Tongue Flora Research Articles

Weifuchun alters tongue flora and decreases serum trefoil factor I levels in gastric intestinal metaplasia: A CONSORT-compliant article.

To explore the molecular mechanisms of Weifuchun in the treatment of gastric intestinal metaplasia (GIM), we designed a preclinical pilot study to examine potential markers of disease progression based on alterations in the tongue flora. Total 27 patients with GIM were treated with Weifuchun for 4 weeks and 26 volunteers as controls. Tongue coating bacteria were profiled using 16S rDNA high-throughput sequencing. Serum pepsinogen I and II levels were detected using the latex immunoturbidimetric assay. The levels of serum trefoil factor I was detected by ELISA. Microplate-based quantification was used to detect serum total bile acid (TBA). After treatment, the relative abundance of 4 dominant tongue coating genera (Granulicatella, Gemella, Lachnoanaerobaculum, and Neisseria) increased significantly wheras Alloprevotella, [Eubacterium] nodatum group, Prevotell, and Ruminococcaceae UCG-014 decreased (P < .05). The results showed that Alloprevotella and 3 rare tongue coating genera (Lautropia, Treponema 2, and Aliihoeflea) might be potential markers or target flora for the treatment of GIM. Kyoto encyclopedia of genes and genomes (KEGG) function prediction analysis showed that Weifuchun may regulate bile secretion and folate biosynthesis in patients with GIM. The level of serum trefoil factor I decreased significantly in response to Weifuchun treatment, which was consistent with the decrease in folate biosynthesis predicted by KEGG. Weifuchun may restore the balance of tongue flora by decreasing the levels of serum trefoil factor I, thereby providing a new way to measuring the underlying effectiveness and potential mechanisms of action of this traditional Chinese medicinal compound in the treatment of GIM.

Study on syndrome rules of stagnated heat in liver and stomach of non-erosive reflux disease based on microecology of tongue coating.

At present, the pathogenesis of non-erosive reflux disease (NERD) is still unclear, and proton pump inhibitors are the main treatment drug. However, the effect is limited. Traditional Chinese medicine treatment of NERD has advantages. Stagnated heat in liver and stomach syndrome is the most important traditional Chinese medicine syndrome type of this disease. Tongue diagnosis is an important basis for the diagnosis of stagnated heat in liver and stomach syndrome. The microecology of tongue coating suggests the occurrence and development of disease. The purpose of this study aims to clarify the regular changes of tongue coating microecology in stagnated heat in liver and stomach syndrome of NERD. This is a cross-sectional clinical trial. This study is divided into NERD stagnated heat in liver and stomach syndrome group, qi stagnation, and phlegm obstruction syndrome control group and normal control group, with 20 cases in each group. Tongue coating samples will be collected from 3 groups, and 16SrRNA gene sequencing technology will be used to detect the genome of tongue coating flora in patients with NERD with stagnated heat in liver and stomach syndrome, control group with qi stagnation and phlegm obstruction syndrome and normal control group. The main outcome measures are the distribution, diversity, and richness of the tongue flora in patients and healthy controls. The results of this study will clarify the internal relationship between NERD stagnated heat in liver and stomach syndrome and the microecological changes in tongue coating.

What is the influence of tonsillectomy on the level of periodontal pathogens on the tongue dorsum and in periodontal pockets

BackgroundFor periodontal treatment, the full mouth disinfection approach suggests disinfection of oral soft tissues, such as tongue and tonsils concomitant to scaling and root planning since patients might benefit from treatment of these oral niches either. Periodontopathogenes in tonsillar tissue support this hypothesis. This prospective controlled clinical study investigated the change in the oral flora of patients who underwent tonsillectomy. Pockets were tested for eleven bacterial species before and six weeks after the surgical intervention.MethodsFifty generally healthy adults were included in this study. The test group consisted of 25 patients with tonsillectomy. The control group included 25 patients with otorhinolarynologic surgery without involvement of the oral cavity. Clinical parameters such as probing pocket depth, bleeding-on-probing index and plaque index were registered the evening before surgery. Also bacterial samples from the gingival sulcus and dorsum linguae were taken, and an additional sample from the removed tonsils in the test group. Six weeks after the intervention microbial samples of pockets and tongue were taken again. Data were tested for significant differences using Wilcoxon rank and Whitney-u-test.ResultsNo relevant intra- or intergroup differences were found for the change of the eleven investigated species.ConclusionBased on the results of the present study, tonsillectomy does not seem to have an immediate relevant effect on the bacterial flora of tongue or periodontium. This study design was approved by the ethical committee of Zurich (KEK-ZH-Nr.2013–0419).Trial registrationThe trial was retrospectively registered in the German Clinical Trials Register (DRK00014077) on February 20, 2018.

Association of Tongue Bacterial Flora and Subtypes of Liver-Fire Hyperactivity Syndrome in Hypertensive Patients.

Structural changes in symbiotic human microorganisms can affect host phenotype. Liver-fire hyperactivity syndrome (LFHS) presents as bitter taste, halitosis, xerostomia, odontalgia, and other oral symptoms. LFHS is associated with hypertension (EH). In this study, tongue flora was analyzed to further understand the intrinsic relationship between tongue flora and LFHS. Samples of tongue coating, from 16 patients with EH-LFHS, 16 with EH-non-LFHS, and 16 controls, were obtained; then, 16S rRNA variable (V3-V4) regions were amplified and sequenced by MiSeq PE300 Sequencing. Tag clustering and Operational Taxonomic Units (OTUs) abundance analysis were used to compare the OTU sequence with the 16S database. The species were classified, and diversity and structure of the bacterial flora were compared between the three groups. Alpha diversity analysis, including Observed Species index and Chao index, indicated significantly higher richness of species in patients with EH-LFHS (p < 0.05). Higher phylogenetic diversity, in patients with EH-non-LFHS, indicates greater differences in evolutionary history than in patients with EH-LFHS. Streptococcus, Rothia, Neisseria, and Sphingomonas were the most prevalent in patients with EH-LFHS, differed from the other two groups. This indicates that richer bacterial diversity, and structure associated with EH-LFHS, may affect the occurrence, development, and outcome of hypertension and syndrome subtypes recognized by TCM.

Halitosis: A mirror of systemic and oral health

Halitosis is known as unpleasant oral odor affecting large proportion of population and may be the cause of a significant social and psychological handicap. People who are not aware of their bad breath may encounter romantic, social and professional rejection without knowing the reason. 85% cases of halitosis originate from microbial putrefaction within the oral cavity itself. Modern analytical and microbiological techniques permit diagnosis of halitosis. Management of oral malodor is directed at managing and reducing the bacterial load from oral cavity by instituting proper oral hygiene measures, control of tongue flora by brushing or scraping, and possibly the adjunctive use of antiplaque agents. Keywords - : Chlorhexidine, oral malodor, organoleptic rating, tongue coatings, volatile Sulphur Compounds.

Application of polymerase chain reaction (PCR)-based denaturing gradient gel electrophoresis for analysis of microbiota on the tongue dorsa of subjects with halitosis

The purpose of this study was to compare the microbial profiles on the tongue dorsa of healthy subjects and subjects with halitosis using polymerase chain reaction-based denaturing gradient gel electrophoresis (PCR-DGGE). Tongue dorsum scrapings from five healthy subjects and six subjects with halitosis were analyzed by PCR-DGGE using primers specific for the V6 to V8 region of the eubacterial 16S rRNA gene. A dendrogram was derived from the PCR-DGGE fingerprints and the prominent DGGE bands of interest were identified through DNA sequencing. The similarity of the PCR-DGGE fingerprints was determined using the unweighted pair group method with an arithmetic mean dendrogram derived using Dice's Coefficient of Similarity. The sequence of PCR amplicons indicated that the microbial species most associated with halitosis wereHaemophilus parainfluenzae and a phylotype of Lachnospiraceae (Lachnospiraceaegenomosp. C1), whereas Streptococcus salivarius subsp. salivarius, Neisseria mucosaand Neisseria cinerea were species that did not appear to be associated with halitosis and are likely part of the healthy tongue flora. These results suggest that the presence ofH. parainfluenzae and Lachnospiraceae genomosp. C1 may be associated with a shift in the balance of oral microbes in subjects with halitosis. Key words: Polymerase chain reaction-based denaturing gradient gel electrophoresis (PCR-DGGE), 16S rRNA, halitosis, microbial profiles.

Oral Malodour and its Management: A Periodontal Perspective

ABSTRACT Halitosis is a very common condition which may affect up to 30% of the population. In most cases the aetiology of the condition is from local oral causes (oral malodour). Oral malodour is the result of the action of anaerobic bacteria in producing a range of malodorous molecular species including volatile sulphur compounds. Patients with halitosis may seek treatment from dental clinicians for their perceived oral malodour. Physiologic halitosis, oral pathologic halitosis and pseudo-halitosis would be in the treatment realm of dental practitioners. Management of oral malodour is directed at managing and reducing the bacterial load both in periodontitis and in tongue coatings by instituting proper oral hygiene measures, control of tongue flora by brushing or scraping, and possibly the adjunctive use of antiseptic agents. Treatments have also been proposed to neutralise malodorous compounds by chemical agents to mask the presence of the condition. Further evidence is required to demonstrate the long-term efficacy of therapies for this troublesome condition. The purpose of this article is to review the etiology, diagnosis and treatment of oral malodor from a periodontal perspective. The review will be limited to bad breath odors originating within the mouth.

Oral malodour – a review

Halitosis is a very common condition which may affect up to 30% of the population. In most cases the aetiology of the condition is from local oral causes (oral malodour). Oral malodour is the result of the action of anaerobic bacteria in producing a range of malodorous molecular species including volatile sulphur compounds. Whilst malodour is often associated with the presence of penodontitis, in many cases there is no such link, and the evidence points to the importance of these anaerobic bacteria in tongue coatings which results in the clinical presentation of oral malodour. Management of oral malodour is directed at managing and reducing the bacterial load both in penodontitis and in tongue coatings by instituting proper oral hygiene measures, control of tongue flora by brushing or scraping, and possibly the adjunctive use of antiseptic agents. Treatments have also been proposed to neutralise malodorous compounds by chemical agents to mask the presence of the condition. Further evidence is required to demonstrate the long-term efficacy of therapies for this troublesome condition.

A clinical study on the antimicrobial and breath-freshening effect of zinc-containing lozenge formulations

Volatile sulphur compounds (VSCs) produced by anaerobic microorganisms on the tongue are major contributors to oral malodour. Antimicrobial agents such as zinc salts may therefore indirectly reduce the production of VSCs. The aim of this study was to evaluate the effect of four zinc-containing sorbitol lozenge formulations (0.1-0.5% zinc gluconate) on oral malodour (‘morning breath’) by breath and tongue flora analysis on 24 healthy volunteers. Chlorhexidine (0.2% chlorhexidine gluconate) mouthwash was used as positive control and sorbitol lozenges as negative control. Breath odour was evaluated by a Halimeter† and organoleptic readings, and tongue flora by culture of oral microorganisms before, and at intervals over a 60 min period after, treatment. All treatments were effective in reducing sulphides in breath odour but chlorhexidine and 0.5% zinc lozenges produced the greatest reduction. All treatments produced a significant decrease (p<0.001) in bacterial counts 15 min post treatment, with chlorhexidine being most effective (p<0.05). Counts on fastidious anaerobic agar containing vancomycin correlated positively with Halimeter† readings. The combination of methods used provided a broader approach to the assessment of breath odour. Key words: oral malodour, volatile sulphur compounds, zinc, chlorhexidine, oral bacteria

A clinical study on the effect of the prebiotic inulin in the control of oral malodour

The aim of this clinical study was to evaluate the potential of an inulin mouth rinse to reduce the proportions of tongue bacteria associated with oral malodour. Thirteen panellists rinsed with either 10% sucrose or a 10% inulin mouth rinse twice daily for 21 days. Breath odour levels were assessed using a Halimeter† and organoleptic assessment, both before and after sucrose, inulin or water rinses. Tongue pH was registered and the tongue flora was cultured on media selective for total and obligate anaerobes, streptococci and inulin fermenters. There were no differences in baseline Halimeter† levels over the 21 day period, but a slight decrease in organoleptic scores was noted. A reduction in odour levels assessed by Halimeter† and organoleptically was observed immediately after rinsing. The effect was greater by the end of the 21 day regime. Microbial counts remained high, and no significant differences were observed, but there was a trend towards increased streptococcal counts by the end of the 21 day period. Tongue pH baseline levels were approximately neutral, but immediately after carbohydrate rinses a typical Stephan curve was observed. There is some indication that the use of twicedaily carbohydrate mouth rinses (sucrose or the prebiotic inulin) can reduce oral malodour by encouraging the growth of acidogenic bacteria and inhibiting the obligate anaerobes associated with malodour. Inulin is a less cariogenic substrate, and inulin mouth rinsing may provide a novel method for the control of oral malodour. Key words: oral malodour, volatile sulphur compounds, prebiotic, inulin, oral bacteria

In vitro biofilm model for studying tongue flora and malodour

In vitro biofilm model for studying tongue flora and malodour

Effects of Various Rinsing Protocols after the Use of Amine Fluoride/Stannous Fluoride Toothpaste on the Acid Production of Dental Plaque and Tongue Flora

The aim of this clinical study was to evaluate the effect of various rinsing protocols on oral acid production 6 h after tooth brushing with an amine fluoride/stannous fluoride (AmF/SnF₂) toothpaste. After a 14-day period of using F-free toothpaste, 30 participants followed three experimental protocols each, followed by F-free washout periods in a randomized crossover trial. They used AmF/SnF₂ toothpaste twice daily for 1 week, and after brushing, they either rinsed with tap water, omitted the post-brush rinse, or rinsed with an AmF/SnF₂ mouthwash. In the F-free washout periods, the participants brushed their teeth without further instructions. Six hours after the last brushing (± rinsing) of each period, subjects rinsed with 10 ml 10% sucrose solution for 2 min. A tongue film sample and a buccal plaque sample were taken 4 and 8 min after the sucrose challenge, respectively. Metabolic acid ions were determined by capillary electrophoresis. The results show that (1) omitting the post-brush water rinse did not reduce the production of lactic, acetic or minor acids in plaque, nor on the tongue, and that (2) the additional use of AmF/SnF₂ mouthwash after brushing reduced the acid production in plaque and tongue samples for at least 6 h. The distributions of acids produced in the plaque or tongue samples were not statistically different between experimental periods. It is concluded that an increase in the antimetabolic effect of AmF/SnF₂ toothpaste in between two daily brushing exercises is not achieved by omitting the post-brush water rinse. The additional use of AmF/SnF₂ mouthwash after brushing is effective in reducing the acid metabolism in dental plaque and tongue flora.

P33 In vitro perfusion biofilm model for the growth of oral microbes associated with oral malodour

Objectives Oral malodour is mainly due to the generation of volatile sulphur compounds (VSC) by oral anaerobes present in the tongue biofilm. The aim of this study was to evaluate the use of a biofilm system to model the ecology and VSC physiology of tongue biofilm microcosms. Of particular interest was the use of the model to maintain a high diversity of bacterial groups and study their response to environmental changes including exposure to VSC substrates and inhibitors.Methods Biofilms were grown using a Sorbarod perfusion model modified by supply of anaerobic gas to grow oral anaerobes. Sorbarods were inoculated using tongue scrape suspension containing 3 × 108 cfu ml−1 and pre‐incubated anaerobically for 24 h at 37°C to promote cell adhesion. After 24 h, the biofilm system was perfused at 12 ml h−1 with BHI (0.74 g L−1) supplemented with haemin, cysteine and/or DTT. Biofilms and eluates (released cells) were sampled up to 96 h and numbers of broad bacterial groups enumerated by selective media. VSC production was measured using a HalimeterTM.Results Repeated analysis of biofilms showed that a quasi‐steady state was achieved between 48 and 96 h. The mean specific growth rate was 0.018 h−1. Ecological analysis showed all broad groups were maintained at a constant proportion reflecting the original inoculum for both biofilms and eluates. VSC specific activity was upregulated when biofilms were perfused with appropriate VSC‐substrates (cysteine, glutathione and methionine). In situ exposure of the biofilms to pulses of putative inhibitors (Zn, H2O2 and chlorhexidine) at a range of concentrations typically used in vivo gave dose‐dependent inhibition of VSC production (for Zn and H2O2) and reduced viable numbers by one to two log‐fold (H2O2 and chlorhexidine).Conclusions The modified Sorbarod perfusion model is suitable for maintaining high diversity biofilms representative of the tongue flora in terms of both ecological behaviour and response towards VSC substrates and inhibitors.

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.

Periodontal pathogen detection in gingiva/tooth and tongue flora samples from 18- to 48-month-old children and periodontal status of their mothers.

Few studies have detected periodontal pathogens in young children, and when detected the prevalence has been relatively low. In this epidemiological study, we determined the prevalence of periodontal pathogen colonization in young children and examined the relationship between periodontitis in mothers and detection of periodontal pathogens in their children aged 18-48 months. Children were selected and enrolled randomly into the study; tongue and gingival/tooth plaque samples were harvested and analyzed by DNA probe checkerboard assay for Porphyromonas gingivalis and Bacteroides forsythus. Clinical measurements included a gingival bleeding score in the children and a periodontal screening and recording (PSR) score in the mothers. Mothers having one or more periodontal sites with probing depths > 5.5 mm were classified as having periodontitis. In this population, 71% (66/93) of the 18- to 48-month-old children were infected with at least one periodontal pathogen. Detection rates for children were 68.8% for P. gingivalis and 29.0% for B. forsythus. About 13.8% (11/80) of children had gingival bleeding in response to a toothpick inserted interproximally. Children in whom B. forsythus was detected were about 6 times more likely to have gingival bleeding than other children. There was no relationship between bleeding and detection of P. gingivalis. 17.0% (16/94) of the mothers had periodontitis. When all mother-child pairs were considered, the periodontal status of the mother was found not to be a determinant for detection of periodontal pathogens in the floral samples from the children. However, the odds ratio that a daughter of a mother with periodontitis would be colonized was 5.2 for B. forsythus. A much higher proportion of children in this population were colonized by P. gingivalis and/or B. forsythus than has been previously reported for other populations. A modest level of association between manifestations of periodontitis in mothers and detection of B. forsythus in their daughters was observed.

The streptococcal flora of the tongue of the monkey Macaca fascicularis

The major streptococcal biotypes in the 8 monkeys investigated resembled Streptococcus sanguis and Streptococcus mitior with Streptococcus salivarius forming only 5 to 6 per cent of the total colony count and being isolated from only 4 monkeys. The predominant tongue streptococci were not isolated from the dental plaque. Similarly, Streptococcus mutans, present in large numbers in the plaque of monkeys fed sucrose-rich diets, was isolated from the tongue of only 2 animals and formed only 2.4 per cent of the total colony count. Changing from a starch-based maintenance diet to sucrose-rich diets did not significantly alter the tongue flora except that the proportion of typical Strep. sanguis was significantly reduced. The oral streptococcal flora of monkeys is similar in distribution to that found in the human mouth.

Effect of oxytetracycline in a periodontal pack on sensitivity and numbers of tongue flora.

Effect of oxytetracycline in a periodontal pack on sensitivity and numbers of tongue flora.