牙龈炎口臭患者主要病原微生物的检测及意义

目的:评价牙龈卟啉单胞菌(Pg)和螺旋体(S%)在牙龈炎口臭形成中的作用。方法:对39例牙龈炎患者用鼻闻法分为口臭组和无口臭组,其中口臭组29例(HG),无口臭组10例(NHG),用Halimeter检测挥发性硫化物(VSCs),厌氧培养检测牙龈卟啉单胞菌和刚果红负性染色剂涂片计算螺旋体。结果:1牙龈炎口臭组和无口臭组牙龈卟啉单胞菌和螺旋体检出率无显著性差异(P>0.05),但构成比实验组显著高于对照组(P<0.05);并且龈下菌斑中,实验组构成比显著高于对照组(P<0.01),舌苔菌斑中,口臭组高于对照组(P<0.05)。2在龈下菌斑中OR值与Pg和S%呈明显正相关(P<0.01),在舌苔菌斑中OR值与S%呈正相关(P<0.05),与Pg无相关关系,在龈下菌斑中VSCs与Pg和S%呈相关(P<0.05),舌苔菌斑中VSCSs值与g和与S%无相关关系。     

Biofilms and the tongue: therapeutical approaches for the control of halitosis

Due to its location and functions, the tongue is one of the most important anatomic structures in the oral cavity. However, knowledge in regards to its role and implications in oral health and disease is scarce. Moreover, although the dorsum of the tongue seems to harbour one of the most complex microbiological niches in human ecology, the knowledge of the role of tongue flora in health and disease is also very limited. Similarly, the nature of the tongue coating and the factors that influence its development and composition are almost unknown. The interest in the study of the tongue niche has increased in recent years due to its association with oral halitosis and to its role as a suitable reservoir for periodontal pathogens. The structure of the tongue favours a unique and complex bacterial biofilm, in which periodontal pathogens are frequently found. However, little is known about how to control this bacterial niche, and factors affecting tongue coating composition and aspect are not fully understood. Studies available on the influence of mechanical or antimicrobial approaches against tongue biofilm are very limited. Mechanical treatments showed a transient reduction in halitosis-related variables but were limited in time. Different antimicrobials agents have been evaluated: chlorhexidine, chlorine dioxide, metal ions, triclosan, formulations containing essential oils , and hydrogen peroxide. However, most studies were designed as short-term models. Some of these studies demonstrated that the reduction in halitosis-related variables was associated with significant changes in the tongue microflora.     

甲壳胺抗口臭作用的实验研究

目的 通过观察甲壳胺凝集口腔细菌及其对产臭菌异味产物的影响，评价甲壳胺的抗口臭作用。方法 本研究选用了五种标准菌株，包括与菌斑形成密切相关的变形链球菌和粘性放线菌以及三种口腔主要产臭菌：牙龈卟啉单胞菌、中间普氏菌、具核梭杆菌。实验包括三个部分：运用厌氧培养观察甲壳胺对五种细菌的抑菌作用及凝集作用；利用气相色谱法分析甲壳胺对产臭菌硫化物及吲哚代谢产物的影响。结果0．002％～1％甲壳胺对五种细菌无明显抑菌作用，凝集实验结果通过肉眼观察及菌液涂片显示：0．125％～1％甲壳胺对这五种细菌产生了明显的凝集作用。色谱分析实验结果显示：在牙龈卟啉单胞菌、中间普氏菌、具核梭杆菌不加药物试管的顶空气体中，均能检测出二甲二硫醇、二甲三硫醇、二甲四硫醇和吲哚的存在，在这三种细菌加有1％甲壳胺的实验组试管的顶空气体中，未能检测出任何一种硫化物的存在，而且，除了中间普氏菌实验组仅检测出极少量的吲哚外(峰面积相当子不加药物试管的1／22)，牙龈卟啉单胞菌、具核梭杆菌实验组均没有检测到吲哚的生成。结论 甲壳胺能吸附凝集细菌，并减少产臭菌异味产物的释放。     

A review of the current literature on aetiology and measurement methods of halitosis

OBJECTIVES: This work reviews the current knowledge of aetiology and measurement methods of halitosis. DATA: Halitosis is an unpleasant or offensive odour emanating from the breath. The condition is multifactorial and may involve both oral and non-oral conditions. SOURCES: A private, monthly with keywords halitosis, malodo(u)r, (a)etiology, measurement, and management from Medline and Pubmed updated database of literature was reviewed. CONCLUSIONS: In approximately 80-90% of all cases, halitosis is caused by oral conditions, defined as oral malodour. Oral malodour results from tongue coating, periodontal disease, peri-implant disease, deep carious lesions, exposed necrotic tooth pulps, pericoronitis, mucosal ulcerations, healing (mucosal) wounds, impacted food or debris, imperfect dental restorations, unclean dentures, and factors causing decreased salivary flow rate. The basic process is microbial degradation of organic substrates. Non-oral aetiologies of halitosis include disturbances of the upper and lower respiratory tract, disorders of the gastrointestinal tract, some systemic diseases, metabolic disorders, medications, and carcinomas. Stressful situations are predisposing factors. There are three primary measurement methods of halitosis. Organoleptic measurement and gas chromatography are very reliable, but not very easily clinically implemented methods. The use of organoleptic measurement is suggested as the 'gold standard'. Gas chromatography is the preferable method if precise measurements of specific gases are required. Sulphide monitoring is an easily used method, but has the limitation that important odours are not detected. The scientific and practical value of additional or alternative measurement methods, such as BANA test, chemical sensors, salivary incubation test, quantifying beta-galactosidase activity, ammonia monitoring, ninhydrin method, and polymerase chain reaction, has to be established.     

口源性口臭检测指标的初步研究

目的：探讨寻找鼻测法替代检测手段的可能性.方法：选取56例医学院在校学生作为研究对象,使用Spearman法和Pearson法,分析鼻测法与口腔可挥发性含硫化合物、唾液pH、舌背微生物培养、唾液尸胺等检测结果间的相关关系.结果：口腔可挥发性含硫化合物（rMax=0.537,P＜0.01;r稳定值=0.572,P＜0.01）、唾液pH（r=0.344,P＜0.01）、唾液尸胺浓度（r=0.352,P＜0.01）、口腔卫生指数的检测结果（r=0.323,P＜0.05）、唾液兼性厌氧培养菌落计数（r=0.398,P＜0.01）、舌背兼性厌氧培养菌落计数（r=0.293,P＜0.05）及舌背专性厌氧培养菌落计数结果（r=0.473,P＜0.01）均与鼻测法结果呈正相关,但相关性均较弱.结论：任一单一指标均不能替代鼻测法对口臭进行诊断.     

Characterization of oral bacteria in the tongue coating of patients with halitosis using 16S rRNA analysis

Abstract

There are many studies on the relationship between the tongue coating and halitosis, but few have evaluated the bacterial community present in the tongue coating. This study identified bacteria in the tongue coating in individuals with and without halitosis using 16S rRNA analysis. Forty subjects (mean age, 46.1?±?15.8?years) who visited the halitosis clinic at the University Dental Hospital between 2016 and 2017 were divided into halitosis (n?=?32) and non-halitosis (n?=?8) groups according to results from an organoleptic test (OT). Additional measurements via gas chromatography (GC) and the Breathtron® instrument confirmed the groupings as the H₂S, CH₃SH, (CH₃)₂S, and total volatile sulphur compounds (VSC) levels were significantly higher in the halitosis group than in the non-halitosis group. Bacterial diversity was higher in the halitosis group; the median (quartile) values of the Shannon index were 4.46 (4.21, 4.67) in the halitosis group and 3.80 (3.45, 4.30) in the non-halitosis group. Additionally, the median (quartile) values of the Chao-1 index were 84.0 (77.2, 95.0) in the halitosis group and 71.3 (65.0, 81.5) in the non-halitosis group. These differences in bacterial composition and diversity may further the understanding of causes and treatments for halitosis.     

胃幽门螺杆菌感染与口腔异味感关系的相关性研究

目的探讨口腔异味感(俗称口臭)的病因与胃幽门螺杆菌感染的相关性。方法随机选择因上消化道症状就诊于我院消化科(无口腔疾病及全身疾病)的353例患者,首先进行口臭测试,根据有无口臭分为口臭组和无口臭组,所有病例均行13C呼气试验,观察各组中幽门螺杆菌感染率。同时根据有无幽门螺杆菌感染分为感染组和无感染组,观察口臭的发生率。结果353例患者中,口臭组166例,占47.03%,其中胃幽门螺杆菌阳性109例(65.66%);无口臭组187例,占52.97%,其中胃幽门螺杆菌阳性68例(36.36%);两组间差异有统计学意义(χ2=30.19,P0.001),口臭与幽门螺杆菌感染两者间相关系数r=0.29。幽门螺杆菌感染阳性177例,感染率为50.14%,其中口臭134例,占75.71%;幽门螺杆菌检测阴性176例,其中口臭32例,占18.19%;两组间差异有统计学意义(χ2=117.22,P0.001),幽门螺杆菌感染与口臭发生率两者间相关系数r=0.58。结论口臭的病因可能与胃幽门螺杆菌感染有较大的相关性,胃幽门螺杆菌感染有可能是导致口臭的一个原因。     

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.     

Halitosis amongst students in tertiary institutions in Lagos state

BackgroundHalitosis is defined as a noticeable unpleasant odor from the mouth. It is a medico-social problem that affects a significant number of people around the world. Research reveals that nearly 50% of the adult population has halitosis.ObjectivesTo determine level of awareness of halitosis and prevalence of the condition amongst students in tertiary institutions as a baseline survey.MethodsFor this project, 100 students from three tertiary institutions in Lagos state were chosen: University of Lagos, Lagos State University, Ojo campus and Yaba College of Technology. A semi-structured questionnaire and practical testing/diagnostic tool were utilized. Data collected was collated and analyzed using Microsoft Excel 2007 and SPSS statistical software.ResultsMost of the respondents were single and Christian. Level of awareness of halitosis was high. Results showed that 15%, 2% and 22% from UNILAG, LASU and YCT respectively said they had halitosis. Using the diagnostic tool, 6%, 8% and 2% respectively were positive for halitosis.ConclusionsThere is high level of awareness of halitosis among the respondents. The prevalence of the disorder is low, however, it is recommended that enlightenment campaigns be mounted in schools to improve level of awareness and treatment seeking.