Oral malodor reduction by a palatal mucoadhesive tablet containing herbal formulation

OBJECTIVE: The aim of the present study was to test the effect of a palatal mucoadhesive tablet containing an herbal formulation on oral malodor production and volatile sulfide compound (VSC) levels, and to evaluate its antimicrobial activity. METHODS: A total of 56 healthy young volunteers participated in experiments 1 and 2. The palatal adhesive tablets were prepared with different active ingredients (herbal formulation, zinc and chlorhexidine), or without an active ingredient as control (placebo). Measurement included odor judge scores (two judges) and VSC readings by a sulfide monitor (Halimeter). In experiment 3, the antimicrobial activity of the herbal formulation ingredients (i.e. sage, Echinacea, Lavender and Mastic gum) were tested against three oral pathogens (Streptoccocus mutans, Porphyromonas gingivalis and Candida albicans) by the agar diffusion test. RESULTS: Application of the palatal adhesive tablets containing herbal formulation resulted in a significant reduction in both oral malodor scores (p<0.001) and VSC levels (p=0.013). Herbal formulation showed higher significance in VSC reduction (p=0.001), as compared to zinc and chlorhexidine (p=0.024 and 0.032, respectively). Sage, Lavender and Mastic gum showed antimicrobial activity against all three oral pathogens. CONCLUSIONS: Results of the present study suggest that the palatal adhesive tablets containing herbal formulation may serve as an effective means of treatment for patients complaining of oral malodor.     

挥发性硫化物检测仪和嗅觉测量口臭的相关性

[目的]比较采用挥发性硫化物(volatile sulfur compounds,VSCs)检测仪和嗅觉测量两种方法测量试验性口臭结果的相关性。[方法]36名健康自愿者含漱自制的"口臭造模液"(主要成分为VSCs)后,先后进行嗅觉测量和口腔VSCs检测。之后每隔1周重复上述试验1次,共测试4次。Spearman相关性检验2种方法测试口臭结果的相关性。[结果]4次测试的口腔VSCs体积分数(ppb)平均分别为688、662、684和602,VAS值平均分别为6.64、6.58、6.58和6.36。4次测试的口腔VSCs体积分数和嗅觉测量VAS值结果的相关系数r分别为0.845、0.769、0.602和0.696,统计学检验的P值均为0.000,提示2种测试方法测得的结果存在正相关关系。[结论]VSCs检测仪可以作为嗅觉测量的辅助手段,在后续的口臭防治相关产品开发时评估口臭改善状况的客观指标之用。     

感官分析法和便携式硫化物检测仪检测口臭的相关性研究

目的比较感官分析法(鼻测法)和便携式硫化物检测仪(商品名Halimeter)检测口臭之间的准确性和一致性。方法首先对2名嗅辨员进行嗅觉检测试验,以确定其进行感官分析评分的资质。选择86例符合试验条件的受试者,分别用感官分析法评价口臭程度,硫化物检测仪检测口腔挥发性硫化物(VSC)含量,使用SPSS11.0软件分析鼻测法得分均值和VSC水平的关系。结果2名嗅辨员一致性良好,Kappa值达到0.568,P<0.01。鼻测法得分均值与Halimeter检测所得硫化物峰值之间相关系数r=0.538,P<0.01;与硫化物稳定值之间相关系数r=0.546,P<0.01。结论鼻测法得分和Halimeter检测的口腔VSC含量之间存在显著相关关系,提示Halimeter可在一定程度上作为鼻测法的辅助手段,用以检测口臭。     

口臭与牙周炎及舌苔的相关性研究

目的　探讨口臭及口气中挥发性硫化物 (volatilesulphurcompounds ,VSCs)与牙周炎及舌苔的相关性 ,舌在口臭及VSCs产生中的作用。方法　选择 6 0例全身健康、有口臭的牙周炎患者 ,鼻闻法检查口臭程度 ,使用便携式口臭测量仪分别测量清除舌苔前后的VSCs量。记录牙周袋探诊深度(probingdepth ,PD)及PD≥ 4mm位点比例 ,出血指数 (bleedingindex ,BI) ,菌斑指数 (plaqueindex ,PLI)及舌苔厚度与面积。结果　Spearman相关分析法显示 ,口臭值、VSCs量与BI、PLI、舌苔厚度存在明显的正相关性 (P <0 0 1) ,与舌苔面积也有关系 (P <0 0 5 )。口臭值与PD及PD≥ 4mm位点比例无关 ,VSCs量与PD及PD≥ 4mm位点比例存在一定的相关性 (r=0 2 6 ,P <0 0 5 )。清除舌苔可以明显降低VSCs量 (t=10 15 ,P <0 0 1) ,其减少量与舌苔厚度及面积均有明显相关性 (P <0 0 1)。结论　口臭值、VSCs量与BI、PLI及舌苔均有关系 ,而牙周袋PD只与VSCs量有关系 ;虽然清除舌苔可以明显降低VSCs量 (降低 36 7% ) ,但由于存在如何完全彻底清除舌苔的问题 ,所以舌与牙周炎在口臭及VSCs形成中的作用尚需进一步研究。     

个性化口腔卫生指导对口腔中挥发性硫化物含量的影响

目的 探讨单纯个性化口腔卫生指导对于清除菌斑、改善口臭及降低口腔中挥发性硫化物(VSCs)水平的作用.方法 选择31例鼻闻法评价口臭程度(OS)≥2的牙用炎患者,对其实施口腔卫生指导.指导前后,用口臭测量仪测量口腔中VSCs水平,并检查菌斑指数(PU).结果 口腔卫生指导前PLI为3.09±0.44,指导后降至2.63±0.46,差异有统计学意义(P<0.05);VSCs由指导前的(186.87±130.95)ppb降至指导后的(154.00±131.49)ppb,但差异无统计学意义(P>0.05);口腔卫生指导前OS值是2.68±0.70,之后是2.35±0.75,差异有统计学意义(P<0.05).结论 口腔卫生指导有助于口臭患者清除菌斑、改善口腔卫生状况,但降低口腔中VSCs含量的作用有限.     

Clinical assessment of oral malodor using autofluorescence of tongue coating

ObjectivesThe aim of this study was to evaluate whether a new method using quantitative light-induced fluorescence-digital (QLF-D) was appropriate for the diagnosis of oral malodor by quantifying the fluorescence of tongue coating.MethodsThis study examined 103 healthy subjects who have an oral malodor as a main complaint. The levels of oral malodor were measured by organoleptic scores (OLS) and volatile sulfur compound (VSC) levels. The fluorescent tongue coating images captured by QLF-D were quantified as the integrated fluorescence score (IF score) by multiplying the intensity and area of fluorescence. The correlations between the fluorescence parameters and OLS as well as VSC levels and the diagnostic accuracy of the IF score were evaluated.ResultsThe IF score of tongue coating showed a significant positive correlation with the OLS (r = 0.54, p < 0.01) and the VSC levels (r = 0.49, p < 0.01). This score was significantly differed with the level of oral malodor (p < 0.001), and its AUC was 0.72 in identifying the patient with definite oral malodor (≥OLS 2).ConclusionsA new method quantifying tongue coating fluorescence detected by QLF-D can be used to diagnose oral malodor and assess its severity in the clinical practice.     

Knowledge and perception of parents regarding halitosis in their children in Saudi Arabia

ObjectiveTo evaluate parents’ knowledge about halitosis, and to compare parents’ perception of halitosis in their children to the presence of halitosis clinically.MethodsChildren between 3 and 8 years attended to Dental University Hospital, King Saud University, were screened. Children satisfying inclusion criteria and their parents agreed to participate were included. Questionnaires regarding parents’ knowledge and perception about halitosis in their children were filled by attending parents. Then, the assessment of halitosis in the participating children carried out by portable gas chromatograph device (OralChroma^TM).ResultsA total of 67 children (44 girls and 23 boys) were included in this study with a mean age of 5.3 years (SD = 1.7). The majority of the questionnaires (n = 44, 65.7%) were filled by accompanying fathers. One in two (52.2%) parents obtained high knowledge score about halitosis. Parents’ knowledge was significantly associated with the mean age of the children (P = 0.02). Thirty-nine (58.2%) parents perceived halitosis in their children. Gender, child’s age, parents’ education level, or family income were not associated with parents’ perception of halitosis. Halitosis was detected clinically in 58 children (86.6%). Thirty-eight (57%) of parents’ perception of halitosis was in consistency with OralChroma^TM readings; however, there was no significant association between parents’ perception and the OralChroma^TM score.ConclusionHalf of the parents had good knowledge about halitosis and 6 in 10 parents perceived halitosis in their children which is quite less than the presence of halitosis detected clinically. Moreover, parents’ perception was not associated with the OralChroma^TM score.     

Systemic effects of H2S inhalation at human equivalent dose of pathologic halitosis on rats

Objectives: Halitosis is composed by hundreds of toxic gases. It is still not clear whether halitosis gases self-inhaled by halitosis patients cause side effects. The aim of the study was to investigate the effect of H₂S inhalation at a low concentration (human equivalent dose of pathologic halitosis) on rats.

Materials and methods: The threshold level of pathologic halitosis perceived by humans at 250?ppb of H₂S was converted to rat equivalent concentration (4.15?ppm). In the experimental group, 8 rats were exposed to H₂S via continuous inhalation but not the control rats. After 50 days, blood parameters were measured and tissue samples were obtained from the brain, kidney and liver and examined histopathologically to determine any systemic effect.

Results: While aspartate transaminase, creatine kinase-MB and lactate dehydrogenase levels were found to be significantly elevated, carbondioxide and alkaline phosphatase were decreased in experimental rats. Other blood parameters were not changed significantly. Experimental rats lost weight and became anxious.

Histopathological examination showed mononuclear inflammatory cell invasion in the portal areas, nuclear glycogen vacuoles in the parenchymal area, single-cell necrosis in a few foci, clear expansion in the central hepatic vein and sinusoids, hyperplasia in Kupffer cells and potential fibrous tissue expansion in the portal areas in the experimental rats. However, no considerable histologic damage was observed in the brain and kidney specimens.

Conclusions: It can be concluded that H₂S inhalation equivalent to pathologic halitosis producing level in humans may lead to systemic effects, particularly heart or liver damage in rats.     

The gastrointestinal aspects of halitosis

BACKGROUND:

Halitosis is a common human condition for which the exact pathophysiological mechanism is unclear. It has been attributed mainly to oral pathologies. Halitosis resulting from gastrointestinal disorders is considered to be extremely rare. However, halitosis has often been reported among the symptoms related to Helicobacter pylori infection and gastroesophageal reflux disease.

OBJECTIVE:

To retrospectively review the experience with children and young adults presenting with halitosis to a pediatric gastroenterology clinic.

METHODS:

A retrospective chart review of patients diagnosed with halitosis as a primary or secondary symptom was conducted. All endoscopies were performed by the same endoscopist.

RESULTS:

A total of 94 patients had halitosis, and of the 56 patients (59.6%) who were recently examined by a dental surgeon, pathology (eg, cavities) was found in only one (1.8%). Pathology was found in only six of 27 patients (28.7%) who were assessed by an otolaryngology surgeon. Gastrointestinal pathology was found to be very common, with halitosis present in 54 of the 94 (57.4%) patients. The pathology was noted regardless of dental or otolaryngological findings. Most pathologies, both macroscopically and microscopically, were noted in the stomach (60% non-H pylori related), followed by the duodenum and the esophagus. Fifty-two of 90 patients (57.8%) were offered a treatment based on their endoscopic findings. Of the 74 patients for whom halitosis improvement data were available, some improvement was noted in 24 patients (32.4%) and complete improvement was noted in 41 patients (55.4%).

CONCLUSIONS:

Gastrointestinal pathology was very common in patients with halitosis regardless of dental or otolaryngological findings, and most patients improved with treatment.