Association between oral malodour and psychological characteristics in subjects with neurotic tendencies complaining of halitosis.

OBJECTIVE: To assess the psychosomatically subjective symptoms of subjects with neurotic tendencies complaining of halitosis. DESIGN: Breath malodour was measured in 368 patients using organoleptic test and gas chromatography. Neurotic tendency and subjective symptoms were assessed using the Cornell Medical Index (CMI). RESULTS: Of the 79 subjects who met the criteria for neurotic tendencies according to CMI scores, 58 (73.4%) had oral malodour, whereas 21 (26.6%) did not. Coated tongue, periodontal pocket, and daily drinking were significantly more common in subjects with oral malodour. On the CMI questionnaire, subjects with no oral malodour more frequently responded 'yes' to questions about fatigue and psychological problems in their families. Additionally, many answered that they had perceived their own bad breath. CONCLUSIONS: Difficulties experienced by subjects with neurotic tendencies and oral malodour may manifest primarily in oral conditions, whereas those experienced by individuals with neurotic tendencies and no oral malodour may manifest primarily in psychosomatic symptoms.

The relationship between alcohol consumption and oral malodour.

OBJECTIVE: To analyse the relationship between alcohol consumption and oral malodour. SUBJECTS: 235 individuals, aged 46.5 +/- 15.3 years (mean +/- SD), who complained of oral malodour. METHODS: An organoleptic test (OLT) was used to estimate the degree of oral malodour, gas chromatography was used to measure volatile sulphur compounds (VSCs), and a questionnaire was used to gather data about the subjects' habits related to alcohol consumption. RESULTS: Of the 55 individuals who consumed alcohol daily, 17 (30.9%) had strong malodour (OLT score, 4), and there were significant differences among the 'daily', 'sometimes', and 'no alcohol' groups (Kruskal-Wallis test, p < 0.01). The daily group also had a higher VSC concentration than the 'sometimes' and 'no alcohol' groups (t-test, p < 0.05), and there was no difference in the VSC concentration among the subjects with strong malodour. Analyses of the relationships between drinking habits and the clinical factors causing oral malodour revealed that daily drinking was positively associated with a probing pocket depth > or = 5 mm (chi2 test, p < 0.01). CONCLUSION: This study found an association between daily alcohol consumption and strong malodour, especially related to periodontal disease.

Detection of Helicobacter pylori DNA in the saliva of patients complaining of halitosis.

Helicobacter pylori infection, which causes peptic ulcers and gastric cancer, is considered a possible cause of halitosis. Recently, the oral cavity was identified as a possible H. pylori reservoir, particularly in the presence of periodontal disease, which is a cause of halitosis. The purpose of this study was to evaluate by PCR the prevalence of oral H. pylori in the saliva of subjects complaining of halitosis. Samples were obtained from 326 non-dyspeptic subjects, comprising 251 subjects with actual malodour and 75 subjects without halitosis. DNA was extracted from the samples, and the presence of H. pylori and periodontopathic bacteria including Porphyromonas gingivalis, Treponema denticola and Prevotella intermedia was examined by PCR. H. pylori was detected in 21 (6.4 %) of 326 samples. The methyl mercaptan concentration and periodontal parameters including tooth mobility, periodontal pocket depth (PPD) and occult blood in the saliva were significantly greater in the H. pylori-positive subjects. Each of the periodontopathic bacteria was also detected at a significantly higher frequency in the H. pylori-positive subjects. Among those patients with a PPD of > or =5 mm and a tongue coating score of < or =2, no difference was observed in oral malodour levels between the H. pylori-positive and -negative subjects. However, the presence of occult blood in the saliva and the prevalence of Prevotella intermedia were significantly greater in the H. pylori-positive subjects. H. pylori was detected in 16 (15.7 %) of 102 subjects with periodontitis, suggesting that progression of periodontal pocket and inflammation may favour colonization by this species and that H. pylori infection may be indirectly associated with oral pathological halitosis following periodontitis.

Stimulation of growth of Porphyromonas gingivalis by cell extracts from Tannerella forsythia.

OBJECTIVE: In order to examine if Tannerella forsythia stimulates the growth of Porphyromonas gingivalis, an in vitro study was performed. BACKGROUND: P. gingivalis and T. forsythia are often isolated simultaneously from active periodontitis sites, indicating that these bacteria somewhat interact in the periodontal environment. We reported previously that mixed infection of P. gingivalis and T. forsythia synergistically induced lesion formation in a murine abscess model, and gingipains of P. gingivalis played an important role in this synergism. One of the possible mechanisms of this synergism is growth promotion by coinfection of the two bacteria. METHODS: Cell extracts of T. forsythia were added to the nutrition-decreased medium and the promotion of growth of P. gingivalis was examined. RESULTS: Sonicated extract of T. forsythia stimulated growth of P. gingivalis in nutrition-decreased medium in a dose-dependent manner. Proteins appeared to be the nature of growth-promoting factor, and the cell extract of T. forsythia had no stimulating effect on the growth of P. gingivalis strain devoid of gingipain activities. CONCLUSION: A product or a component of T. forsythia seemed to stimulate growth of P. gingivalis under nutrition-limited conditions. Gingipains are considered to play an important role in digestion or uptake of this growth-promoting factor. The interaction between T. forsythia and P. gingivalis in growth may be in part related with the synergistic virulence in a murine model.