presente estudo teve como objetivo avaliar a frequência e distribuição de halitose em um grupo de pacientes com doença periodontal em um estudo transversal observacional (n=112) e, em um estudo intervencionista, avaliar o efeito do tratamento periodontal full-mouth e convencional na redução da halitose em um grupo de pacientes com doença periodontal. Os pacientes responderam a uma anamnese, tiveram seu hálito mensurado pelo halímetro e teste organoléptico, além de realizados Índice de placa visível, Índice de sangramento gengival, Índice de saburra lingual e exame periodontal completo. No estudo 2, os pacientes foram submetidos a seis distintas formas de tratamento: terapia periodontal em sessão única, terapia convencional em quadrantes e, um grupo controle, com somente instrução de higiene oral. Todas as modalidades subdivididas: com e sem raspagem lingual diária. No primeiro estudo os resultados mostraram que, tanto para teste organoléptico quanto para o halímetro, houve maior grau de halitose nos grupos de idades mais avançadas, nos que relataram sangramento gengival e escovação menos que três vezes ao dia. Ainda no teste organoléptico a escovação de língua gerou diferença estatística. Não houve diferença estatística entre as medidas de halitose entre teste organoléptico e halímetro. Foram encontrados aproximadamente 75% de pacientes periodontais com halitose. No segundo estudo os resultados mostraram superioridade conforme análise do halímetro para 30, 60 e 90 dias para os grupos de raspagem em sessão única contra raspagem por quadrantes. Sendo todos os grupos superiores ao controle. Não houve diferença na abordagem com ou sem a raspagem de língua. De acordo com o teste...

Halitosis is characterized by the emission of an unpleasant odor about 90% originates in the oral cavity. Studies have shown a direct relationship between periodontal disease and the offensive odor of breath. The present study aimed to determine the prevalence of halitosis in patients with periodontal disease in an observational cross-sectional study (n = 112) and, in an intervention study, the patients have had six distinct forms of treatment (n = 90) to verify the efficacy of full- vs. partial-mouth disinfection in the control of halitosis. Patients answered an interview, they have had their breath collected by halimeter, they have evaluated by organoleptic test, and visible plaque index, gingival bleeding index, index of tongue coating and periodontal examination. In the second step, patients have been submitted to six different forms of treatment: periodontal therapy in one session, conventional therapy in quadrants, and the control group, with only oral hygiene instruction. All types split: with and without tongue scraping daily. The first study results shown for both organoleptic test as halimeter, a greater degree of halitosis in the older age groups, we have reported that gum bleeding and brushing less than three times per day. Still in organoleptic test brushing of tongue generated statistical difference. There was no statistical difference between the measures between halitosis and organoleptic test halimeter. There was about 75% og periodontal patients with halitosis. In the second study the results shown the superiority analysis as halimeter for 30, 60 and 90 days for groups of scraping in single session against scraping by quadrants. Being all groups superior from control. There was no difference in approach with or without tongue scraping. According to the organoleptic test, there was no difference between the four types of periodontal treatment compared to the control groups. The same...

Efeito do tratamento periodontal full-mouth e convencional na redução da halitose / Effect of periodontal treatment full-mouth and conventional in the reduction of halitosis

A halitose se caracterizada pela emanação de um odor desagradável onde cerca de 90% de se origina dentro da cavidade oral. Estudos têm demonstrado uma relação direta entre a doença periodontal e o odor ofensivo do hálito. O presente estudo teve como objetivo avaliar a frequência e distribuição de halitose em um grupo de pacientes com doença periodontal em um estudo transversal observacional (n=112) e, em um estudo intervencionista, avaliar o efeito do tratamento periodontal full-mouth e convencional na redução da halitose em um grupo de pacientes com doença periodontal. Os pacientes responderam a uma anamnese, tiveram seu hálito mensurado pelo halímetro e teste organoléptico, além de realizados Índice de placa visível, Índice de sangramento gengival, Índice de saburra lingual e exame periodontal completo. No estudo 2, os pacientes foram submetidos a seis distintas formas de tratamento: terapia periodontal em sessão única, terapia convencional em quadrantes e, um grupo controle, com somente instrução de higiene oral. Todas as modalidades subdivididas: com e sem raspagem lingual diária. No primeiro estudo os resultados mostraram que, tanto para teste organoléptico quanto para o halímetro, houve maior grau de halitose nos grupos de idades mais avançadas, nos que relataram sangramento gengival e escovação menos que três vezes ao dia. Ainda no teste organoléptico a escovação de língua gerou diferença estatística. Não houve diferença estatística entre as medidas de halitose entre teste organoléptico e halímetro. Foram encontrados aproximadamente 75% de pacientes periodontais com halitose. No segundo estudo os resultados mostraram superioridade conforme análise do halímetro para 30, 60 e 90 dias para os grupos de raspagem em sessão única contra raspagem por quadrantes. Sendo todos os grupos superiores ao controle. Não houve diferença na abordagem com ou sem a raspagem de língua. De acordo com o teste ...

Halitosis is characterized by the emission of an unpleasant odor about 90% originates in the oral cavity. Studies have shown a direct relationship between periodontal disease and the offensive odor of breath. The present study aimed to determine the prevalence of halitosis in patients with periodontal disease in an observational cross-sectional study (n = 112) and, in an intervention study, the patients have had six distinct forms of treatment (n = 90) to verify the efficacy of full- vs. partial-mouth disinfection in the control of halitosis. Patients answered an interview, they have had their breath collected by halimeter, they have evaluated by organoleptic test, and visible plaque index, gingival bleeding index, index of tongue coating and periodontal examination. In the second step, patients have been submitted to six different forms of treatment: periodontal therapy in one session, conventional therapy in quadrants, and the control group, with only oral hygiene instruction. All types split: with and without tongue scraping daily. The first study results shown for both organoleptic test as halimeter, a greater degree of halitosis in the older age groups, we have reported that gum bleeding and brushing less than three times per day. Still in organoleptic test brushing of tongue generated statistical difference. There was no statistical difference between the measures between halitosis and organoleptic test halimeter. There was about 75% og periodontal patients with halitosis. In the second study the results shown the superiority analysis as halimeter for 30, 60 and 90 days for groups of scraping in single session against scraping by quadrants. Being all groups superior from control. There was no difference in approach with or without tongue scraping. According to the organoleptic test, there was no difference between the four types of periodontal treatment compared to the control groups. The same ...

Detection of odoriferous subgingival and tongue microbiota in diabetic and nondiabetic patients with oral malodor using polymerase chain reaction.

Background: Halitosis has been correlated with the concentration of volatile sulfur compounds (VSCs) produced in the oral cavity by metabolic activity of bacteria colonizing the periodontal pockets and the dorsum of the tongue. It has been assumed that there is a relationship between periodontal disease and diabetes mellitus. Objectives: The aim of the study was to assess the malodor using the organoleptic method and tanita device; to quantify odoriferous microorganisms of subgingival plaque and tongue coating, such as P. gingivalis (Pg), T. forsythia (Tf), and F. nucleatum (Fn) using polymerase chain reaction (PCR) in nondiabetic and diabetic chronic periodontitis patients. Patients and Methods: Thirty chronic periodontitis patients (with and without diabetes) with 5-7 mm pocket depth, radiographic evidence of bone loss, and presence of oral malodor participated in this study. Subjective assessment of mouth air was done organoleptically and by using a portable sulfide monitor. Tongue coating was also assessed. Results: The scores of plaque index, gingival index, gingival bleeding index, VSC levels, and tongue coating between the nondiabetic and diabetic patients were not significant (P>0.5). In nondiabetic patients, Fn was found to be significantly (P<0.5) more in tongue samples, whereas Pg and Tf have not shown significant values (P>0.5). In diabetic patients, Fn and Tf have shown significant (P<0.5) an increase in subgingival and tongue samples, respectively, whereas Pg has not shown significant difference between subgingival and tongue samples. Interpretation and Conclusion: The results confirm that there is no difference in clinical parameters between nondiabetic and diabetic periodontitis patients, but the odoriferous microbial profiles in tongue samples of diabetic patients were found to be high. However, there is a weak positive correlation between VSC levels, clinical parameters, and odoriferous microbial profiles.

Helicobacter pylori infection; in cases with and with out subjective halitosis

In most individuals H. Pylori is acquired early in the life [before 5 years]. H. Pylori infection is more common in the third world countries, where about 90% of adults may be infected. Helicobacter pylori is one of the suspected causes of halitosis in children. To evaluate the relationship of helicobacter pylori and halitosis. 33 patients with chief complaint of halitosis included in our study. Halitosis was evaluated as a subjective symptom in this study. Careful history was obtained. All patients underwent physical examination in order to rule out sinusitis, otitis, and possible cause of halitosis. 67 patients without halitosis were selected as control group. All patients were aged 4-17 years old. Urea Breath Test was done for all patients. UBT has >95% sensitivity and specifity for diagnosis of H.pylori infection. Chi-square test and Yate's corrected x[2] was used to analyzes finding. Epi-info ver 6 were used. In the case groups 7 patients had H. pylori infection and 26 patients had not. In the control group 18 patients had H.pylori infection and 49 patients had not halitosis [P=0.53]. There is no significant differences between case and control group. In this study we did not find relationship between H.pylori infection and halitosis

Enterobacteriaceae and pseudomonadaceae on the dorsum of the human tongue

OBJECTIVE: The aim of this study was to correlate the presence of Enterobacteriaceae, Pseudomonadaceae, Moraxellaceae and Xanthomonadaceae on the posterior dorsum of the human tongue with the presence of tongue coating, gender, age, smoking habit and denture use. MATERIAL AND METHODS: Bacteria were isolated from the posterior tongue dorsum of 100 individuals in MacConkey agar medium and were identified by the API 20E system (Biolab-Mérieux). RESULTS: 43 percent of the individuals, presented the target microorganisms on the tongue dorsum, with greater prevalence among individuals between 40 and 50 years of age (p = 0.001) and non-smokers (p=0.0485). CONCLUSIONS: A higher prevalence of Enterobacteriaceae and Pseudomonadaceae was observed on the tongue dorsum of the individuals evaluated. There was no correlation between these species and the presence and thickness of tongue coating, gender and presence of dentures.

Enterobacteriaceae: produção de compostos sulfurados voláteis / Enterobacteriaceae: production of volate sulfur compounds

A halitose pode ser causada pelo metabolismo de algumas bactérias proteolíticas Gram-negativas que residem na cavidade bucal. Alguns estudos verificaram a produção dos compostos sulfurados voláteis (CSV) por bactérias dos gêneros Porphyromonas, Prevotella, Bacteroides, Treponema, Actinobacillus e Fusobacterium. O objetivo deste trabalho foi avaliar in vitro a capacidade de produção de CSV por algumas espécies de bactérias da família Enterobacteriaceae. Foram estudadas 37 cepas de bacilos Gram-negativos isolados da cavidade bucal, sendo nove Enterobacter sakazakii, nove Klebsiella pneumoniae, nove Enterobacter cloacae, cinco Chryseomonasluteola e cinco Escherichia coli. De cada cepa, foram preparadas oito culturas em Caldo Infuso Cérebro-Coração (BHI), sendo três para o teste de medições com halímetro e cinco para o teste organoléptico. As medições com o halímetro foram realizadas diretamente nos tubos de ensaio e os testes organolépticos foram feitos por cinco participantes devidamente treinados, obedecendo escala com escores de O a 5. No teste de medição com o halímetro, ocorreu maior produção de CSV por cepas de E. coli, seguida por E. cloacae. Cepas de E. sakazakii, K. pneumoniae e C. luteola apresentaram baixa produção de CSV. No teste organoléptico, os escores mais altos foram atribuídos a E. coli. Concluiu-se que as espécies testadas produziram CSV, sendo E. coli a espécie com maior produção desses compostos em ambos os testes.

Halitosis is influenced by the action of proteolitic Gram-negative bacteria which live in the oral cavity. In some previous studies, the production of volatile sulfur compounds (VSC) was observed by members from the gemes: Porphyromonas, Prevotella, Bacteroides, Treponema, Actinobacillus and Fusobacterium. The objective of this study was to examine VSC production by some species of the Enterobacteriaceae family. 37 strains of Enterobacteriaceae were isolated from oral cavities; nine Enterobacter sakazakii, nine Klebsiella pneumoniae, nine Enterobacter cloacae, five Chryseomonas luteola and five Escherichia coli. Eight cultures were obtained from each strain and inoculated into Brain Heart Infusion (BHI) broth, resulting in a total of 296 cultures. Three cultures were tested by means of a Halimeter® and five by means of organoleptic test. The Halimeter® measurements were performed directly from the open test tubes and the organoleptic measurements were determined by five odor judges by smelling the contents of the test tubes and scoring them on a scale of O to 5. The Halimeter® test showed a higher production of VSC by E. coli strains, followed by E. cloacae. However E. sakazakii, K. pneumoniae and C. luteola presented low VSC production. E. coli, produced the highest scores with the organoleptic test. In conclusion, all tested species yielded VSC, overall the specie with the highest production of these compounds in both tests was E. coli.

Flavoring agents present in a dentifrice can modify volatile sulphur compounds (VSCs) formation in morning bad breath

This study aimed to evaluate the effects of a flavor-containing dentifrice on the formation of volatile sulphur compounds (VSCs) in morning bad breath. A two-step, blinded, crossover, randomized study was carried out in 50 dental students with a healthy periodontium divided into two experimental groups: flavor-containing dentifrice (test) and non-flavor-containing dentifrice (control). The volunteers received the designated dentifrice and a new toothbrush for a 3 X/day brushing regimen for 2 periods of 30 days. A seven-day washout interval was used between the periods. The assessed parameters were: plaque index (PI), gingival index (GI), organoleptic breath scores (ORG), VSC levels (as measured by a portable sulphide monitor) before (H1) and after (H2) cleaning of the tongue, tongue coating (TC) wet weight and BANA test from TC samples. The intra-group analysis showed a decrease in ORG, from 3 to 2, after 30 days for the test group (p < 0.05). The inter-group analysis showed lower values in ORG, H1 and H2 for the test group (p < 0.05). There was no difference between the amount of TC between groups and the presence of flavor also did not interfere in the BANA results between groups (p > 0.05). These findings suggest that a flavor-containing dentifrice seems to prevent VSCs formation in morning bad breath regardless of the amount of TC in periodontally healthy subjects.

[Halitosis and its treatment]

Halitosis is a general term used to describe an unpleasant offensive odor emanating from the oral cavity. Under normal conditions, breathing has a special and not a bothering odor, which is called human odor. Around 90% of all the causes of bad breath originate from the oral cavity, and more specifically, it has been reported that around 40% come from the dorso-posterior region of the tongue. Moreover, nonoral pathologic conditions, including upper and lower respiratory tract and gastro-intestinal infections, as well as some metabolic diseases, have also been identified as halitosis-inducing factors. Oral cavity malodor can be attributed to a variety of products arising from bacterial amino acids' metabolism. These metabolites include many compounds, such as indole, skatole and volatile sulfur compounds, like methyl mercaptan, hydrogen sulfide, dimethyl sulfide, which are the main components of bad breath originating from the oral cavity. The microorganisms that contribute to halitosis include gram negatives, anaerobes, klebsiella, and bacteroids. Local pathologic factors like poor oral hygiene, chronic gingivitis, dental caries, dental plaques, malignancies of the oral cavity and surrounding tissues, tonsillar chronic infections, foreign bodies in tonsils or oral cavity, fissured tongue and sino-nasal diseases can also induce halitosis. In addition, systemic pathologic etiologies like lower respiratory tract infections, gastro-intestinal disorders, blood dyscrasias, diabetes, liver cirrhosis, renal failure, vitamin deficiencies, especially vitamin C deficiency, and some drugs can cause halitosis. Local non-pathologic factors, such as smoking, dental prosthesis, saliva stasis, and systemic non-pathologic ones, like pregnancy, menstruation, menopause, fasting, old age, and some foods can bring about malodorous breath. Old age, salivary gland aplasia, diabetes, menopause, bad oral and dental hygiene, and spices can cause mouth dryness and reduce salivary flow and mouth washing, hence leading to a foul-smelling mouth. Complete and close physical examination and history taking can guide the physician toward the diagnosis and help to find the exact cause of halitosis. Bad odors of short time duration are mainly caused by infections, severe systemic diseases, foreign bodies, or recent drug therapy. In contrast, majority of long-lasting bad odors are due to poor oral hygiene, malignancies of the oral cavity or surrounding tissues, respiratory tract, or bronchiectasis. Intake of some foods and sleeping may result in intermittent halitosis. Eradication of halitosis inducing factors is the first step toward problem solving. Besides, care of the oral hygiene, teeth, gums, tongue brushing, and dental flossing help to overcome bad breath originating from the oral cavity