An objective assessment of halitosis in children with adenoid vegetation during pre- and post-operative period

ObjectivesAlthough most specialists in otorhinolaryngology and pediatrics find halitosis to be a common problem in children with adenoid hypertrophy, there are no objective data on this topic in the literature. Whether adenoid hypertrophy is a risk factor for halitosis or whether halitosis is a sign of adenoid hypertrophy remains unclear. Thus, the aim of this study was to investigate whether children diagnosed with adenoid hypertrophy have a higher probability of halitosis than do children in the normal population and whether adenoidectomy can decrease oral malodor.MethodsForty children with adenoid hypertrophy and 40 healthy subjects aged 5–15 years were included in the study. The children with adenoid hypertrophy underwent adenoidectomy operations and were followed for 3 months. We measured volatile sulfur compounds (VSCs), hydrogen sulfide (H₂S), methyl mercaptan (CH₃SH), and dimethyl sulfide (CH₃)₂S using an objective method, a portable gas chromatograph (OralChroma; AbiMedical, Osaka, Japan).ResultsThe mean CH₃SH and (CH₃)₂S levels were significantly different (p < 0.05) between the adenoid hypertrophy group and the controls. The H₂S, CH₃SH, and (CH₃)₂S levels in the third postoperative month were significantly lower (p < 0.05) than those in the preoperative period, and there was no significant difference postoperatively between the patients with adenoid hypertrophy and controls. There was a positive correlation between age and VSC levels, and CH₃SH levels were significantly higher in patients with ventilation tube insertion, rather than just adenoidectomy.ConclusionsThere was a statistically significant association between halitosis and adenoid hypertrophy, and a significant improvement in halitosis was obtained following adenoidectomy. The present study provides an association between halitosis and adenoid hypertrophy. If there is no other oral pathology causing halitosis, halitosis can be a sign of adenoid hypertrophy in children.     

口腔挥发性硫化物水平与牙周炎及舌苔的相关性研究

目的 研究口气中挥发性硫化物(VSC)与牙周临床指标及舌苔的相关性.方法 采用鼻闻法评定口臭值(OS),筛选出口臭值≥2,全身健康牙周炎患者50例.使用便携式气相色谱仪(Oral ChromaTM)检测每例患者口气中硫化氢(H2S)、甲基硫醇(CH3SH)、二甲基硫[(CH3)2S]的浓度.记录牙周袋探诊深度(PD),出血指数(BI),菌斑指数(PLI)以及舌苔厚度(Tt)与舌苔面积(Ta).结果 口臭值(3.28±0.75)与VSC中硫化氢、甲基硫醇、二甲基硫的水平[(810.30±204.09、234.53±113.88、21.45±13.12)μg/L]呈正相关(r=0.456、r=0.386、r=0.325,均P＜0.05).与PLI、BI也呈正相关(r=0.528,r=0.558,均P＜0.05).硫化氢与PD、BI间呈正相关(r=0.356,r=0.306,均P＜0.05).甲基硫醇与PLI、PD、BI均呈正相关(r=0.416、r=0.407、r=0.489,均P＜0.05).二甲基硫与PD、BI间均呈正相关(r=0.369,r=0.443,均P＜0.05).口臭值、硫化氢与舌苔面积、舌苔厚度均呈正相关(P＜0.05).甲基硫醇与舌苔厚度呈正相关(P＜0.05).结论 口气挥发性硫化物中二甲基硫可能主要来源于牙周袋,而硫化氢和甲基硫醇则可能来源于牙周炎与舌苔.     

Saliva and tongue coating pH before and after use of mouthwashes and relationship with parameters of halitosis

Objectives

The aim of this work was to evaluate saliva and tongue coating pH in oral healthy patients with morning bad breath before and after use of different oral mouthrinses.

Material and Methods

aliva and tongue coating pH of 50 patients allocated in 5 groups were measured respectively by a digital pHmeter and color pH indicators, before, immediately after and 30 min after rinsing 5 different mouthrinses: cetilpiridine chloride associated with sodium chloride, triclosan, enzymatic solution, essential oil and distilled water.

Results

Only triclosan and essential oil increased salivary pH immediately after rising. The enzymatic solution decreased salivary and tongue coating pH immediately after rinsing.

Conclusion

Salivary pH tended to be acidic while tongue coating pH tended to be alkaline, even after rising. Triclosan and essential oil mouthrinses increased salivary pH immediately after rinsing. Enzymatic solution decreased saliva and tongue coating pH immediately after rising.     

胃幽门螺杆菌感染与口臭关系的初步研究

目的：探讨胃幽门螺杆菌感染与口臭的关系。方法：选择无牙周疾病和全身疾病（上消化道疾病除外）的受试者50例．在胃镜检查或呼气试验前进行口臭测试及口腔相关指标检查，然后进行胃镜活检和呼气试验检测胃内幽门螺杆菌感染情况。使用SPSS11．5对数据进行统计学分析。结果：50例受试者经鼻测法测试有口臭28例，无口臭22例。各项牙周指标表明，受试者均牙周健康。χ^2检验表明，有、无口臭的受试者中，幽门螺杆菌的阳性率分别为57．1％和18．2％．差异具有统计学意义（P〈0．01）。Logistic回归方程显示，胃内幽门螺杆菌感染是方程中唯一有统计学意义的变量（P〈0．05）。结论：幽门螺杆菌可能与牙周健康者的口臭有关。     

Volatile sulphur compounds in morning breath of human volunteers

Objective

Morning breath contains elevated concentrations of volatile sulphur components (VSCs). Therefore, morning breath is recognised as a surrogate target for interventions on breath quality. Nevertheless, factors influencing morning breath are poorly understood. Our aim was to evaluate concentrations of VSC at the time of awakening.

Methods

A procedure was developed to collect breath samples at home. Intra- and inter-person variations were determined in two small studies based on measurements of hydrogen sulphide, methyl mercaptan and dimethyl sulphide in healthy volunteers.

Results

Highest levels of VSC were found directly after waking up, followed by a significant decline afterward. Considerable day-to-day variation was found, but could not be linked to dietary intake. A significantly higher concentration of H₂S and CH₃SH was observed in the group of female subjects compared to males.

Conclusions

When morning breath is used as a target for interventions, breath collected at the time of or shortly after waking up is preferred over breath collected later during the morning. Gender plays an important role in VSC levels, and should be taken into account.     

Effect of bracket type on halitosis,periodontal status,and microbial colonization

Objective: To determine the effect of bracket type on halitosis, periodontal status, and microbial colonization.Materials and Methods:Forty-six patients scheduled for fixed orthodontic treatment (age 11–16 years) were selected from the orthodontic department of Suleyman Demirel University. Patients were divided into two groups with random distribution of brackets; 23 patients were treated with self-ligating brackets (group SLBs), the others with conventional brackets (group CBs). Halitosis measurements and periodontal and microbial records were obtained before the placement of brackets (T0), 1 week later (T1), and 5 weeks after bonding (T2). Periodontal parameters, including plaque index (PI), gingival index (GI), and bleeding on probing index (BOP), were obtained from all the bonded teeth. Halitosis measurements were performed at the same time. Microbial samples were obtained from the buccal surfaces of all the bonded teeth. Data were analyzed by using a repeated-measurement analysis of variance test for the comparison of parameters between groups and times.Results:Periodontal parameters and halitosis results were higher in the CBs group than in the SLBs group (P < .05). In the SLBs group, halitosis and BOP values revealed no pronounced changes between T1 and T2 (P > .05). Intra- and intergroup comparisons showed that there were no statistically significant differences for microbial colonization between all the time intervals (P > .05).Conclusion:Bracket type has an effect on halitosis and periodontal status. Therefore, self-ligating brackets may be advised in order to prevent patients from developing halitosis and to increase the likelihood of good oral hygiene during orthodontic treatment.     

Rhinosinusitis in oral medicine and dentistry

Rhinosinusitis is a very common condition which is normally readily recognizable. Given the intimate anatomic relationship between the antrum and the posterior maxillary teeth, maxillary sinusitis can present as odontalgia. Distinguishing between odontogenic orofacial pain and pain associated with maxillary sinusitis is important to prevent unnecessary dental intervention and to direct patients to medical colleagues. Conversely, odontogenic infection can spread to involve the antrum, termed odontogenic sinusitis, or maxillary sinusitis of dental origin. Odontogenic sinusitis accounts for about 10–40% of all cases of sinusitis, and usually requires combined dental and medical treatment. Maxillary sinusitis can also be a complication of exodontia, resulting from tuberosity fractures, displaced teeth or root fragments and the creation of oroantral communications and fistulae. Dental implants and endodontic materials can also impinge on the maxillary sinus, and are rare causes of sinusitis. Often it is stated that rhinosinusitis may contribute to a halitosis complaint, and widely used diagnostic protocols for rhinosinusitis sometimes list halitosis as a minor criterion. However, gold standards in halitotosis research such as organoleptic assessment or gas chromatography have not been used to validate a correlation between objective (genuine) halitosis and sinusitis. The pathophysiology of this mechanism is unclear, and the relative importance of this alongside other causes of extraoral halitosis is debated.     

Characterization of volatile sulfur compound production by Solobacterium moorei

Objective

Solobacterium moorei is a Gram positive bacterium that has been specifically associated with halitosis. The aim of this study was to characterize volatile sulfur compound (VSC) production by S. moorei.

Methods

S. moorei was either grown or incubated in the presence of various supplements prior to determining VSC production with a Halimeter sulfide monitor. The effect of exogenous proteases or glycosidase inhibitors on VSC production by S. moorei was examined.

Results

We first showed that S. moorei can convert cysteine into hydrogen sulfide. The capacity of S. moorei to produce VSCs from serum, saliva, and mucin was dependent on the presence of an exogenous source of proteases such as pancreatic trypsin or Porphyromonas gingivalis gingipains. VSC production from mucin was inhibited by the presence of a β-galactosidase inhibitor, thus suggesting that deglycosylation of mucin by S. moorei is critical for VSC production.

Conclusion

Our study suggests that S. moorei can be a major source of malodorous compounds in halitosis by producing VSCs through a process involving the β-galactosidase activity of the bacterium and an exogenous source of proteases.     

没食子口含液对牙周临床指标及口气的影响

目的： 评价使用没食子口含液对牙周临床指标和口气的影响。方法： 采用随机对照单盲试验的方法,选择2008年10月至2009年9月就诊于北京大学口腔医院牙周科门诊的菌斑性龈炎或轻、中度慢性牙周炎患者70例,随机分为仅使用没食子口含液口含2周的试验组和没有任何辅助用药的对照组,两组在基线时都接受了相同的口腔卫生指导,基线及2周时分别测定并记录口气指标［包括感官值（organoleptic score,OS）、口腔挥发性硫化物（volatile sulphur compounds,VSCs）水平、舌苔面积(area of tongue coating,Ta)、舌苔厚度(thickness of tongue coating,Tt)］和牙周指标［包括菌斑指数（plaque index,PlI）、探诊深度（probing depth, PD）、 牙龈出血指数(bleeding index,BI)和色素指数（staining index ,SI）］。 结果： 2周后,两组牙周临床指标除了SI外都有显著改善(P<0.001) ,且试验组治疗后PlI的改善程度明显优于对照组,差异有统计学意义（P<0.05）;2周后试验组的OS值和Tt以及对照组的OS值均降低（P<0.05）,虽然试验组的口腔VSCs降低程度、OS值和Tt的改善程度有高于对照组的趋势,但差异并无统计学意义（P>0.05）。结论： 对于未治疗的菌斑性龈炎及轻、中度慢性牙周炎患者,没食子口含液有显著的菌斑抑制作用,但在改善口气方面较单纯刷牙不具有优势。     

体检人群口臭与代谢指标的相关性分析

目的 比较健康体检者口臭程度与代谢指标的相关性。方法 选取体检者2 885例,纳入分析的体检指标有体质量、身高、血压、血糖、胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白以及尿酸。由口腔医师检查患者口气情况,比较非口臭者和口臭患者的代谢指标,并对口臭组的口臭程度与代谢指标之间的关系进行深入分析。结果 男性出现口臭的比例较高（P<0.01）;两组代谢指标的比较,体质指数、收缩压、舒张压、空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白和尿酸的平均水平口臭组均高于非口臭组,高密度脂蛋白口臭组低于非口臭组;口臭值较高的患者,其代谢指标的平均水平（除高密度脂蛋白低）均高于口臭组中口臭值较轻者。结论 口臭与代谢指标异常之间存在同质关系,两者之间有相关性。