Treatment Of Halitosis Research Articles

Aloe Vera – Nature’s Power

Aloe vera is a plant used in various fields like Homeopathy, Ayurveda, Allopathy, Siddha, Unani, cosmetology, dermatology and surprisingly even in dentistry. Aloe vera is richest source of health for humans with various benefits and properties like wound healing, anti-microbial, anti-inflammatory, immunomodulatory, anti-septic, anti-helmenthic and anti-oxidant. Aloe vera is used in dentistry as active ingredient in tooth pastes, tooth gels and mouth rinse for plaque control, treatment of various oral lesions, halitosis and gingivitis, as decontaminant in endodontics, in extraction sockets, dental implants and in denture care. This paper gives an overview of aloe vera plant, its ingredients, properties and various therapeutic and dental applications.

Duration of effect of the mouthwash CB12 for the treatment of intra-oral halitosis: a double-blind, randomised, controlled trial

Halitosis occurs in approximately 30% of the adult population and has a negative social and psychological impact on affected individuals. Mouthwashes may be used to prevent unpleasant odour, with long-duration of effect being a desirable attribute. The aim of this study was to assess the long-term efficacy of CB12 (a mixture of 0.3% zinc acetate and 0.025% chlorhexidine) for the treatment of intra-oral halitosis. Thirty-four subjects with confirmed intra-oral halitosis were randomized into a double-blind, controlled, cross-over study to one of 2 groups; (i) CB12–water–water or (ii) water–CB12–CB12. Each group comprised 3 treatments, each given evening and morning (12 h apart) on consecutive study days, with a 5 d washout between treatments. Intra-oral halitosis was assessed objectively by measuring concentrations of hydrogen sulphide, methyl mercaptan, dimethyl sulphide and total volatile sulphur compound (VSC) concentrations and subjectively using organoleptic score (OLS). These were measured at baseline, 12 h after the evening rinse (i.e. 12 h overnight assessment) and 12 h after the daytime rinse (i.e. 12 h day time assessment). CB12 significantly reduced mean hydrogen sulphide, methyl mercaptan, dimethyl sulphide and VSC concentrations, with a duration of effect lasting 12 h, whether assessed overnight (all p ⩽ 0.0003 versus water) or during the day (all p ⩽ 0.0007 versus water). CB12’s effect on OLS was also evident for 12 h overnight (p = 0.0043). CB12 was well-tolerated. In conclusion, CB12 showed a clear and durable effect on intra-oral halitosis which lasted at least 12 h, both during the day and overnight, with consistent effect on both objective and subjective variables.

Dorsal Lingual Surface and Halitosis: a Morphological Point of View.

The interest in the study of the tongue papillary niches and the related biofilm has increased in recent years because they form a suitable source of periodontal microorganisms and are associated with development of halitosis. Tongue dorsum structure represents a factor favoring a particular and complex bacterial biofilm where periodontal pathogens are frequently found. The aim of this preliminary study was to associate the tongue papillary structure with the biofilm causing halitosis by means of a new clinical protocol. In this study, one subject affected by oral malodor was selected and included. A photograph of lingual dorsum was taken to spot the areas with visible lingual coating. A tongue dorsum impression was obtained, divided and cut with a blade in six parts, according to Winkel Tongue Coated Index by means of the 2-step double-mix impression technique. The contours of the six parts were observed by the stereomicroscope LEICA LED2000 and analyzed by ImageJ software. The results showed that the depth of papillae was associated with visible presence of the tongue biofilm and indirectly correlated with halitosis in patients.. The morphological papillary structure of the tongue dorsal surface influences the presence of the tongue biofilm. The presented protocol can be further considered in clinical application for a correct diagnosis and a personalized treatment of halitosis.

Effect of photodynamic therapy for the treatment of halitosis in adolescents - a controlled, microbiological, clinical trial.

Halitosis can exert a negative influence on the social relations of adolescents and affect one's self-image. The aim of this study was to evaluate the clinical and microbiological effect of antimicrobial photodynamic therapy (aPDT) on halitosis in adolescents. Forty-six individuals aged 12 to 19 years were randomly allocated: Group 1 - treatment with photodynamic therapy; Group 2 - treatment with a tongue scraper and Group 3 - treatment with a tongue scraper and photodynamic therapy. The count of bacterial colony-forming units per milliliter was used for the microbiological analysis. Statistical analysis involved the Kruskal-Wallis test followed by the Student-Newman-Keuls test. ANOVA was used for the determination of colony-forming units after treatment. The level of significance for all statistical tests was 5% (p < 0.05). After treatment, a statistically significant reduction in total volatile sulfur compounds was found in all groups (p < 0.001), with the largest reduction (median: 0) found in Group 3 (tongue scraper and photodynamic therapy). Moreover, a statistically significant difference was found between treatment with aPDT and a tongue scraper alone (p < 0.001). The present findings demonstrate an option for the treatment of halitosis in adolescents, with an immediate effect and without the mechanical aggression to the toungue. Clinical Trials: NCT02007993.

WITHDRAWN: Mouthrinses for the treatment of halitosis.

WITHDRAWN: Mouthrinses for the treatment of halitosis.

Halitosis: Current concepts on etiology, diagnosis and management.

Halitosis or oral malodor is an offensive odor originating from the oral cavity, leading to anxiety and psychosocial embarrassment. A patient with halitosis is most likely to contact primary care practitioner for the diagnosis and management. With proper diagnosis, identification of the etiology and timely referrals certain steps are taken to create a successful individualized therapeutic approach for each patient seeking assistance. It is significant to highlight the necessity of an interdisciplinary method for the treatment of halitosis to prevent misdiagnosis or unnecessary treatment. The literature on halitosis, especially with randomized clinical trials, is scarce and additional studies are required. This article succinctly focuses on the development of a systematic flow of events to come to the best management of the halitosis from the primary care practitioner's point of view.

Awareness and Knowledge of Halitosis: Comparison of Two Grades of Dental Hygienist Students

Many people worry about their breath odor, and the importance of halitosis treatment is increasing. Consequently, it is necessary for dental hygienists to obtain a basic knowledge of halitosis. To achieve this, we must improve the motivation of dental hygienist students to acquire such knowledge. To this end, we conducted a questionnaire survey to assess the awareness and knowledge of the problem among dental hygienist students and compared the results of the survey for students in the first and third grades. The percentage of students who perceived the oral malodor of patients was higher in the third grade group. The third graders also placed a greater importance on the participation of dental hygienists in halitosis treatment. Most students in both grades believed that demand for halitosis treatment would increase, although there were students in the first grade that did not hold this view. A similar percentage of students in the two grades were willing to study halitosis, although some first grade students were not at all interested. Many more students in the third grade wanted to take part in halitosis treatment. Student knowledge of halitosis was approximately the same in both grades, but, surprisingly, the third graders gave some incorrect answers in this area. From the results of this study, the third grade students appeared to have higher motivation to study halitosis treatment than the first graders. However, the upper grade students seemed to lack some knowledge, which may be due to the extended time since they had studied the topic at school. It is necessary for us to improve student motivation for studying halitosis and for maintaining their knowledge in order to better perform the treatment of halitosis after the students become dental hygienists.

Diagnosis and treatment of physiologic halitosis: a case report

We selected a patient with physiological bad breath from among the outpatients with bad breath that have visited the halitosis control clinic in KUMC. We identified the factors that were associated with the development of bad breath and assessed the occurrence of discomfort in the mouth; thereafter, we were able to prescribe a treatment method for the patient. We determined the daily routine of the patient through a questionnaire and a diary of dietary life. From these analyses, we deduced the factors associated with her physiologic halitosis. We combined this information with the results of analysis of her oral and exhaled gas measurements, nasal gas measurements by oral malodor measuring devices, and salivary measurements to develop a treatment method that we prescribed to the patient. We conclude that oral health education, including correction of the patient's mismanaged oral-care methods and routines, could act as an alternative treatment method for patients with physiologic halitosis in Korea.

Immediate results of photodynamic therapy for the treatment of halitosis in adolescents: a randomized, controlled, clinical trial.

Light with or without chemical agents has been used to induce therapeutic and antimicrobial effects. With photodynamic therapy, the antimicrobial effect is confined to areas covered by a photosensitive dye and irradiated with light. The aim of the present study was to evaluate the effect of photodynamic therapy for the treatment of halitosis in adolescents through the analysis of volatile sulfur compounds, especially sulfide. A controlled, clinical trial was conducted with 45 adolescents randomly allocated to three groups: group 1, photodynamic therapy administered to the dorsum of the tongue; group 2, treatment with a tongue scraper; and group 3, treatment with a tongue scraper combined with photodynamic therapy. The diagnosis of halitosis was performed using gas chromatography before and after treatment. Comparisons were made using the Kruskal-Wallis test followed by the Student-Newman-Keuls test, with the level of significance set at 5% (p < 0.05). After treatment, a statistically significant reduction in halitosis was found in all groups (p < 0.001). The greatest reduction in total sulfides (median = 0) occurred with the combination of tongue scraper and photodynamic therapy. The present study describes a novel option for the treatment of halitosis in adolescents with an immediate effect that does not involve the mechanical aggression of the lingual papillae that occurs with conventional treatment. Photodynamic Therapy in Adolescents Halitosis ( https://clinicaltrials.gov/ct2/show/NCT02007993?term=NCT02007993&rank=1 )Number: NCT02007993FUNDING:FAPESPNumber: 2013/13032-8.

Avaliação da percepção pessoal em relação à condição de halitose e confirmação clínica

ResumoIntroduçãoA halitose é uma condição em que o hálito se apresenta de forma desagradável, acometendo milhares de pessoas e causando impacto negativo para as mesmas.ObjetivoA presente pesquisa em campo buscou avaliar a percepção pessoal em relação à condição de halitose por meio de aplicação de questionário específico e confirmação clínica.Material e métodoA amostra foi composta por 59 indivíduos entre 20 e 60 anos de idade, usuários de Unidades Básicas de Saúde de Araraquara, que foram selecionados de forma aleatória. A metodologia empregada constituiu-se de: i) Assinatura do Termo de Consentimento Livre e Esclarecido; ii) Aplicação de questionário especialmente elaborado para esta pesquisa; iii) Confirmação clínica, com a aplicação do teste com halímetro (Tanita Breath Alert CHC-212S). Após o experimento, todos receberam folhetos informativos com dados gerais sobre halitose. Os resultados obtidos foram agrupados em tabelas de contingência, construídas pelo Microsoft Excel, sendo então analisados pelo teste do Qui-quadrado.Resultado e conclusãoApós análises, conclui-se que as pessoas perderam a capacidade de perceber o próprio hálito quando tinham halitose; não tiveram condições de se autoavaliarem de forma eficaz; os fatores de riscos que influenciaram na halitose foram: idade superior aos 40 anos, uso de alguns tipos de medicamentos, algumas patologias, frequência de visita ao Dentista e falhas em procedimentos de higiene bucal, tais como escovação dentária, uso do fio dental, limpeza da língua e limpeza de próteses. Os outros fatores pesquisados não se mostraram estatisticamente suficientes para estabelecerem relação de influência na halitose.

Multi-Sensor Approach for the Monitoring of Halitosis Treatment via Lactobacillus brevis (CD2)-Containing Lozenges--A Randomized, Double-Blind Placebo-Controlled Clinical Trial.

The aim of this randomized clinical trial was to evaluate whether a recently described multi-sensor approach called BIONOTE® is accurate enough to verify the efficacy of treatment of patients with halitosis. A treatment with Lactobacillus brevis (CD2)–containing lozenges, compared with placebo was tested. The BIONOTE® was compared with traditional techniques used to detect halitosis: OralChroma™ and two calibrated odor judges enrolled for the organoleptic assessments. Twenty patients (10 treated and 10 placebo), suffering from active phase halitosis were included in the study. Treatment consisted of Lactobacillus brevis (CD2)—containing lozenges or placebo, 4 tablets/day for 14 days. t0 was before the beginning of the study; t1 was day 7 and t2 was day 14. The effectiveness of treatment was assessed through: (1) Rosenberg score; (2) Winkel tongue coating index (WTCI) anterior and posterior; (2) OralChroma™; (3) the new developed multi-sensor approach, called BIONOTE® (test technique). Only the WTCI anterior revealed statistically significant changes between t0 and t2 data (p = 0.014) in the treated group. Except for the WTCI anterior, all diagnostic methods revealed the lack of effectiveness for halitosis of a 14-days treatment with Lactobacillus brevis (CD2)–containing lozenges. The BIONOTE® multisensor system seems accurate in addition to OralChroma™ to assess the initial condition of halitosis and its mitigation during treatment.

The differential expression of mgl mRNA by Porphyromonas gingivalis affects the production of methyl mercaptan.

A large number of individuals have halitosis. The total amount of volatile sulfur compounds, which are the main cause of halitosis, has been correlated with periodontitis following bacterial infection. In this study, Porphyromonas gingivalis (Pg), a major periodontopathogenic bacterium, was isolated from patients with halitosis by the amplification of 16S rRNA, and the ability of isolated Pg to produce methyl mercaptan (CH3 SH) was determined to clarify the relationship between halitosis and Pg infection. CH3 SH concentrations were measured in patients using Oral Chroma. The production of CH3 SH by Pg standard and clinical strains was also measured invitro. Real-time PCR was performed to compare the expression of mgl mRNA (which encoded l-methionine-a-deamino-g-mercaptomethane-lyase) among the Pg strains. The production of CH3 SH and the expression of mgl mRNA were also determined to assess the effects of oriental medicine. The production of CH3 SH and the expression of mgl mRNA strongly correlated with each other in the presence of l-methionine. The expression of mgl mRNA by Pg W83 was strongly inhibited by magnoliaceae. The production of CH3 SH was correlated with the expression of mgl. Furthermore, the oriental medicine, magnoliaceae, may represent a potential treatment for halitosis.

Diagnosis and treatment of patients with halitosis by dental hygienists and dentists in the Netherlands

The aims of this study were to ascertain the knowledge level of halitosis in dental hygienists and dentists in the Netherlands and to examine how they deal with patients with halitosis. A written survey (comprising 29 questions on personal and professional characteristics, clinical observation and treatment of halitosis, the referral of patients with halitosis and expert knowledge of halitosis) was randomly distributed to a sample of 327 Dutch dentist members of the Royal Dutch Dental Association (Koninklijke Nederlandse Maatschappij tot bevordering der Tandheelkunde; KNMT) and to a sample of 205 members of the Dutch Dental Hygienists' Association (members of the Nederlandse Vereniging van Mondhygiënisten; NVM). A total sample of 168 oral health professionals (92 NVM-dental hygienists and 76 dentists) was included. This sample can be considered as representative of the population of dental hygienists and dentists working in the Netherlands. Knowledge of halitosis in NVM-dental hygienists and dentists was generally the same. In both professions, attention to, and treatment of, halitosis did not take place at every patient contact, even among those who were able to treat patients with halitosis. This study supports the importance of training programmes aimed at increasing assertiveness, as well as the social and communication skills of dentists and dental hygienists to improve the diagnosis and treatment of patients with halitosis. A guideline on screening, diagnosis and treatment of halitosis may be useful to improve the attitude and behaviour of oral health-care professionals, ultimately aimed at stimulating optimal oral health care.

Probiotics in the dental practice: a review.

During the last decade an increased interest in alternative, preventive, and therapeutic strategies in dentistry has arisen. Probiotics are living microorganisms which, if administered in sufficient amounts, provide a health benefit to the host. Their precise mechanisms of action have not been identified, but they are able to interfere with the imbalance occurring in biofilm-associated infections. In other fields of medicine, mainly in gastroenterology, their usefulness is already proven. Concerning oral threats, probiotic bacteria may reduce the numbers of pathogens associated with dental caries (mutans streptococci). Clinically, results are encouraging, but further research is needed to demonstrate apparent effects of certain probiotic strains on oral health as well as their desired concentration and vehicle. The use of probiotics in prevention and treatment of caries, periodontal diseases, halitosis, and other oral diseases needs to be further investigated.

Effect of Metronidazole on Halitosis of 2 to 10 Years Old Children.

Background:Regarding the fact that halitosis has social and personal aspects which can lead to social embarrassment and consequently low self-esteem and self-confidence in subjects suffering from the problem, especially children, its proper treatment is an important issue.Objectives:The aim of this study was to evaluate the effect of metronidazole as a nonspecific antimicrobial agent in the treatment of halitosis in children.Materials and Methods:In this study, 2-10 years old children with oral halitosis were enrolled. Children without H. pylori infection and parasitic infection were randomized in two interventional and control groups. Metronidazole was given 5mg/kg/day for one week. Information regarding the demographic characteristics of studied population and halitosis (duration and time of day with more halitosis and its severity) before and after intervention was recorded using a questionnaireResults:77 children with halitosis were studied in two interventional (40 children) and control (37 children) groups. There was no significant difference between two groups before intervention. After intervention, halitosis improvement rate - according to the reports of mothers of studied children - was higher significantly in intervention group (P < 0.05). Conclusions:The results support the effectiveness of metronidazole in the treatment of halitosis. Moreover, it supports recent findings regarding the participation of specific bacteria specially unculturable ones in the pathogenesis of the disease.

Knowledge of different medical and dental professional groups in Switzerland about halitosis.

Although halitosis is a widespread condition, it is still seen as too personal or embarrassing to talk about. The cause of real halitosis can be intraoral or extraoral. In order to determine the level of knowledge of health care providers in Switzerland, a survey was conducted over a period of three years in which 150 family physicians, 150 ear, nose and throat specialists, 154 dentists and 151 dental hygienists were personally interviewed. The survey shows that only 46.7% of the dentists and only 47.0% of the dental hygienists are consulted by patients for their halitosis, whereas 58.0% of the family physicians and 50.7% of the ENT specialists reported treating 1-10 patients for halitosis per year, while 46.7% of the ENT doctors even reported treating 11-100 patients for halitosis per year. 81.5% of all interviewed doctors and dental hygienists were of the opinion that halitosis mainly originates intraorally. 76.0% of the dentists and 72.8% of the dental hygienists as well as 33.3% of the family physicians recommend periodontitis therapy as halitosis treatment. This proves that a large percentage of medical professionals thinks that marginal periodontitis is the most common cause of halitosis. This study also shows that patients seek first consultations with dentists and dental hygienists less often than with family physicians and ENT specialists, despite the fact that the cause of halitosis is primarily intraoral.

Diagnosis, Prevalence, and Treatment of Halitosis

Halitosis affects a large part of the population. Many of those that are affected suffer from this problem for a long time before they visit a professional halitosis clinic. Further, halitosis creates social and psychological disadvantages. Although halitosis has multifactorial origins, in nine out of ten cases the source can be found within the oral cavity. The most frequent intra-oral causes are tongue coating, gingivitis, and periodontitis, or a combination of these. A general dental practitioner is often faced with patients suffering from halitosis in her/his dental practice and therefore should be able to manage it. Using standardized strategies, a high level of treatment success can be achieved. In the literature, several methods to determine halitosis and various possibilities for treatment are described. The present review summarizes diagnostics, prevalence, and current treatments of oral halitosis.

Halitosis management by the general dental practitioner—results of an international consensus workshop**Workshop at BREATH ANALYSIS Summit 2013—International Conference of Breath Research, 9th of June 2013—Saarbrücken/Wallerfangen, Germany.

Clinical investigations on patients suffering from halitosis clearly reveal that in the vast majority of cases the source for an offensive breath odor can be found within the oral cavity (90%). Based on these studies, the main sources for intra-oral halitosis where tongue coating, gingivitis/periodontitis or a combination of the two. Thus, it is perfectly logical that general dental practitioners (GDPs) should be able to manage intra-oral halitosis under the conditions found in a normal dental practice. However, GDPs who are interested in diagnosing and treating halitosis are challenged to incorporate scientifically based strategies for use in their clinics. Therefore, the present paper summarizes the results of a consensus workshop of international authorities held with the aim to reach a consensus on general guidelines on how to assess and diagnose patients’ breath odor concerns and general guidelines on regimens for the treatment of halitosis.

A review of knowledge, diagnosis and treatment of halitosis among nigerian dentists- a pilot study

Abstract Background: Halitosis is an unpleasant or offensive odour emanating from the breath. The aim of this study is to determine the depth of knowledge of diagnosis and management of halitosis among Nigerian

Halitosis: aetiology, effects and management

Dental care professionals play a major role in providing advice and treatment for halitosis, which can cause social distress for patients. This article discusses the aetiology of oral malodour, how it affects patients and how dental care professionals can manage it