Hematological biomarkers of systemic inflammation in genuine (physiologic and pathologic) halitosis.

Halitosis is an unpleasant odor discharged through the oral cavity with a prevalence as high as 30%-50% of the general population. Conventional diagnostic methods have been focused on mouth air analysis measuring the amount of sulfur compounds which does not directly reflect the cause of halitosis. Also, the possible role of halitosis as an indicator of general health status has been steadily suggested and inflammation has been constantly associated with aversive body odor. Therefore, this study aimed to search for inter-relationships between hematologic indicators, clinical characteristics, and halitosis measurement that can predict the presence of pathologic halitosis and its intensity. Furthermore, the tentative relationship between halitosis and the presence of systemic inflammation was investigated. A total of 125 patients were divided into 103 patients in the genuine halitosis group (value ⩾80 ppb) and 22 patients in the pseudo halitosis group (value <80 ppb) based on portable sulfide monitor measurements. Clinical examination and hematological indices including inflammatory prognostic factors and halitosis measurements including organoleptic testing, portable sulfide monitor, and gas chromatography were evaluated. The genuine halitosis group showed a significantly higher white blood cell (WBC) count (p< 0.01) compared to the pseudo halitosis group. Erythrocyte sedimentation rate (ESR,ß= 0.341,p< 0.05) values and duration of halitosis (ß= 0.353,p< 0.05) showed a significant association with halitosis intensity and neutrophil to lymphocyte ratio (NLR) values (ß= 3.859,p< 0.05) were significantly related to genuine halitosis diagnosis. A new WBC cut-off value of 5575µl-1showed near to fair discriminative power in predicting genuine halitosis (area under the curve 0.661,p< 0.05). The results of this study showing an increased WBC count in genuine halitosis and its strong association with hematologic indices of subclinical inflammation including ESR and NLR suggest inflammatory hematologic markers as potential diagnostic tools in the diagnosis of genuine halitosis.

Direct effect of chlorine dioxide, zinc chloride and chlorhexidine solution on the gaseous volatile sulfur compounds.

OBJECTIVE: This study focused on the ability of aqueous anti-volatile-sulfur-compound (VSC) solutions to eliminate gaseous VSCs by direct contact in a sealed space to describe possible mode of action of anti-VSC agents. MATERIALS AND METHODS: Twenty milliliters of each experimental solution, 0.16% sodium chlorite, 0.25% zinc chloride, 0.1% chlorhexidine and distilled water, was injected into a Teflon bag containing mixed VSCs, hydrogen sulfide, methyl mercaptan and dimethyl sulfide and mixed vigorously for 30 s. The VSC concentration was measured by gas chromatography before, immediately after, 30 min and 60 min after mixing. RESULTS: The sodium chlorite solution reduced the VSC concentration remarkably. After mixing, nearly all VSCs were eliminated immediately and no VSCs were detected at 30 and 60 min post-mixing. However, in the other solutions, the VSC concentration decreased by ∼30% immediately after mixing and there was no further decrease. CONCLUSION: The results suggest that sodium chlorite solution has the effect of eliminating gaseous VSCs directly. This must be because it can release chlorine dioxide gas which can react directly with gaseous VSCs. In the case of other solutions that have been proved to be effective to reduce halitosis clinically, it can be proposed that their anti-VSC effect is less likely due to the direct chemical elimination of gaseous VSCs in the mouth.

Relationships between disk displacement, joint effusion, and degenerative changes of the TMJ in TMD patients based on MRI findings.

This study was performed to investigate the relationships between disk displacement, joint effusion, and degenerative changes in patients with temporomandibular disorders using MRI. Randomly selected MRIs of 508 temporomandibular joints of 254 patients (92 males and 162 females, mean age was 30.5±12.0 years) were reviewed retrospectively. Seventy-eight percent (198 out of 254) of the patients complained of joint pain. Compared with joints with a normal disk position, the joints with anterior disk displacement with reduction showed a 2.01 odds ratio (P<0.01) of degenerative changes and a 2.85 odds ratio (P<0.001) of joint effusions. The joints with anterior disk displacement without reduction showed a 4.43 odds ratio (P<0.001) of degenerative changes and a 4.61 odds ratio (P<0.001) of joint effusions. These results clearly show that the risk of degenerative changes and joint effusions increase with displacement of the disk position in patients with temporomandibular disorders. Although all disk displacement situations do not progress to painful joints and/or degenerative joint diseases, the possibility of an increased risk of progression by a breakdown in the balance between a patient's adaptive capacity and functional loading of the TMJ should be assessed in each and every patient through comprehensive evaluation of various contributing factors.

A comparison of neurosensory alteration and recovery pattern among different types of orthognathic surgeries using the current perception threshold.

OBJECTIVE: The objective of this study was to compare postsurgical neurosensory alteration and recovery patterns among different nerve fiber types and orthognathic surgeries by measuring current perception thresholds (CPT). STUDY DESIGN: CPTs of 186 patients who underwent various orthognathic surgeries (Le Fort I or II, bilateral sagittal split [BSSRO] or intraoral vertico-sagittal [IVSRO] ramus osteotomy with or without genioplasty) were measured at 2000, 250, and 5 Hz, assessing 3 different nerve fiber types before surgery and at 3, 6, and 12 months after surgery. RESULTS: CPTs were highest at 3 months postsurgery and gradually returned to presurgical levels until 12 months postsurgery in most cases. CPT at 2000 Hz showed the largest amount of increase. Le Fort I and IVSRO caused less neurosensory alteration compared with Le Fort II and BSSRO, respectively. CONCLUSION: Our data provide nerve recovery patterns following various orthognathic surgeries that may be applied to evaluating the patient's severity and recovery of nerve damage.

Dry mouth among the elderly in Korea: a survey of prevalence, severity, and associated factors.

OBJECTIVES: The aim of this study was to investigate the prevalence and severity of dry mouth among elderly population of Korea and to evaluate associate factors and their impact. STUDY DESIGN: Telephone interviews were conducted on a stratified random sample of 1,012 subjects aged ≥ 55 years. Prevalence of dry mouth symptoms, severity of overall oral dryness, and associated factors were assessed using a structured questionnaire. RESULTS: Among the subjects, 70.1% reported to have at least one dry mouth-related symptom and 25.8% were classified with considerable dry mouth. Overall oral dryness severity of each of these groups was 4.30 ± 2.67 and 6.09 ± 2.25, respectively, on a 0-10 scale. Odds ratio of dry mouth increased in women, in smokers, and with increased age and number of medications taken. Women and number of medications taken were significantly associated with overall oral dryness severity. CONCLUSION: A major portion of the Korean elderly reported various dry mouth symptoms, and a wide range of severity and discomfort was caused by these symptoms.

Effect of botulinum toxin on pressure pain threshold and EMG power spectrum of masseter muscle during sustained fatiguing contraction.

OBJECTIVES: The aims of this study were to test the effect of botulinum toxin on a reversible, prolonged, experimental pain and on muscle fatigue in human masseter muscle, both caused by a sustained clench. DESIGN: The masseter muscles were injected with botulinum toxin in 19 subjects and with isotonic saline in 16 subjects. We measured electromyographic activity at maximum voluntary contraction, pressure pain threshold before and after a 70% maximum voluntary contraction clench sustained to pain tolerance, and the median frequency of the electromyographic power spectrum during that clench at baseline and at 1, 2, and 3 mos after botulinum toxin or saline injection. RESULTS: After botulinum toxin injection, the botulinum toxin group had a reduced maximum voluntary contraction for the ensuing 3 mos and smaller decreases in pressure pain threshold from before to after the sustained clench. Also, the change in median frequency from before to after the sustained clench did not significantly differ during the postinjection sessions. However, postinjection, preclench median frequency was lower in the group injected with botulinum toxin. CONCLUSIONS: We interpret the reduced change in pressure pain threshold with botulinum toxin as a clinically modest but statistically significant analgesic effect on this model of acute muscle pain.

Effect of botulinum toxin injection on nocturnal bruxism: a randomized controlled trial.

OBJECTIVE: To evaluate the effect of botulinum toxin type A on nocturnal bruxism. DESIGN: Twelve subjects reporting nocturnal bruxism were recruited for a double-blind, randomized clinical trial. Six bruxers were injected with botulinum toxin in both masseters, and six with saline. Nocturnal electromyographic activity was recorded in the subject's natural sleeping environment from masseter and temporalis muscles before injection, and 4, 8, and 12 wks after injection and then used to calculate bruxism events. Bruxism symptoms were investigated using questionnaires. RESULTS: Bruxism events in the masseter muscle decreased significantly in the botulinum toxin injection group (P = 0.027). In the temporalis muscle, bruxism events did not differ between groups or among times. Subjective bruxism symptoms decreased in both groups after injection (P < 0.001). CONCLUSIONS: Our results suggest that botulinum toxin injection reduced the number of bruxism events, most likely mediated its effect through a decrease in muscle activity rather than the central nervous system. We controlled for placebo effects by randomizing the interventions between groups, obtaining subjective and objective outcome measures, using the temporalis muscle as a control, and collecting data at three postinjection times. Our controlled study supports the use of botulinum toxin injection as an effective treatment for nocturnal bruxism.

Salivary levels of IL-1beta, IL-6, IL-8, and TNF-alpha in patients with burning mouth syndrome.

OBJECTIVE: To compare salivary IL-1beta, IL-6, IL-8, and TNF-alpha levels between patients with burning mouth syndrome (BMS) and controls. DESIGN: Forty female patients with BMS (mean age: 61.6+/-10.1 years) and 20 female control subjects (mean age: 65.1+/-9.0 years) were included in the study. Unstimulated (UWS) and stimulated whole saliva samples (SWS) were collected and their flow rates were determined. Salivary IL-1beta, IL-6, IL-8, and TNF-alpha levels and total protein concentration were also determined. Salivary transferrin level was determined to investigate the level of blood contamination in saliva samples. Gingival index of the subjects was also examined. Student's t-test, Pearson's correlation analysis, and analysis of covariance were used. RESULTS: No significant differences were found in the salivary levels of IL-1beta, IL-6, IL-8, and TNF-alpha in BMS patients compared with controls. Salivary flow rates and their total protein concentrations did not differ significantly between the groups. The levels of salivary cytokines and total protein concentration correlated significantly with the level of blood contamination in both UWS and SWS. CONCLUSION: There were no differences in the salivary levels of IL-1beta, IL-6, IL-8, and TNF-alpha in BMS patients compared with controls. Cytokine levels in whole saliva were affected mainly by the amount of blood contamination.

Development of third molars in Korean juveniles and adolescents.

The aim of the present study was to provide reference data of the Korean population which is adequate to compare with other mongoloid populations and can be applied to the age estimation of Korean juveniles and adolescents. A cross-sectional study was performed on a randomly selected sample of 3301 orthopantomographs taken of patients aged from 4 to 26 years, and the developmental stages of the third molars were evaluated based on Demirjian's stages. The results showed that the development of third molars in the Korean population was likely to begin at age 7 in both males and females and be completed by age 22 in males and 24 in females at the latest, and the level of development of all four third molars correlated significantly with age in both genders. There were significantly more subjects without third molars in females than in males, however, subjects with all four third molars were significantly more common in males than in females. The Demirjian's stages C, F and G could be used as a reference stage to determine dichotomously whether a Korean is more likely to be under or above age 14, 18, or 20, respectively. These results will provide a reference for age estimation of Korean juveniles and adolescents and enable comparison with results from other ethnic populations.

Effects of CYP2D6 and CYP3A5 genotypes on the plasma concentrations of risperidone and 9-hydroxyrisperidone in Korean schizophrenic patients.

This study was conducted to evaluate the effects of the CYP2D6 and CYP3A5 genotypes on the steady-state plasma levels of risperidone (RIS), 9-hydroxyrisperidone (9-OH-RIS), and the active moiety (RIS plus 9-OH-RIS) in Korean schizophrenic patients. Sixty-four Korean schizophrenic patients were enrolled. CYP2D6 and CYP3A5 genotypes were determined, and the plasma levels of RIS and 9-OH-RIS were measured using high-performance liquid chromatography. The dose-normalized plasma concentrations of RIS, 9-OH-RIS, and the active moiety were compared according to the CYP2D6 and CYP3A5 genotypes. Among the patients, 57 were CYP2D6 extensive metabolizers (EMs; CYP2D6*1/*1, *1/*10, and *10/*10) and 7 were CYP2D6 poor metabolizers (PMs; CYP2D6*1/*5 and *10/*5). For the CYP3A5 genotype, 30 patients were CYP3A5*1 expressors (*1/*1 [n = 1] and *1/*3 [n = 29]) and 34 patients were CYP3A5 nonexpressors (*3/*3). The plasma levels of RIS (2.03 ng/mL per milligram for EMs vs 5.57 ng/mL per milligram for PMs, P < 0.001) and 9-OH-RIS (5.06 ng/mL per milligram for EMs vs 0.22 ng/mL per milligram for PMs, P < 0.001) were significantly different among CYP2D6 genotype groups, but the CYP2D6 EMs (7.09 ng/mL per milligram) and PMs (5.79 ng/mL per milligram) did not show no difference in the levels of the active moiety (P = 0.470). CYP3A5 nonexpressors exhibited higher plasma concentrations of both RIS and 9-OH-RIS than its expressors. In the case of 9-OH-RIS, CYP3A5 nonexpressors exhibited significantly higher concentrations than CYP3A5 expressors (5.42 vs 3.51 ng/mL per milligram, P = 0.022). In addition, concentrations of the active moiety were also significantly different between the CYP3A5 nonexpressors (8.39 ng/mL per milligram) and expressors (5.30 ng/mL per milligram, P = 0.005). In conclusion, both CYP2D6 and CYP3A5 genotypes affected plasma levels of RIS and 9-OH-RIS, whereas the active moiety levels were influenced only by the CYP3A5 genotype but not by the CYP2D6 genotype.

A new organoleptic testing method for evaluating halitosis.

BACKGROUND: Halitosis is a common condition in the adult population. The organoleptic method has been used widely in the clinical field for the diagnosis of halitosis because of its simplicity; however, this method has limitations as a result of its lack of objectivity and reproducibility. We developed a new method of organoleptic testing using a gastight syringe to overcome these limitations. The purpose of this study was to investigate the clinical usefulness of this new method by analyzing the correlations between the organoleptic score measured by it and data from the portable sulfide monitor and gas chromatography in the same subjects. METHODS: Fifty-two subjects (20 males and 32 females; mean age, 35.6 +/- 12.8) who visited the Halitosis Clinic at Seoul National University Dental Hospital, were recruited. We recorded the organoleptic score and measured the concentration of volatile sulfur compounds (VSCs) using a portable sulfide monitor and gas chromatography. The organoleptic test was performed in a standardized way using a gastight syringe and a paper cup connected to a plastic straw. RESULTS: The organoleptic score by the new method showed a significant positive correlation with the total VSC concentrations that were measured by gas chromatography (r = 0.790; P <0.01) and with the portable sulfide monitor (r = 0.822; P <0.01). There were significant positive correlations between the organoleptic score obtained by the new method and the concentration of H(2)S (r = 0.776; P <0.01), CH(3)SH (r = 0.715; P <0.01), and (CH(3))(2)S (r = 0.674; P <0.01) measured by gas chromatography. CONCLUSION: The new organoleptic test is a valuable tool for measuring halitosis in the clinical field.

Age estimation of Korean children based on dental maturity.

The aim of this study was to evaluate the relationship between age and dental maturity and to establish the standard database of dental maturity based on the Demirjian's stages, which can be used for the age estimation of Korean children. For this purpose, dental maturity was measured by the Demirjian's stages on a randomly selected sample of panoramic radiographs taken from 2706 patients between 1 and 20 years of age and analyzed by multiple linear regression analysis based on the method of least squares. The results showed that, except for the third molars, the development of permanent teeth in Korean children was more advanced in females. The Demirjian's stage G of the second molar appeared last in both male and female subjects by age 18, showing 95th percentile at age in the male and female subjects between 16.7-17.4 years and 17.1-17.3 years, respectively. Coefficients of determination (r(2)) of the Demirjian's stages relative to age in regression analysis were 0.9721 in male and 0.9740 in female subjects. The standard error was 0.63 years in male and 0.62 years in female subjects. The estimated age according to regression analysis was within +/-1.0 year of the actual age in 92.0% of male and 92.5% of female subjects. Collectively, the data of the present study can be used as a reference for dental maturity and a standard for age estimation of Korean children.

Age estimation of Korean adults by occlusal tooth wear.

The aim of the present study was to evaluate the validity of the modified Kim's scoring system as a practical method of recording occlusal tooth wear and estimating age. For this purpose, 1092 pairs of maxillary and mandibular full-arch casts were randomly selected, scored, and analyzed. The results showed that the modified Kim's scoring system had excellent reliability, and that occlusal tooth wear had a positive correlation with age. Tooth wear scores of all teeth except the two lower central incisors were higher in males than in females. Calculating tables for age estimation were designed by multiple linear regression analysis. Estimated ages were within +/-5 years of actual ages in 63.5% of male subjects, and 64.0% of female subjects. The accuracy of age estimation was increased when the subjects were divided into two age groups and data were re-analyzed. Collectively, it was shown that the modified Kim's scoring system is a reliable and accurate method for age estimation, and that the data from these 1092 individuals can be used as a standard for age estimation of Korean adults.

Volatile sulfur compounds produced by Helicobacter pylori.

GOALS: To assess the volatile sulfur compounds produced by three strains of Helicobacter pylori in broth cultures mixed with sulfur-containing amino acids. BACKGROUND: Halitosis has been reported in H. pylori-positive patients, and volatile sulfur compounds such as hydrogen sulfide and methyl mercaptan are known to be responsible for inducing oral malodor. Whether H. pylori produces these volatile sulfur compounds has yet to be established. STUDY: Three strains of H. pylori (ATCC 43504, SS 1, DSM 4867) were cultured with 5 mM cysteine and methionine. After 72 hours of incubation, the headspace air was aspirated and injected directly into a gas chromatograph. The concentrations of hydrogen sulfide and methyl mercaptan were analyzed and compared between experimental and control cultures RESULTS: In broth containing 5 mM cysteine, hydrogen sulfide was increased by ATCC 43504 (P < 0.01) and SS 1 (P < 0.05), while methyl mercaptan was elevated only by SS 1 (P < 0.05). In broth containing 5 mM methionine, methyl mercaptan increases were significant for SS 1 (P < 0.05) and DSM 4867 (P < 0.05). In broth containing 5 mM cysteine and 5 mM methionine, the concentration of hydrogen sulfide was higher than in controls for all three strains (P < 0.01); that of methyl mercaptan was higher only for SS 1 (P < 0.01). Cysteine addition to cultures containing methionine increased hydrogen sulfide and methyl mercaptan for ATCC 43504 (P < 0.05) and SS 1 (P < 0.05). Conversely, addition of methionine to cultures containing cysteine increased methyl mercaptan only for DSM 4867 (P < 0.01). CONCLUSIONS: The production of volatile sulfur compounds by H. pylori is not only very complicated but also strain-specific. Nevertheless, H. pylori was shown to produce hydrogen sulfide and methyl mercaptan, which suggests that this microorganism can contribute to the development of halitosis.

Influences of animal mucins on lysozyme activity in solution and on hydroxyapatite surfaces.

The purpose of this study was to investigate the influence of animal mucins on lysozyme activity in solution and on the surface of hydroxyapatite (HA) beads. The effects of animal mucins on lysozyme activity in solution were examined by incubating porcine gastric mucin (PGM) or bovine submaxillary mucin (BSM) with hen egg-white lysozyme (HEWL) or salivary samples. HA-immobilised animal mucins or lysozyme were used to determine the influence of animal mucins on lysozyme activity on HA surfaces. Lysozyme activity was determined by turbidity measurement of a Micrococcus lysodeikticus substrate suspension. Protein concentration was determined by ninhydrin assay. PGM inhibited the activity of HEWL and salivary lysozyme in solution. The amount of inhibition was dependent on mucin concentration, incubation time and temperature, and the structural integrity of the mucin. The inhibition of salivary lysozyme activity by PGM was greater in submandibular/sublingual saliva than in parotid saliva. The inhibition of lysozyme activity by PGM was markedly dependent on pH. However, BSM did not inhibit the in-solution lysozyme activities of HEWL and clarified saliva. Both PGM and BSM bound to HA surfaces, and HA-adsorbed animal mucins increased the subsequent adsorption of lysozyme. When HA beads were exposed to a mixture of HEWL and PGM or BSM, lysozyme activity on the HA surfaces was significantly increased. The results suggest that animal mucins affect lysozyme activity, and the effects are different on HA surfaces compared with in solution. Further research is needed to determine the effect of animal mucins on lysozyme activity in vivo.

The relationship between phenylthiocarbamide (PTC) and 6-n-propylthiouracil (PROP) taster status and taste thresholds for sucrose and quinine.

OBJECTIVE: The aim of this study was to investigate the relationship of taster status with taste detection and recognition thresholds for sucrose and quinine. DESIGN: Sixty-nine subjects (35 men and 34 women; mean age, 23.9+/-1.2 years) were included. Stimulus fluids were prepared, one each for phenylthiocarbamide (PTC), 6-n-propylthiouracil (PROP), sucrose and quinine HCl. In each series, successive solutions, which comprised a total of 15 grades, differed by 0.25log units of the molar concentration. Two concentrations of NaCl (0.32 and 1.0 M) were prepared. The subjects were classified as nontasters and tasters using their PTC and PROP perceptions. Tasters were classified as medium-tasters and supertasters by the ratio of perceived bitterness of above-threshold PROP relative to the perceived saltiness of NaCl (PROP ratio). Taste detection and recognition thresholds for sucrose and quinine were determined by standard two-alternative forced choice trials. A Student's t-test, a Pearson's correlation analysis and linear contrasts in a one-way analysis of variance (ANOVA) were used. RESULTS: The percentages of nontaster, medium-taster and supertaster were 13, 70 and 17%, respectively. There were no significant gender differences in the taste detection and recognition thresholds for sucrose and quinine. The threshold for PTC and PROP showed significant correlations with taste threshold for quinine. Linear contrast in one-way ANOVA showed that the greater the value of PROP ratio, the more sensitive to sweet and bitter tastes (p<0.001). CONCLUSION: The PTC and PROP taster status is closely related with taste detection and recognition thresholds for sucrose and quinine.

The relationship between PTC taster status and taste thresholds in young adults.

OBJECTIVE: The aim of this study was to compare taste detection and recognition thresholds of young males and females, and young phenylthiocarbamide (PTC) "tasters" and "nontasters" for stimuli representing sweet, sour, bitter, salty, and umami classes of taste sensations. STUDY DESIGN: Thirty-eight men and 37 women (mean [SD] age = 24.5 [2.5] years) were classified as PTC tasters and nontasters according to their PTC recognition thresholds. Detection and recognition thresholds for the non-PTC stimuli were determined using a 2-alternative, forced choice procedure. RESULTS: The detection thresholds for quinine-HCl and sucrose and the recognition threshold for quinine-HCl were significantly higher in the PTC nontasters than in the tasters. The PTC threshold showed significant correlations with detection or recognition thresholds for sucrose, sodium chloride, quinine-HCl, and monosodium glutamate. The sucrose recognition threshold was lower in women than in men. CONCLUSION: In this study, gender and PTC taster status were found to be associated with thresholds for sucrose and quinine-HCl.

Chronic orofacial pain among Korean elders: prevalence, and impact using the graded chronic pain scale.

The aims of this study were to investigate the prevalence of orofacial pain symptoms in the Korean elderly population, and to evaluate factors associated with orofacial pain and graded chronic pain. Of 4,342 Korean elders from the cohort of Korean National Interview Survey of Oral Health Status in 2000, telephone interviews were conducted on a stratified random sample of 1,032 people aged 55 years or older. Prevalence of five orofacial pain symptoms (jaw joint pain, face pain, toothache, oral sores, and burning mouth) in the past 6 months along with questions from the graded chronic pain scale were assessed by telephone using a structured questionnaire. The results suggested that the 6-month prevalence of joint pain (15.5%), face pain (9.3%), toothache (26.8%), oral sores (26.2%), and burning mouth (14.2%) in Korean elders were higher than in studies on Caucasian populations. Painful oral sores and burning mouth had higher prevalence for females than for males. Subjects with joint pain, burning mouth or toothache pain were more likely to report high levels of a pain-related disability compared with subjects not reporting those symptoms. There were no age group differences in pain intensity, but the older age group reported a higher number of disability days because of their pain. Chronic orofacial pain is a substantial health problem in the elderly population.

The relationship between oral Candida carriage and the secretor status of blood group antigens in saliva.

OBJECTIVE: The aim of the study was to investigate the relationship between oral Candida carriage and the secretor status of blood group antigens. STUDY DESIGN: Unstimulated whole saliva and oral rinse samples were obtained from 180 healthy subjects. These samples were plated on Sabouraud's dextrose agar media to determine oral Candida carriage. Sodium dodecylsulfate polyacrylamide gel electrophoresis and immunoblotting were performed on whole saliva samples to determine the secretor status of blood group antigens. RESULTS: The oral Candida carriage rate was found to be 45.0%. The sensitivity of the concentrated rinse culture proved to be superior. Oral Candida carriage was not significantly related to the blood group or secretor status of ABH or Lewis antigens. No significant relationship was found between oral Candida carriage and salivary flow rate. However, smoking affected oral Candida carriage. CONCLUSION: Oral Candida carriage in healthy individuals is not significantly related to blood group or secretor status.

The relationship between volatile sulfur compounds and major halitosis-inducing factors.

BACKGROUND: Although tongue coating and periodontal conditions have been reported to be major halitosis-inducing factors, the relationship between volatile sulfur compounds (VSC) and these 2 major factors is not yet fully understood. The aim of this study was to investigate the relationship of VSC concentrations to tongue coating and periodontal health. METHODS: Forty subjects (mean age 33.3 years, range 14 to 64 years) were enrolled in this study. Gas chromatography was performed to analyze each VSC component from the mouth air sampled prior to tongue scraping, after tongue scraping, and after a subsequent prophylaxis on the interdental spaces. RESULTS: CH3SH was the most malodorous component among the 3 major VSC from the mouth air. The high CH3SH group showed a significantly higher organoleptic rating (P < 0.01), gingival index (P < 0.01), bleeding index (P < 0.01), probing depth (P < 0.05), and VSC concentrations prior to tongue scraping (P < 0.01), except for the amount of tongue coating, compared to the low CH3SH group. All VSC concentrations were vastly reduced by tongue scraping in both groups, and the remaining contents were nearly all removed by the subsequent prophylaxis. The VSC contents produced by the tongue coating played a major role [H2S: 76%; CH3SH: 52%; (CH3)2S: 55%] in the low CH3SH group. In the high CH3SH group which had poor periodontal health, the tongue coating still played a major role [H2S: 67%; CH3SH: 59%; (CH3)2S: 48%], but the interdental spaces also contributed to VSC production [H2S: 26%; CH3SH: 32%; (CH3)2S; 36%]. CONCLUSIONS: The tongue coating was demonstrated to be a primary halitosis-inducing factor. Periodontal health was also shown to contribute to VSC production.