Association Between Oral Malodor and Dementia: An 11-Year Follow-Up Study in Japan.

Background: As infrequent social interaction is a potential risk of dementia, oral malodor may increase the risk of dementia, including Alzheimer's disease. Objective: This study investigated the association between malodor and dementia. Methods: We used the Japan Public Health Center-based Prospective Study data obtained at Yokote City. A total of 1,493 individuals aged 56 to 75 years underwent a dental examination and self-reported survey from May 2005 to January 2006. Follow-up for the onset of dementia was conducted using long-term care insurance data from 2006 to 2016. Hazard ratios of oral malodor on dementia were estimated by the Cox proportional hazards model. The inverse probability-weighted Cox model was used as a sensitivity analysis. Results: The study comprised 1493 participants (53.6% women) with a mean age of 65.6 (SD = 5.8) years old; at the end of the follow-up, 6.4% (n = 96) developed dementia, and the percentage was 20.7 in severe malodor group. Throughout 15274.133 person-years of follow-up, the average incidence rate for the onset of dementia per 1000 person-years was 6.29. The highest incidence rate was seen in participants with severe malodor (22.4 per 1000 person-years). After adjusting for confounders, compared to those with no malodor, there was a 3.8 (95% confidence interval: 1.5 to 9.4) times greater hazard of developing dementia in participants with severe malodor. The inverse probability weighted Cox model confirmed the same trend with an adjusted marginal hazard ratio of 4.4 (1.2 to 16.4). CONCLUSIONS: A significant association between oral malodor and the onset of dementia exists.

Effects of honokiol combined with resveratrol on bacteria responsible for oral malodor and their biofilm.

Background: This study aimed to investigate the effect of honokiol combined with resveratrol on bacteria responsible for oral malodor and their biofilm. Method: This study investigated drug's MIC, FICI and dynamic bactericidal susceptibility activities against Pg and Fn. The effects of drugs on biofilm metabolic activity, biofilm total amount, and biofilm microstructure were determined by CCK-8 experiment, semi-quantitative adhesion experiment and SEM, respectively. The effects of drugs on biofilm genes, extracellular polysaccharides, proteins and DNA content were determined by qRT-PCR, phenol-sulfuric acid method, BCA method and Nano Drop one C, respectively. Results: The combination had synergistic antibacterial effect on Pg and Fn. 1/2×MIC and 1×MIC combination inhibit the whole process of Pg and Fn growth. The results showed that the combination effectively reduce biofilm metabolic activity and total amount, and destroy biofilm microstructure. The results showed that the combination downregulate the gene expression both Pg and Fn, reduce extracellular polysaccharides and DNA of Pg, and reduce extracellular proteins and DNA of Fn. Conclusion: This study showed that the combination had a synergistic antibacterial effect on Pg and Fn, reduced the biofilm extracellular matrix, inhibited biofilm formation, and downregulated the expression of genes related to biofilm formation.

Is There a Correlation Between Periodontal Disease Symptoms and the COVID-19 Vaccination?

OBJECTIVE: This study aimed to investigate and compare potential associations between different COVID-19 vaccines and periodontal diseases, mainly gingival bleeding and oral malodor (bad breath). MATERIALS AND METHODS: This cross-sectional study used an online questionnaire consisting of 15 questions regarding demographic information, medical history, type of COVID-19 vaccine received, history of COVID-19, and general and periodontal symptoms after vaccination. The survey was voluntary and privately accessed online using SurveyMonkey®. A total of 2000 participants from three regions of Saudi Arabia participated in the study from October 11, 2021, to October 11, 2022. RESULTS: Of the participants, 95.8% received at least one dose of the available COVID-19 vaccine. Oxford-AstraZeneca was the most administered (41.7%). Patients who suffered from chronic diseases or had a history of COVID-19 infection were less likely to be vaccinated (OR= 0.62, 95% CI 0.40-0.97; OR=0.62, 95% CI 0.39-0.99) compared with people with no chronic diseases or who had a history of COVID-19. The odds ratios for gingival bleeding, oral malodor, mobility, and tooth loss indicated no significant differences regarding vaccination status. CONCLUSION: COVID-19 vaccines might not affect periodontal tissue conditions. People should not avoid vaccination due to concerns with oral or general health, as the benefits of vaccination outweigh the potential side effects.

Volatile sulfur compounds in asthmatic children and adolescents: A cross-sectional study in breath and saliva.

BACKGROUND: Halitosis in children implies psychosocial repercussions. Risk factors associated with this condition are unclear, and detection methods are inaccurate. AIM: To quantify the levels of sulfur-like compounds in children with asthma and healthy children from a novel validated assay, and to establish the risk factors related to halitosis. DESIGN: One hundred and twenty-eight individuals (63 healthy and 65 asthmatic) from 3 to 17 years of age were tested using a passive colorimetric sensor to measure the levels of sulfur-like compounds in breath and saliva. Information was collected on oral hygiene habits, gingival and dental health, breathing type, and dental malocclusion. RESULTS: The mean values of hydrogen sulfide were 4.0 ± 6.8 and 19.7 ± 12.2 ppbv (parts per billion in volume) in the control and asthmatic groups, respectively (p < .001). The presence of higher concentrations of sulfur compounds was significantly associated (p < .05) with the presence of gingival inflammation, tongue coating, dental plaque, mouth breathing, hypomineralization, age, tongue brushing, and the use of dental floss. CONCLUSION: The level of sulfur in breath and saliva was significantly higher in patients with asthma. These results can serve as a precedent to raise awareness among paediatricians and parents about oral hygiene care in children and adolescents.

Multi-function screening of probiotics to improve oral health and evaluating their efficacy in a rat periodontitis model.

The oral cavity is the second most microbially rich region of the human body, and many studies have shown that there is a strong association between microorganisms and oral health. Some pathogenic bacteria produce biofilms and harmful metabolites in the mouth that may cause oral problems such as oral malodor, periodontitis, and dental caries. Altering the oral microbiota by using probiotics may alleviate oral health problems. Thus, using multi-function screening, we aimed to identify probiotics that can significantly improve oral health. The main parameters were the inhibition of pathogenic bacteria growth, inhibition of biofilm formation, reduction in the production of indole, H2S, and NH3 metabolites that cause halitosis, increase in the production of H2O2 to combat harmful bacteria, and co-aggregation with pathogens to prevent their adhesion and colonization in the oral cavity. Tolerance to cholic acid and choline was also assessed. Bifidobacterium animalis ZK-77, Lactobacillus salivarius ZK-88, and Streptococcus salivarius ZK-102 had antibacterial activity and inhibited biofilm production to prevent caries. They also improved the oral malodor parameter, H2S, NH3, and indole production. The selected probiotics (especially L. salivarius ZK-88) alleviated the inflammation in the oral cavity of rats with periodontitis. The analysis of the gingival crevicular fluid microbiome after probiotic intervention showed that B. animalis ZK-77 likely helped to restore the oral microbiota and maintain the oral microecology. Next, we determined the best prebiotics for each candidate probiotic in order to obtain a formulation with improved effects. We then verified that a probiotics/prebiotic combination (B. animalis ZK-77, L. salivarius ZK-88, and fructooligosaccharides) significantly improved halitosis and teeth color in cats. Using whole-genome sequencing and acute toxicity mouse experiments involving the two probiotics, we found that neither probiotic had virulence genes and they had no significant effects on the growth or development of mice, indicating their safety. Taking the results together, B. animalis ZK-77 and L. salivarius ZK-88 can improve oral health, as verified by in vivo and in vitro experiments. This study provides a reference for clinical research and also provides new evidence for the oral health benefits of probiotics.

Halitosis: etiology, prevention, and the role of microbiota.

OBJECTIVES: This study aims to review halitosis research, discuss its various causes, and propose effective interventions based on the underlying etiologies and mechanisms. The main research question is to identify the primary factors contributing to halitosis and appropriate strategies to address them. MATERIALS AND METHODS: A comprehensive literature review was conducted on halitosis and its associated causes, including oral pathological factors, oral microbial influences, microbial metabolic pathways, gastrointestinal diseases, and gut microbiota dysbiosis. RESULTS: Unhealthy eating habits and an imbalance of microorganisms in the oral cavity and gastrointestinal tract were identified as primary causes of halitosis. Dental caries, periodontal disease, xerostomia, and digestive disorders like gastritis and irritable bowel syndrome were also found to be related to the development of halitosis. Due to poor oral hygiene or antibiotic use, disruption of microbial communities can result in dysbiosis, inflammation, and halitosis. CONCLUSIONS: Halitosis is a multifactorial condition with various underlying causes, including oral and systemic diseases. Effective interventions should be tailored based on the specific etiologies and mechanisms involved. CLINICAL RELEVANCE: Understanding the factors contributing to halitosis is crucial for developing appropriate treatment strategies. Enhancing oral hygiene habits, using antimicrobial drugs, or administering probiotics may help regulate oral or intestinal flora, thereby improving halitosis and overall oral health.

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

Objective: Halitosis or oral malodor is an unpleasant odor from the oral cavity. However, although patients with periodontitis often complain of halitosis, their relationship has not been fully elucidated. We reviewed previous literature based on the hypothesis that the relationship between halitosis and periodontitis is mediated by the oral microbiome. Materials and methods: This narrative review sought to provide insight into the causative role of the oral microbiome in influencing halitosis and periodontitis. In addition, we tried to deepen knowledge related to the relationship between halitosis and periodontitis generated by the oral microbiome accumulated over the past 40 years. Results: From 1984 to 2023, a total of 106 papers that carefully and scientifically dealt with halitosis and periodontitis were included in this narrative review. Based on previous results, halitosis and periodontitis were closely related. For decades, researchers have taken an intriguing approach to the question of whether there is a relationship between halitosis and periodontitis. Central factors in the relationship between halitosis and periodontitis include volatile sulfur compounds (VSCs), the oral microbiota that produce VSCs, and the inflammatory response. Conclusions: Taken together, the more severe periodontitis, the higher the level of VSC in halitosis, which may be mediated by oral microbiome. However, the relationship between the occurrence, maintenance, and exacerbation of periodontitis and halitosis is not a necessary and sufficient condition for each other because they are complex interplay even in one individual.

Oral-malodor measurement and intention to quit smoking in men: A before-after study.

INTRODUCTION: Few studies have examined the effect of feedback based on oral-malodor measurements on the motivation to quit smoking. Therefore, this study examined whether oral-malodor measurements were associated with the intention to quit smoking. METHODS: This retrospective, uncontrolled before-after study invited smokers to a workplace health event in 2019 and 2020 to motivate them to quit smoking. They attended seminars on oral health and smoking cessation aids, and then underwent respiratory function and oral-malodor measurements using exhaled and oral cavity air, respectively. Intention to quit smoking was evaluated by answers to questions regarding the intention to quit in the next 1 or 6 months in questionnaires collected before and after the event. This study analyzed 241 men aged 20-54 years (mean: 33.2 ± 10.5) to examine factors associated with the intention to quit in multivariable logistic regression analyses for age, tobacco type (cigarettes and heated-tobacco products), and category of tobacco consumption. RESULTS: Before the event, 8.7%, 17.0%, and 74.3% of smokers had intended to quit in the next month, the next six months, or had no intention to quit, respectively. After the event, the respective percentages were 17.8%, 26.6%, and 55.6%. A higher methyl mercaptan concentration, a volatile sulfide component of oral malodor, was significantly associated with the intention to quit in the next month (adjusted odds ratio, AOR=4.24; 95% CI: 1.52-11.8, p=0.006). The participants with higher daily tobacco consumption were less likely to acquire the intention to quit in the next six months (AOR=0.37; 95% CI: 0.15-0.92, p=0.032). Other variables, such as lung age deficit, exhaled CO concentration, and hydrogen sulfide concentration (another component of oral malodor), were not significantly associated. CONCLUSIONS: Oral-malodor measurement feedback may help motivate men to quit smoking in the next 1 month rather than in the next six months.

Effectiveness of lasers and aPDT in elimination of intraoral halitosis: a systematic review based on clinical trials.

In recent years, there has been increasing interest in research showing positive results in antimicrobial photodynamic therapy (aPDT) and laser therapy (LT) in dentistry. The authors of this review tried to answer the question: "Is the effectiveness of lasers and aPDT in the elimination of intraoral halitosis possible?" For this purpose, the electronic database of PubMed and Cochrane Library were searched until September 2021 using a combination of different keywords: (bad breath OR fetor ex ore OR halitosis OR oral malodor) AND (laser OR PDT OR PACT OR photodynamic inactivation OR photodynamic therapy OR photodynamic antimicrobial chemotherapy). Initially, 83 studies were identified. A total of 9 articles were qualified after the application of the eligibility criteria. Eight works concerned aPDT treatment, and only one dedicated to the Er,Cr:YSGG laser. A significant reduction in halitosis occurred immediately after both LT and aPDT. The review found the confirmation of the effectiveness of laser therapy in reducing the number of volatile sulfur compounds (VSC) and the amount of anaerobic bacteria responsible for VSC formation. In most studies, a positive effect was observed for a 1-week follow-up. Laser therapy (aPDT, Er,Cr:YSGG) effectively eliminates microorganisms that produce volatile compounds and can effectively eliminate bad breath for the longer period of time than traditional methods of combatting this ailment.

Criticism of the organoleptic examination for the diagnosis of oral halitosis.

Due to the fact that only a human can judge the objectionability of an odor, organoleptic examination (sniffing and scoring oral odor) was used as a reference standard of oral halitosis measurement. However, there are several problems that make the diagnostic value of organoleptic examination questionable. There is no universally accepted, precise definition, standardization or calibration in organoleptic examination, including scoring, scaling or safety protocols. Standardization, calibration, reproducibility, reliability, objectivity, specificity, accuracy and sensitivity of organoleptic measurements are doubtful. It is extremely subjective, emotional, instinctive, intuitive, speculative, hedonic and highly flexible. In addition, it is found to be repulsive, primitive and moreover even shame is experienced by patients and examiners. Non-standard protocols on pre-measurement, scoring, scaling, and training processes may cause misinterpretation or misdiagnosis since it depends on the examiner's emotional mood, gender, ethnicity, odor detection spectrum, threshold and even climatic conditions. It is not the gold standard, and not even considered standard. It is difficult to recognize, identify or focus on a particular gas among thousands in the breath. Organoleptic examination may not be necessary due to it not being a good diagnostic tool for halitosis. There may be an infection risk for sniffers or patients. Moreover, female examiners may have disadvantages in olfactory accuracy during organoleptic examination since menstruation, pregnancy and menopause may alter their odor sensation. In addition, age limits the reliability of examiners due to age-related smell loss. According to the psychophysics laws, the human nose can recognize odors logarithmically. There is no reason to think that scoring the oral malodor by sniffing the mouth of the patients obtains sufficient evidence for the diagnosis of halitosis. Portable multi-gas detectors and electronic noses, can be suggested as an alternative instead of sniffing patients. This is the first paper in the literature to criticize organoleptic examination, revalue its health risks and inconsistencies in assessment protocols.

Cysteine challenge test as a novel diagnostic tool to distinguish oral halitosis.

BACKGROUND: The cysteine challenge test is often used to check the H2 S production capacity of the mouth. Patients with oral halitosis group (n = 305) or non-oral halitosis group (n = 191) and healthy individuals (control group, n = 102) were compared with each other to identify any possible relationship between initial and cysteine-induced oral H2 S concentrations. SUBJECTS AND METHOD: The medical records of 598 participants were reviewed retrospectively. Oral H2 S concentrations before (pre-CR) and after cysteine rinse (post-CR) with 5 mL of 20 mmol L-cysteine solution for 30 s were compared. RESULTS: Pre-CR H2 S concentrations were >0.8 ppm in 75.1% of oral group patients but less than <0.8 ppm in 87.3% of the non-oral group and 86.9% of controls. After cysteine rinse, oral H2 S concentrations exceeded 12 ppm in 72% of the oral halitosis patients but were lower in 88% of non-oral group and 99% of controls. Whilst post-CR/pre-CR ratio was >12 in 74.5% of the oral group, it was <12 in 81.7% of the non-oral group and 83.4% of controls. CONCLUSION: Cysteine challenge test can be used as a diagnostic tool to identify an individual's tendency to produce oral malodor, not only to quantify momentary halitosis level.

Risk Factors, Diagnosis, and Management of Halitosis in Children: A Comprehensive Review.

AIM: The present manuscript aims at providing a comprehensive overview of the epidemiology, risk factors, diagnostic aids, and management of halitosis in a pediatric population. BACKGROUND: Halitosis refers to bad breath from the mouth that seems unpleasant or offensive to others. This condition is prevalent worldwide, including all age-groups. However, studies on the pediatric population are limited. Self-confidence and personality development are important factors that the child builds up during their developmental stages. Halitosis may affect them both on personal and social aspects; hence, it is important to have beforehand knowledge and the modes to intercept it, paving the way to a positive growth of the child. REVIEW RESULTS: On reviewing the literature, the common risk factors for halitosis in children constituted predominantly oral factors that varied from poor oral hygiene, gingivitis, periodontal diseases, dental caries, tongue coating, mouth breathing, and so on. Their diagnosis commonly included the organoleptic test, sulfide monitoring, and gas chromatography along with the assessment of questionnaire by the parents and older children. The management was predominantly directed toward the identified source of halitosis along with instructions and counseling on the benefits of a good oral hygiene regime. CONCLUSION: The importance of cultivating a day-to-day practice of oral hygiene regime in the children will not only accustom them toward the benefits of good oral health but also help them to tackle halitosis and in turn their inhibitions associated with it. CLINICAL SIGNIFICANCE: Halitosis, though a prevalent condition experienced at various stages of life, is crucial to identify and manage, especially in the pediatric population owing to its influence on personal and on social aspects of life.

Evaluation of the Efficacy of Lacer HaliTM Treatment on the Management of Halitosis: A Randomized Double-Blind Clinical Trial.

BACKGROUND: Halitosis of oral origin is very common in the general population. Due to their antimicrobial properties, chlorhexidine-based products are widely used in the management of this condition, but these are associated with reversible side effects. In this study we evaluated the efficacy of Lacer HaliTM mouthrinse and toothpaste in subjects with intraoral halitosis after several applications under normal conditions of use. METHODS: In this randomized clinical trial with mouth rinse and toothpaste, single-center, double-blinded, parallel participants were assigned to an experimental group (Lacer HaliTM,, n = 20), a positive control group (HalitaTM, n = 20), and a placebo group (n = 20). The active duration of the study was 18 days. The clinical follow-up evaluations were performed at five time points (T0, T1, T2, T3, and T4). The intensity of halitosis was evaluated by organoleptic measurement and the portable gas chromatograph OralChromaTM. The data were analyzed using generalized mixed linear models. RESULTS: Sixty patients completed the study. Lacer HaliTM, in comparison with HalitaTM, did not show statistically significant differences at any time during the study except for the levels of hydrogen sulfide and total volatile sulfur compounds at 15 days, where HalitaTM was better. Compared to the placebo treatment, Lacer HaliTM, was significantly more efficient, in terms of both the organoleptic evaluations at 8 days and the levels of hydrogen sulfide. CONCLUSIONS: Lacer HaliTM is an alternative to chlorhexidine-based toothpaste and mouthwashes in the management of halitosis.

The Prevalence and Determinant Factors of Oral Halitosis in Northwest Ethiopia: A Cross-Sectional Study.

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.

Efficacy of Arabic Coffee and Black Tea in Reducing Halitosis: A Randomized, Double-Blind, Controlled, Crossover Clinical Trial.

The aim of the study was to objectively evaluate the short-term effect of Arabic coffee and black tea on oral halitosis. This study was a single-center, randomized, double-blind, placebo-controlled, crossover clinical trial on 17 healthy individuals. During the initial visit, pre-treatment breath samples were collected from each subject and analyzed using portable gas chromatography (OralChroma™). Four interventions were evaluated, with Arabic coffee and black tea as the test intervention tools, mouthwash containing a solution (0.05% chlorhexidine, 0.05% cetylpyridinium chloride, and 0.14% zinc lactate (CHX-CPC-Zn)) as a positive control, and drinking water as a negative control. Halitosis was induced by rinsing with 10 mL solution of L-cysteine for 30 s. Twenty minutes later, a breath sample was taken to record the baseline volatile sulfur compounds (VSC) levels (T0). Then, the participants were asked to rinse with 10 mL of a randomly-assigned solution for 30 s. Sixty minutes later, another breath sample was recorded (T1). Finally, after 120 min, the final breath sample was recorded (T2). It was found that rinsing with Arabic coffee decreased the level of H2S both in the first hour (T1) and the second hour (T2). The reduction was significantly greater at T1 (p = 0.017). There was a similar result after the volunteers rinsed with black tea. At T2, Arabic coffee showed a substantially greater reduction in H2S (p < 0.001). On the contrary, using CHX-CPC-Zn showed a significant and continuous decrease in H2S values in the breath throughout the experiment (p < 0.001). Water showed no significant impact on the level of VSC (p = 0.71). This study demonstrates that black tea and Arabic coffee had inhibitory effects on halitosis that was greater in the first hour and was not sustained over a long period. Additionally, Arabic coffee had a greater inhibitory effect on halitosis than black tea.

Investigation of oral malodor prevention by dentifrices as measured by VSC reduction.

The oral malodor reduction efficacy of dentifrices containing stannous fluoride (SnF2) or zinc plus arginine (Zn/Arg) was evaluated using a halimeter to measure volatile sulfur compounds (VSCs) in two randomized, controlled, single-blind, cross-over pilot clinical trials. Study 1 (N= 16) had five 1100 ppm F dentifrices and five treatment periods: negative control (NC): 0.243% sodium fluoride (NaF); SnF2A: 0.454% SnF2+ pyrophosphate; SnF2B: 0.454% SnF2+ sodium hexametaphosphate; SnF2C: 0.454% SnF2+ citrate; and SnF2D: experimental 0.454% SnF2with increased bioavailable Sn. Study 2 (N= 16) had four 1450 ppm F dentifrices and four treatment periods: NC: 0.1% NaF + 0.76% sodium monofluorophosphate; Zn/Arg: NaF + zinc + arginine; SnF2E: 0.454% SnF2+ 0.078% NaF + sodium hexametaphosphate; SnF2F: 0.454% SnF2+ 0.078% NaF + citrate. Each period took 96 h; baseline (day 0) morning to day 4 morning. Subjects brushed 2x/day with the treatment dentifrice. VSC levels were measured in the morning, prior to morning brushing, on days 0 and 4. Changes in VSC scores from day 0 to day 4 were assessed using a mixed-model analysis of covariance for cross-over studies. In study 1, SnF2dentifrices B, C and D showed statistically significant reductions (31.3%, 24.8%, 34%, respectively) in VSC scores versus baseline (p< 0.001); the benefits of these treatments versus NC and SnF2dentifrice A were statistically significant (p⩽ 0.001). In study 2, SnF2dentifrices E and F showed statistically significant reductions (31.2%, 22.1%, respectively) in VSC scores versus baseline (p⩽ 0.010); the benefits of these treatments versus NC and the Zn/Arg dentifrice were statistically significant (p⩽ 0.035). The Zn/Arg dentifrice showed a significant increase of 35.2% (p< 0.001) in VSC scores versus baseline. These studies demonstrated that SnF2dentifrices can provide significant oral malodor reductions, but the benefit is formulation dependent. The presence of SnF2is not sufficient to ensure efficacy. The Zn/Arg dentifrice increased VSC levels, indicating greater malodor.Clinical Trial Numbers: 20190429 and 20191028.

Relationship between Fixed Dental Crowns and Volatile Sulphur Compounds.

OBJECTIVES: The aim of this study was to investigate and compare the level of halitosis in patients with/without fixed crowns and in addition the influence of various crown parameters on halitosis was also explored. METHODS: In total, 96 subjects (fixed crowns = 52; no crowns = 44) participated in the study. The levels volatile sulphur compounds (VSCs) of hydrogen sulphide (H2S), methyl mercaptan (CH3SH), and dimethyl sulphide (CH3SCH3) were evaluated with breath samples using gas chromatography and used for classification as presence or absence of halitosis. The periodontal clinical parameters for all the participants as well as the crown parameters for participants with fixed crowns were also evaluated. Cross tabulation, Chi-square test, and one-way analysis of variance tests were used for the statistical analysis and comparisons. RESULTS: Breath samples revealed, 50 (52.1%) participants were suffering from halitosis. Out of VSCs, the level of CH3SCH3 (62.5%) was found to be the most prevalent. Significant correlations were observed between the presence of fixed crowns and oral halitosis (p < 0.001). Statistically significant difference in the concentration of H2S and CH3SH (p < 0.001) and no significance for CH3SCH3 (p = 0.075) between patients with/without fixed crowns was found. The presence of halitosis was more prevalent in the subjects with crown parameters (subgingival margin, over-contoured margin, open-crown margin, over-contoured and under-contoured crowns) considered clinically defective/unacceptable (p < 0.05). CONCLUSIONS: Presence of fixed dental crowns significantly contributes to the oral halitosis. Dental crowns with defects significantly impair the hygienic conditions and oral microflora resulting in high prevalence of halitosis.

Knowledge and Management of Halitosis in France and Lebanon: A Questionnaire-Based Study.

Halitosis is a growing issue and its management is highly challenging. The aim of this study was to evaluate the knowledge and treatment strategies used by French (FD) and Lebanese (LD) dentists. A self-administered structured questionnaire was sent to FD and LD comprising questions about professional characteristics, management, and treatment of halitosis, patients' referral, and halitosis-related knowledge. A multivariate analysis was conducted to determine differences between FD and LD and to identify parameters that could influence dentists' management of halitosis. The questionnaire was filled out by 156 FD and 257 LD. Among them, 78.8% of FD and 68.9% of LD were confronted with halitosis management, while only a few routinely asked their patients about halitosis (16% FD, 13.2% LD). Regarding anamnesis, oral hygiene habits were more investigated by FD than LD (p < 0.05). The overall treatment satisfaction was low with 39.7% of FD and 28.4% of LD considering their treatment effective. Regarding halitosis-related knowledge, extra-oral causes were overestimated in both populations. FD (83.4%) and LD (65.8%) considered their education regarding halitosis as insufficient. This study highlights the need of professional education in both countries, targeting proper diagnosis and treatment strategies of halitosis.

The association between periodontal diseases and halitosis among Saudi patients.

OBJECTIVES: To assess the relationship between the presence of periodontal disease and halitosis. METHODS: A total of 120 patients were enrolled and divided into 2 groups, 60 patients with probing depth (PD) > 3.0 mm (group 1) and 60 patients with PD ≤ 3.0 mm (group 2). Clinical parameters including, plaque index (PI), bleeding index (BI), and PD were obtained. Breath samples were collected and analyzed using a portable gas chromatograph to measure the concentration of volatile sulfur compounds (VSC). RESULTS: Halitosis was found to affect 58.3% of the total patients. The means of PI, BI, and VSC were significantly higher in group 1 (PD > 3.0 mm) than in group 2 (PD ≤ 3 mm). CONCLUSIONS: The percentage of patients suffering from halitosis in the Saudi population are comparatively high. In addition, there was a positive association between periodontal disease and halitosis.