Treatment Of Halitosis Research Articles

Halitosis, what experiences and methods apply Dutch dental hygienists.

The aim of this research is to gain more insight in the methods and experiences of dental hygienists in the Netherlands regarding the treatment of patients with halitosis. A total of 92 dental hygienists completed the questionnaire (consisting of 19 questions on personal and professional characteristics, clinical observation and treatment of halitosis, the referral of patients with halitosis, the presence and usefulness of a protocol). The questionnaire was distributed using a social media platform for dental professionals in oral health care from all over the Netherlands. 83.4% of 90 dental hygienists had paid attention to the patient's breath but only 37.8% of dental hygienists always informed the patient. Reasons for not informing patients were the fear of the patient's possible reaction or because other oral health problems were more important. Of the included dental hygienists 67.8% had never referred a patient for treatment of halitosis. 86.7% of the dental hygienists stated there was no protocol for diagnosis and treatment of patients with halitosis. However, 90.0% of the dental hygienists acknowledged a protocol would be useful. The majority of the dental hygienists in the Netherlands had paid attention to the patient's breath, but only a small group of dental hygienists informed their patients about halitosis. In dental practices halitosis is an underestimated problem. During the coronavirus pandemic people are more aware with the smell of their breath. Dental hygienists indicated scaling and root planning and/or providing information and instruction by patients with a bad breath.

Formulation Herbal Mouthwash Combination Extract of Ginger and Lemongrass as Antibacterial Causes of Halitosis in Diabetes Mellitus Patients

Background. Ginger and lemongrass are plants known as the king of rhizomes with a healthy stance becauseempirically many have used them as halitosis treatment in people with diabetes mellitus. The researchobjective was to formulate herbal mouthwash from extracts of natural ingredients, namely a combinationof ginger and lemongrass which has the potential as antibacterial causes of bad breath (halitosis) in peoplewith Diabetes Mellitus (DM). Material and Methods. The extraction of the sample will be carried out by amodified extraction method using ethanol and water solvents, then biological activity testing will be carriedout in-vitro with the diffusion method so that the antibacterial activity test against several bacteria that causehalitosis will be tested. Antibacterial sample is an active compound resulting from the extraction process.Bacteria that had been inoculated into the growth medium (NB) were put into sterile soft NA media (0.7%)with a concentration of 10,000.8,000,7,500 and 6,000 ppm, respectively. Results. There is an inhibitoryeffect, on p. gingivalis but the pattern of values is uncertain. A solution of formulation A with a concentrationof 75% occurs inhibition with an inhibition diameter of 15.7%. This inhibitory effect is not an activity offormulation A, because acetic acid also has the ability to inhibit bacteria. In the sample solution with aconcentration of 100% chitosan (w / v), the highest inhibition occurred with an inhibition diameter of 18.7mm / mg of the sample extract. Formulation A with a concentration of 25% (w / v), the lowest inhibitionoccurred. The test solution of formulation A with a concentration of 25% has shown an inhibitory effect onthe growth of Streptococcus mutans. This effect is stronger at concentrations of 100%, 75%, and 50%. Theantimicrobial effect actually increased with an increase in the concentration of the test solution in successionof 25%, 50%, 75%, 100%. Formulation C with a concentration of 10000ppm, 8000ppm, 7500ppm, 6000ppmshowed that the antimicrobial effect actually increased with an increase in the concentration of the testsolution in succession. This shows that there is a strong positive relationship between concentration andinhibition zone. Conclusion. All tests for both formulation A and formulation C using several concentrationsshowed quite good results with the antibacterial activity being directly proportional to the concentration, thegreater the concentration the greater the activity.

The effect of Brazilian propolis type-3 against oral microbiota and volatile sulfur compounds in subjects with morning breath malodor.

To evaluate propolis type-3 mouthrinse effects on the concentration of volatile sulfur compounds (VSCs) and on tongue dorsum microbial profile. A three-step double-blind, crossover, randomized study with 10 individuals divided into three groups: I-placebo (P); II-ethanolic extract of propolis type-3 3% (EEP); and III-chlorhexidine 0.12% (CHX) and instructed to rinse twice daily for 5days. Each experimental period was followed by a 21-day washout interval. Morning mouth breath was assessed by VSC concentrations and microbiological samples were obtained from tongue dorsum at baseline and the end of period of rinses and analyzed using checkerboard DNA-DNA hybridization technique for 39 bacterial species. CHX and EEP presented the lowest VSC concentration when compared with placebo (p < 0.05). Even in the absence of mechanical plaque control, CHX and EEP treatments reduced VSC levels and there were no statistical differences for VSC measurement between CHX and EEP. There was a significant reduction in mean counts of 10 species including some VSC producers (Prevotella intermedia, Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia) by EEP. Total counts of organisms, gram-negative and gram-positive bacterial species showed a decrease for EEP and CHX (p < 0.05). In addition, no statistical difference was observed between EEP and CHX (p > 0.05). A positive correlation was observed between decrease of bacterial counts and decrease of VCSs concentration for the EEP and CHX. The use of a 3% propolis type-3 mouthrinse is an effective way to prevent morning bad breath. Thus, propolis may be a promising agent for the treatment of halitosis. Propolis type-3 may be used as adjuvant treatment for morning breath malodor.

Development of the composition and technology of the curative preventive toothpaste with antimicrobial and deodorating properties

The significant prevalence of diseases of the oral cavity predetermine the relevance of preventive means aimed at maintaining the dental health of the population. The application of toothpastes and elixirs with anti-inflammatory, antimicrobial and deodorant properties improves the condition of the oral cavity, and is also one of the means for the prevention and treatment of periodontal disease and halitosis.&#x0D; The aim of the work was to develop the composition and laboratory technology of curative and prophylactic toothpaste and to study the indicators of its quality.&#x0D; Research materials: carbopol, xanthan gum, propolis tincture, bee bread tincture, thyme essential oil, xylitol, sorbitol, and a sample of toothpaste. Pharmacological-technical methods, potentiometric and alkalimetric study methods were used.&#x0D; In order to develop the composition of a toothpaste, requirements of the current regulatory documents for the composition and characteristics of toothpastes were analyzed. The composition and quantity of components for the curative and prophylactic toothpaste have been theoretically substantiated. Carbopol and xanthan gum were used as gelling agents. Calcium carbonate was chosen as the abrasive basis of the toothpaste, which helps to remove plaque from the tooth enamel. Such polyhydric alcohols as sorbitol, glycerin, xylitol and propylene glycol were used as plasticizers. Considering the antioxidant, anti-inflammatory, antimicrobial and radioprotective properties of propolis tincture and bee bread tincture, they were incorporated in the toothpaste composition. The technology of laboratory batches of toothpaste was based on the general principles of obtaining suspension gels and pastes. The quality of the toothpastes was controlled for organoleptic and physicochemical indicators in accordance with the requirements of the regulatory documents.&#x0D; The theoretical and experimental justification of the composition of the curative and prophylactic toothpaste of antimicrobial actvity with a deodorant effect. This paste contained carbopol, xanthan gum, calcium carbonate, xylitol, tinctures of bee products (propolis and bee bread) and thyme essential oil. On the basis of pharmacological-technical research, a rational technology of the curative and prophylactic toothpaste has been developed. Organoleptic and physicochemical indicators of the quality of the developed curative and prophylactic toothpaste have been established and its classification characteristics have been determined.

Coblation cryptolysis method in treatment of tonsil caseum-induced halitosis

PurposeHalitosis, is a social problem affecting many patients seeking help from clinicians. Tonsil stones can cause halitosis and especially occur in crypts of palatine tonsils. Coblation cryptolysis is an alternative method for tonsil caseum treatment. The coblation technology includes passing a radiofrequency bipolar electrical current through a medium of normal saline which results in the production of a plasma field of sodium ions. In this study, our aim was to investigate the effectiveness of coblator cryptolysis treatment method in chronic caseous tonsillitis-induced halitosis. MethodsWe included in our study 28 patients who underwent coblator cryptolysis surgery for halitosis due to chronic caseous tonsillitis. The efficacy of treatment and the presence of caseoma were evaluated with the Finkelstein test, organoleptic test and VAS before the procedure and at the 6th month control after the treatment was completed. ResultsAt the 6th month follow-up after the procedure (a single coblation cryptolysis) we found that 23 of the patients (82.1%) had no caseum. There was a statistically significant change in Finkelstein measurements before and after the procedure (p < 0.001). Organoleptic measurements demonstrated that 21 patients had no halitosis postoperatively and the mean organoleptic test score was calculated as 0.39 ± 0.79 after the procedure. The recovery was statistically significant (p < 0.001). The mean VAS score before coblation cryptolysis was 8.0 ± 1.33 (range 5–10). On the other hand 6 months after a single coblation cryptolysis session, the mean VAS score was 1.25 ± 1.78 (range: 0–6). This difference was statistically significant (p < 0.001). ConclusionsOur results suggest that coblation crptolysis is an effective, safe, minimally invasive and practical alternative method in treatment of halitosis due to tonsil caseums. We did not observe any complication after the procedure.

Protocol for treating the psychological consequences of halitosis complaint

INTRODUCTION: People with halitosis suffer various consequences, incurring social, professional, and affective limitations that impair their confidence, spontaneity, and self-esteem. However, the existing treatment protocols focus on treating halitosis alone, rather than its psychological consequences. OBJECTIVE: The objective of this study is to present a new protocol for treating the consequences of halitosis, as well as investigating its clinical application. METHODS: After briefly reviewing existing halitosis classifications and their limitations, this paper presents new classifications and techniques appropriate for the present protocol, such as the use of in vivo exposure, adequate to halitosis treatment. A total of 156 people complaining of halitosis were selected. The participants breath was evaluated using the organoleptic test and Halimeter®. The psychological consequences of halitosis were assessed using the Halitosis Consequences Inventory (ICH). The symptoms of Social Anxiety Disorder (SAD) were measured using the Social Phobia Inventory (SPIN) and its short version (Mini-SPIN). RESULTS: The results showed that all participants had tongue coating or tongue biofilm. Of the 156 volunteers, 74.38% had halitosis (n=116), of whom 100% had oral halitosis, and 3.21% had oral halitosis simultaneous with extraoral halitosis (n=5). A comparison between the pre- and post-treatment results indicated that the protocol was effective to treat bad breath as well as the feeling of insecurity, since significantly decreased the psychological consequences of halitosis and SAD symptoms; 62.6% of participants reported a significant improvement in their confidence and spontaneity at the end of treatment. CONCLUSION: Taken together, these findings were most effective for those who followed the treatment guidelines strictly.

“Say Ahhh”: Experience and Views on Halitosis Management in the General Public in Victoria, Australia

IntroductionHalitosis is common and can have a significant impact on quality of life. It is attributed to both intraoral and extraoral causes. Although halitosis treatment depends on the aetiology, little is known about consumers’ perception of halitosis causes and the types of assistance sought. The Say Ahhh Study aimed to explore the interprofessional care for halitosis and improve understanding by the general public. Phase 1 explored the perceptions of health care providers. This article reports the findings of Phase 2, which explored the general public's knowledge of halitosis, its management, and help-seeking behaviour. MethodsPatients and clients at 2 medical clinics, 3 dental clinics, and 2 pharmacies in Melbourne and rural Victoria were approached and invited to participate in a short semistructured interview. Qualitative data was thematically analysed. ResultsA total of 122 participants (54 males, 66 females, 2 missing) were interviewed. Participants’ past experience with halitosis influences their understanding of the cause. Halitosis was attributed mostly to poor oral hygiene and diet and less commonly to systemic disease. Their perception of the condition's severity influenced whether they seek professional help. Their perceived roles of health professionals and ease of access influenced their choice of health professionals to seek help from. ConclusionThe Victorian general public is aware of the causes of halitosis and the available treatment options. Choice of treatment and help-seeking behaviour are influenced by experience, perceived severity of the condition, and perceived role of health professionals and their accessibility.

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.

Alternative therapies in controlling oral malodour: a systematic review

Is there a role for alternative therapies in controlling intra-oral halitosis? Treatments other than tongue cleaning and anti-halitosis products containing zinc, chlorhexidine and cetylpyridinium chloride were considered as alternative therapies. Four databases were searched (PubMed, EMBASE, Web of Science and The Cochrane Library). Inclusion criteria were: examination of alternative halitosis therapies, study population with oral malodour, a (negative or positive) control group and evaluation of breath odour via organoleptic and/or instrumental assessment. Data were extracted for descriptive analysis. The screening of 7656 titles led to the inclusion of 26 articles. Analysis showed heterogeneity concerning the population of interest (from cysteine-induced to genuine halitosis), the examined treatment and the reported outcomes. This made a meta-analysis impossible. Essential oils, fluoride-containing products and herbal substances were the most studied. Results varied enormously and none of the active ingredients had an unambiguously positive effect on the malodour. The risk of bias was assessed as high in all articles. Given the fact that little evidence was found for each of the investigated treatments, it could be concluded that there is currently insufficient evidence that alternative therapies are of added value in the treatment of halitosis. Clinical relevance Scientific rationale: Halitosis is a common problem causing social isolation. Out of embarrassment, patients search the internet, leading to many questions about alternative solutions (e.g. oil pulling, herbs). This is the first systematic review on these alternative therapies. Principal findings: Results varied among studies. Some promising results were found for fluoride-containing toothpastes and probiotics. For other products (such as herbal and antibacterial products and essential oils) results were inconsistent. Long-term follow-up studies on these products are scarce. Moreover, the quality of the studies was poor. Practical implications: No clear evidence was found to support a certain alternative anti-halitosis therapy.

Treatment of halitosis with photodynamic therapy in older adults with complete dentures: A randomized, controlled, clinical trial.

Halitosis of oral origin is mainly caused by the release of H2S (hydrogen sulfide) by bacteria lodged on the tongue. Antimicrobial photodynamic therapy (aPDT) has been evaluated for the treatment of halitosis, but there are no previous reports of the use of this treatment modality in older people with dentures. The aim of the present study was to compare the effect of aPDT and tongue scraping (standard treatment) in older people with complete dentures diagnosed with halitosis (H2S gas concentration>112 ppb). The participants were divided into two groups: G1- treatment with a tongue scraper (n = 20); G2- treatment with aPDT (n = 20). Halimeter testing was performed before and after treatments using gas chromatography and was repeated after seven days. After treatment, the group treated with aPDT had a lower mean concentration of H2S gas (18.5 ppb) than the tongue scraping group (185.3 ppb). After one week, the mean concentration of H2S increased to 218.2 ppb in the tongue scraping group and 39 ppb in the PDT group. Both treatments were able to reduce the concentration of H2S but only treatment with aPDT was able to decrease halitosis to socially unnoticeable levels. Moreover, this normal breath condition remained for seven days only in the aPDT group.

Oral hygiene associated with antimicrobial photodynamic therapy or lingual scraper in the reduction of halitosis after 90 days follow up: A randomized, controlled, single-blinded trial.

Although antimicrobial photodynamic therapy (aPDT) can reduce halitosis immediately after application, it returns after a week. This probably occurs because bacteria residing in the oral cavity may recolonize the dorsum of the tongue. Verify if modification of oral hygiene behavior associated with aPDT or lingual scraper can reduce halitosis after a 90-day follow-up. Forty adults with positive halitosis were randomized in G1 (n = 20) -aPDT + oral hygiene behavior (OHB) or G2 (n = 20)- lingual scraper + OHB. G1 group were submitted to 0.005 % methylene blue in the middle and posterior third of the tongue, with pre-irradiation of 1 min. Irradiations were performed with red laser diode (λ =660 nm), 100 mW, 318 J/cm2, 3537 mW/cm2, 9 J per point at 6 points. In the G2 group, the tongue was scraped 10 times on the right side and on the left side with a tongue scraper. All patients were instructed on OHB at baseline, 7 and 90 days (guidance on the use of dental floss and the Bass technique for brushing). Halitosis was evaluated by gas chromatography (OralChroma®). Values ​​> 112 ppb for Hydrogen sulfide (H2S) gas was considered positive halitosis. Methylmercaptanes and dimethylsulfide were also measured. The gas measures were assessed at baseline, immediately, and at 7 and 90 days. Paired t-test was used for the statistical analysis. For comparison between groups, the t-test was used. Values of p < 0.05 were considered statistically significant. There was no difference between groups immediately after treatment (p = .1532) after 7 days (p = 0.9312) and 90 days (p = 0.6642). For the aPDT group, there was a decrease in hydrogen sulfide ​​immediately after treatment (p = 0.0001), after 7 days, values remained 3-fold smaller (p = 0.0088) and 2-fold smaller after 90 days (p = 0.0270). For the scraper group, there was a decrease immediately after treatment (p = 0.0001), the values remains 2-fold smaller ​​(p = 0.0003) after 7 days and 3 months (p = 0.0001). The oral hygiene behavior associated with aPDT or tongue scraper was not able to reduce halitosis after 90-day follow-up. Despite halitosis remaining ​​ higher than 112 ppb in all follow-up periods, the mean values remain 2 or 3 fold smaller than baseline values. Future studies should include other oral hygiene behavior to achieve better results in the treatment of halitosis.

Effect of essential oils on oral halitosis treatment: a review.

Halitosis is a very common condition which may affect up to 30% of the population. In about 90% of the cases, halitosis originates in the mouth due to inadequate plaque control, periodontal disease, dry mouth, faulty restorations, and in particular due to excessive bacterial growth. Oral malodor is mainly caused by a microbial degradation of amino acids into volatile, bad-smelling gases (volatile sulfur compounds - VSCs). Management of oral malodor is directed primarily at managing and reducing the VSC-producing bacteria count as well as masking the odor. Essential oils have been used for this purpose in traditional medicine for centuries. In the present review, data on the antimicrobial activity of essential oils against relevant oral VSC-producing bacteria are compiled and compared. Additionally, other positive aspects of essential oils with regard to oral odor are considered.

Antimicrobial capacity of photodynamic therapy on oral health-related quality of life and halitosis among elderly patients wearing removal dentures.

The aim of the present clinical trial was to evaluate the efficacy of antimicrobial photodynamic therapy (PDT) for the treatment of halitosis in elderly patients wearing dentures. Elderly patients (>60 years age) wearing complete dentures and diagnosed with halitosis (H2S levels >112 ppb) were divided into two groups: patients undergoing treatment with tongue scraper and full mouth disinfection (Group I) and patients undergoing treatment with tongue scraper, full mouth disinfection and single application of PDT (Group II). Oral health related quality of life (OHRQoL) was assessed using a 14-point Likert scale used in oral health impact profile (OHIP). The assessment of halitosis was done with the help of a device called Oral Chroma™. Microbial sampling for detection of Porphyromonas gingivalis (P. gingivalis) was performed from the dorsum of the tongue using a sterile swab at baseline and after treatment on day 5, 15 and 30 and quantified using polymerase chain reaction. Forty elderly patients with halitosis completed the trial. The mean age in Group I and Group II was estimated to be 66.42 years and 67.91 years, respectively. Group II participants also maintained good OHRQoL in the post-operative period that reported statistically significant difference when compared with the control group (p < 0.01). Group II showed significant improvement in H2S concentration values at final analysis compared to Group-I (p = 0.001). P. gingivalis showed statistically significant reduction on day 5 only with PDT in Group II (p < 0.05). Antimicrobial PDT helped in reducing H2S gas concentration and improving quality of life in elderly patients wearing dentures. A significant reduction of P. gingivalis occurred only in the short-term follow-up.

Diagnostic Technique for Assessing Halitosis Origin Using Oral and Nasal Organoleptic Tests, Including Safety Measures Post Covid-19

Organoleptic tests are essential in the diagnosis and treatment of halitosis due to three main functions: (A) measuring halitosis, for which it is considered as the gold standard method; (B) helping patients to recover their self-confidence as they get more confident each time their breath is well evaluated; (C) assessing the origin of halitosis through oral and nasal organoleptic tests and by comparing mouth and nose exhaled air, which is possible for diagnosing oral, nasal or extraoral origins of halitosis with a very small error margin. Nevertheless, literature for organoleptic scales that recommend the use of nasal organoleptic tests and/or techniques to diagnose halitosis origin is scarce. Two significant aspects that must be contemplated seriously are the potential risk of cross infections following organoleptic tests as well as the lack of safety guidelines, especially with regards to the recent contagious potential of SARS-CoV-2 worldwide. An important safety aspect concerns avoiding performing organoleptic tests whenever feeling flu-like symptoms, such as fever, dry cough, or difficulty breathing. Also, individuals at higher risk for severe illness should not be elected examiners. Although a safer oral and nasal organoleptic technique is being proposed based on literature, organoleptic assessment should be temporarily suspended until the COVID-19 pandemic situation has normalized and further studies to evaluate the safety of different organoleptic tests methods are performed. Depending on the results of the tests a different origin of halitosis can be inferred, thus avoiding diagnostic errors and unnecessary treatments. The regular use of the present technique on patients and in research can provide more precise diagnostic results. It also allows patients to check their breath at home and consequently take some actions to solve or identify the causing issue in case an alteration is detected, as well as reinforces patients` self-confidence when receiving pleasant breath results after consecutive tests.

Systematic Review on Effectiveness of Zinc Chloride in the Treatment of Halitosis

Background: Halitosis refers to a chronic offensive mal odour produced from body cavities, especially oral cavity. It can cause detrimental psychological effects on the patient as well as aggravate infections in the oral cavity due to increase in bacterial load. Zinc chloride provides a solution for both by providing an antibacterial property and neutralises the VSCs that cause halitosis. Aim: To study the effectiveness of Zinc chloride in the treatment of Halitosis Study Design: A systematic review of research articles was performed. Electronic and hand search retrieved 515 records, 436 were screened. The intervention and outcomes were assessed in the study included for systematic review. Results: Four studies were included in this systematic review. These studies showed the antimicrobial efficacy and ability of zinc chloride to inhibit the Volatile sulphur compound (VSC) production by oral bacteria. It also showed the synergistic property of Zinc chloride when combined with other compounds. Conclusion: Despite the effective antimicrobial property and neutralisation of Volatile sulphur compound by zinc chloride, it still is unable to directly act on the gaseous VSCs. Therefore further studies must be done to improve the efficacy of zinc chloride and to develop new formulations that will help in managing the condition in a more effective way.

Halitosis vs tonsil stones: is this an otolaryngological problem?

Chronic bad breath, malodor or halitosis is a common symptom that often brings the patient to the physicians. Is necessary to differentiate genuine halitosis (physiological and pathological types), pseudo-halitosis and halitophobia. Tonsils stones are a pathological condition as a result of dysfunction of the self-cleaning mechanism of the tonsil crypts, which predisposes the accumulation of food residues in the tonsil crypts and formation of mass with an unpleasant smell. Including this symptom as a feature of chronic tonsillitis is still controversial. The presence of tonsil stones does not always cause discomfort or other signs and not must be treated. Tonsils stones are only 3% of all causes of halitosis. This fact must keep in mind during the diagnosis and treatment of halitosis. Over 90% of the halitosis deriving in the oral cavity.

Social distance towards halitosis sufferers

Halitosis is a frustrating condition that can lead to significant discomforts, negative social and psychological effects including social interaction suppression and self-confidence diminution. The purpose of the study was to assess the social distance attitude towards halitosis sufferers in Nigeria. A cross-sectional survey was carried out among young adult Nigerians recruited from University of Benin, Benin City, Nigeria, as part of a larger-scale halitosis-relational survey. Information obtained were age, gender and social distance attitude. The social distance attitude was measured with the Halitosis Social Distance Scale (HSDS) which was modelled after the seven-item modified Bogardus Social Distance Scale. A total of 370 out of 400 questionnaires distributed were returned giving a 92.5% participation rate. About one quarter of the participants (23.0%) reported high social distance towards halitosis sufferers. The level of social distance towards halitosis sufferers was seen to be significantly higher among males than females. The closer the suggested relation with the halitosis sufferers, the greater the reported social distance in the HSDS. Data from this study revealed evident social distance towards halitosis sufferers that may be a contributory explanation of social isolation of halitosis sufferers. Community education regarding the aetiology, treatment and prognosis of halitosis may help offset this social distancing attitude.

Social distance towards halitosis sufferers

Halitosis is a frustrating condition that can lead to significant discomforts, negative social and psychological effects including social interaction suppression and self-confidence diminution. The purpose of the study was to assess the social distance attitude towards halitosis sufferers in Nigeria. A cross-sectional survey was carried out among young adult Nigerians recruited from University of Benin, Benin City, Nigeria, as part of a larger-scale halitosis-relational survey. Information obtained were age, gender and social distance attitude. The social distance attitude was measured with the Halitosis Social Distance Scale (HSDS) which was modelled after the seven-item modified Bogardus Social Distance Scale. A total of 370 out of 400 questionnaires distributed were returned giving a 92.5% participation rate. About one quarter of the participants (23.0%) reported high social distance towards halitosis sufferers. The level of social distance towards halitosis sufferers was seen to be significantly higher among males than females. The closer the suggested relation with the halitosis sufferers, the greater the reported social distance in the HSDS. Data from this study revealed evident social distance towards halitosis sufferers that may be a contributory explanation of social isolation of halitosis sufferers. Community education regarding the aetiology, treatment and prognosis of halitosis may help offset this social distancing attitude.

Relationship of tongue coating microbiome on volatile sulfur compounds in healthy and halitosis adults

Aim: This study aims to assess the microbiome variations related to intraoral halitosis and its relationship with volatile sulfur compounds (VSCs) among periodontally healthy Chinese adults. Material and methods: Tongue coating samples were collected from 28 periodontally healthy subjects (16 subjects with halitosis and 12 subjects without halitosis) who fulfilled the selection criteria. The organoleptic score (OS) was used to evaluate the halitosis status. The characterization of associated microbial communities was performed using 16S rRNA gene pyrosequencing and metagenomics methods. Results: A wide range of microbial communities, including 13 phyla, 23 classes, 37 orders, 134 genera, 266 species and 349 operational taxonomic units (OTUs), were detected. The Shannon index values were significantly higher in the halitosis group. Genera, such as Prevotella, Alloprevotella, Leptotrichia, Peptostreptococcus and Stomatobaculum, exhibited significantly higher relative percentages in halitosis samples, when compared to healthy samples. Peptostreptococcus, Alloprevotella, Eubacterium nodatum and Stomatobaculum exhibited significantly positive correlations with the total number of VSCs. Prevotella, Peptostreptococcus, Eubacterium nodatum and Alloprevotella were correlated with increased H2S and CH3SH concentration values. Bergeyella was correlated with decreased total VSC, H2S and CH3SH concentration values. Conclusion: Microbial diversity was higher in the halitosis group than in the control group, and several bacteria were significantly correlated to halitosis. Furthermore, there were correlations between tongue bacterial composition structure and VSC gases. Tongue coating microbiota can offer important clues in the investigation of the pathogenesis and treatment of halitosis.

ANTIHALITOSIS EFFECT OF ESSENTIAL OIL EXTRACTED FROM ZANTHOXYLUM ACANTHOPODIUM FRUITS

Halitosis is associated with the excessive production of acid and volatile sulphur compounds (VSCs), as well as accumulation of biofilm plaque by oral bacteria in mouth cavity. Zanthoxylum acanthopodium, locally known as andaliman or lemon pepper, is an Indonesian endemic spice with high content of essential oils, including carveol that has been reported for its potential antimicrobial and anti-inflammatory activities. We determined whether extract of Z. acanthopodium essential oil (ZAEO) exerted anti-halitosis effect on reducing biofilm plaque, acid production, and VSCs by using Actinomyces viscosus model in vitro. ZAEO was extracted in n-hexane followed by evaporation. ZAEO at various doses (20-100 µg/ml) was tested and quantified for its antibiofilm, acid production, and total VSCs production toward A. viscosus oral bacteria in vitro by conducting biofilm assays for preventing and eradicating effects, pH-stat analysis, and VSCs assay. At lowest dose (20 µg/ml), ZAEO inhibited and removed &gt;50% of A. viscosus biofilms. A. viscosus was able to produce acid rapidly in 20 minutes, resulting in the pH terminal of 5.57, and ZAEO treatment at 40 µg/ml exerted significant inhibition on acid production with the terminal pH of 5.93, respectively. ZAEO at lowest dose also reduced &gt;50% of total VCSs produced by A. viscosus. Our results suggest that ZAEO extract could be applied as a natural ingredient for halitosis treatment.