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PubMed1992

[Odontostomatological changes induced by drugs. I].

The purpose of the present review is to describe the unwanted effects of drugs or chemicals in the orofacial region. The authors take into consideration the alterations of salivation such as xerostomia and ptyalism, disturbances of sense of taste, halitosis and pain and swelling of the salivary glands. The dental surgeon who suspects that an oral alteration might be a drug reaction can play an important role in preventing the development of more severe toxic effects. All this points to the importance of the knowledge of pharmacology for dental practitioners.

Drug-Related Side Effects and Adverse Reactions↗
PubMed2002

Oral malodour and its clinical management.

Oral malodour or halitosis is one of the most common complaints by dental patients. It often creates serious personal and social embarrassment for the afflicted individual. Dental health care workers can play a pivotal role in helping these patients by eliminating dental diseases and improving oral hygiene. This paper reviews the current understanding in the microbiology and aetiology of oral malodour and presents a clinical management strategy, which is both rational and effective.

Gram-Negative Bacteria↗
PubMed2003

Oral hygiene practices, smoking habit, and self-perceived oral malodor among dental students.

The aims of this study were to determine the prevalence of oral hygiene practices and halitosis among undergraduate students from King Saud University, College of Dentistry. A self-administered questionnaire was distributed among all 481 students; 263 male and 218 female students. A questionnaire was developed to assess the self-reported perception of oral breath, awareness of bad breath, timing of bad breath, treatment received for bad breath, oral hygiene practices, caries and bleeding gums, dryness of the mouth, smoking and tea drinking habits, and tongue coating. The response rate was 77%. Forty four percent of male and 32% of female students reported the self-perception of breath odor. Self-treatment was sought by 12% male and 22% female. Six percent of males and 4% of females experienced bad breath interference at their work. Seventy-eight percent of male and 62% of female students experienced bad breath after waking up. Brushing was prevalent among 81% of male and 99% of female students. Both miswak (chewing sticks) and tooth brushing were used by 53% male and 83% female students. Fifty seven percent of male students and 44% of female students reported caries. Bleeding gingiva was experienced by 26% of males and 14% of females. Dry mouth was common among 14% of males and 17% of females, while smoking was prevalent among 13% of males and 2% of females. Tea drinking was common among 44% of males and 37% of females, while tongue coating was equally common among both males and females (21% and 20%), respectively. The results indicate female students had better oral hygiene practices, significantly less self-reported oral bad breath, and smoked less compared to male students. There was no difference in tongue coating among male and female students. Further research is needed to examine oral malodor clinically and objectively by the standard procedures available. Students should be motivated to be a health symbol and keeping their mouths free from oral malodor.

Adult↗
PubMedDate not supplied

Impact of socio-demographic variables, oral hygiene practices and oral habits on periodontal health status of Indian elderly: a community-based study.

Periodontal disease is the most common cause of tooth loss. It is has insidious onset, chronic course, and commonly result due to cumulative effect of dietary habits, oral hygiene methods and oral habits practiced over the years. This study was planned to evaluate the periodontal health status of elderly population (above 60 years) in the community, using CPITN index, gingival recession, mobility of teeth and halitosis, using modified WHO Oral Health Survey Proforma. In addition, impact of several socio-demographic variables, oral hygiene practices, oral habits, chronic systemic diseases, dietary preferences and body mass index (BMI) on periodontal health status was also studied. It was found that prevalence of periodontal diseases in the elderly was high. Step-wise multivariate logistic regression analysis showed that periodontal diseases were directly correlated with age, oral hygiene practices and presence of cardiac diseases.

Aged↗
PubMed2006

Clinical application of a VSCs monitor for oral malodour assessment.

PURPOSE: The purpose of this study was to evaluate a volatile sulfur compounds (VSCs) monitor's ability to assess oral malodour in patients with and without periodontal disease in comparison with the assessment by gas chromatography (GC) or organoleptic testing. MATERIALS AND METHODS: Ninety-nine patients' mouth air was measured by GC, a VSCs monitor (Breathtron) and organoleptic test. Patients who had a periodontal pocket depth of 4 mm and more for at least two tooth surfaces were assigned to the periodontal disease group. RESULTS: Total VSCs value by the Breathtron was higher in periodontal disease group than that in non-periodontal disease group, and it showed statistically significant correlations with specific VSCs gases from GC and with the organoleptic measurement. The Breathtron had high sensitivity in both groups. CONCLUSION: The Breathtron can be a reliable instrument for the diagnosis of halitosis. However, the Breathtron should be used properly for measuring VSCs that are related to periodontal disease.

Adult↗
PubMed2006

Oral malodor: a review of the literature.

Oral malodor or halitosis is any unpleasant odor emerging from the mouth that is detected by others. Many patients experience extreme discomfort and embarrassment and therefore seek help for this problem. Oral causes, such as poor oral hygiene, periodontal disease, tongue coating, food impaction, unclean dentures, faulty restorations, and dry mouth, are far more common than nonoral causes of malodor. Management may include simple measures such as scaling and root planing, instructions in oral hygiene, tongue cleaning, and mouth rinsing. This paper reviews the current knowledge, etiology, diagnosis, and possible treatment strategies for oral malodor. Emphasis is placed on the recognition of the dental hygienist as a specialist in aspects of patient care and instruction, which relate to the prevention and control of oral malodor.

Breath Tests↗
PubMed1989

Dietary replacement in preschool-aged hyperactive boys.

A 10-week study was conducted in which all food was provided for the families of 24 hyperactive preschool-aged boys whose parents reported the existence of sleep problems or physical signs and symptoms. A within-subject crossover design was used, and the study was divided into three periods: a baseline period of 3 weeks, a placebo-control period of 3 weeks, and an experimental diet period of 4 weeks. The experimental diet was broader than those studied previously in that it eliminated not only artificial colors and flavors but also chocolate, monosodium glutamate, preservatives, caffeine, and any substance that families reported might affect their specific child. The diet was also low in simple sugars, and it was dairy free if the family reported a history of possible problems with cow's milk. According to the parental report, more than half of the subjects exhibited a reliable improvement in behavior and negligible placebo effects. In addition, several nonbehavioral variables tended to improve while the children received the experimental diet, particularly halitosis, night awakenings, and latency to sleep onset.

Attention Deficit Disorder with Hyperactivity↗
PubMed1995

Faecaloid breath heralding secondary aorto-enteric fistula.

A patient underwent simultaneous abdominal aortic prosthetic replacement and resection of a Meckel diverticulum. He then developed faecaloid breath. Later reoperation for aorto-enteric fistula cured halitosis. We conclude in retrospect that faecaloid breath may herald a secondary aorto-enteric fistula. A pathophysiological mechanism is suggested and discussed.

Aortic Aneurysm, Abdominal↗
PubMed1994

Laser-assisted serial tonsillectomy.

Laser ablation of the palatine tonsils is a useful alternative to tonsillectomy in adults. Cryptic tonsillitis is a common problem causing recurrent infection, sore throat, and halitosis. Elimination and/or obliteration of surface pockets (crypts) of the palatine tonsils utilizing the CO2 laser was effective in 86 patients treated in the past 4 years. Ablation of the tonsil surface was performed in stages under local anesthesia in an office setting; CO2 laser energy delivered through the "SwiftLase" handpiece extension provided char-free, superficial layer ablation of tissue. "SwiftLase" is easily installed onto existing CO2 laser units and provides high-power densities by utilizing a focused laser beam in an extremely fast uniform scan over an extended area (up to 4 mm) within a fraction of a second. This method and results of its use are discussed.

Adolescent↗
PubMed1997

The effect of some metal ions on volatile sulfur-containing compounds originating from the oral cavity.

Halitosis originates mainly from the oral cavity, and the volatile sulfur-containing compounds (VSC) are the major contributors of the unpleasant odor. Anaerobic G- bacteria use sulfur-containing amino acids in their production of VSC. Zinc has been shown to inhibit production of odiferous VSC, and the mechanism proposed has been that zinc, with its affinity for sulfur, oxidizes thiol groups and thereby inhibits the precursors of VSC. The aim of the study was to investigate whether, and to what extent, other metal ions with affinity for sulfur exert the same effect and whether a correlation exists between the sulfur affinity and VSC-inhibiting activity of these metals. VSC levels were measured on the 'morning breath' of 10 test subjects, using a portable sulfide monitor. The mouthrinses tested were aqueous solutions of zinc chloride, zinc citrate, stannous fluoride, cuprous gluconate, ferrous gluconate, and silver acetate, and they contained equimolar amounts of metals (1.47 mmol/I). The results showed that the ranking of Zn++ and Sn++ differed in the clinical test compared with sulfur affinity, and likewise with Ag+ and Fe++. It may therefore be concluded that there is no positive correlation between the inhibiting effect of metal ions on VSC and their affinity for sulfur.

Acetates↗
PubMed1997

Detecting and treating oral and nonoral malodors.

This article suggests methods on how to detect and treat the various oral and nonoral malodor conditions with which patients present. These conditions are separated into those emanating from the nasal passage, sinuses and upper respiratory sources; the mouth; the tongue; the oropharynx; the lower respiratory tract; and the lungs. Foul odors also develop as a result of systemic and gastrointestinal disorders and diseases, as well as the normal breakdown of odiferous ingested foods. The available detection methods are described and future methods are suggested. The overall conclusions made from this review are that currently available management methods will be able to treat most cases. A careful, knowledgeable clinician can usually determine the patient's problem by the use of a thorough history and examination. Occasionally medical consults will be needed; and, in these cases, the approach that must be taken is a combined treatment approach. For example, effective therapy might require a combination of periodontal disease treatment, correction of dental restoration-based food traps and a rigorous daily mechanical debridement of the tongue. The above treatments will often have to be supplemented by the most appropriate mouthwash for the patient's specific condition. Finally, this article hopes to encourage manufacturers of "halitosis products" to support and conduct well-designed clinical trials on their products so that the field is advanced and treatments become more predictable.

Breath Tests↗
PubMedDate not supplied

Battling bad breath: a new approach to an old problem.

Bad breath plagues millions of people in the US. Because breath malodor is viewed as a social, not medical, condition, bad breath usually is not part of dental school curriculums. Desperate halitosis sufferers looking for help are turning to the dental profession for answers.

Halitosis↗
PubMed1995

Use of an oral antiseptic bioadhesive tablet in dogs.

V3703 (Stomadhex) is a tablet with bioadhesive properties enabling it to remain in place for several hours after it has been placed on the oral mucosa. It continuously releases chlorhexidine and niacinamide. In a study conducted in 15 dogs, the tablets were well tolerated by the animals. The product significantly reduced (p < 0.05): dental plaque; quantitative periodontopathogen and total anaerobic bacterial counts; spirochetes; and halitosis when used daily over a 14 day period. Gingivitis was also reduced, though not significantly (p = 0.07). Stomadhex treatment can provide a carry-over effect following dental scaling by reducing oral microflora and retarding the reappearance of dental plaque.

Administration, Topical↗
PubMed1998

Immunoapheresis in paraneoplastic pemphigus.

BACKGROUND: Paraneoplastic pemphigus was first described in 1990 in 5 patients with extensive mucocutaneous erosions, a distinct set of autoantibodies, and underlying neoplasia. Since then, patients described have been middle-aged, have suffered from prognostically unfavorable malignant neoplasms, and have responded poorly to immunosuppressive agents. OBSERVATION: A 16-year-old boy was examined with extensive oral erosions, halitosis that interfered with his quality of life, and rapid weight loss. The suspected clinical diagnosis of paraneoplastic pemphigus was confirmed by histopathological, immunofluorescence, and biochemical (eg, immunoblotting and immunoprecipitation) findings as well as by the demonstration of an inflammatory myofibroblastic tumor of the left retroclavicular region. Despite administration of corticosteroids, followed by excision of the neoplasm, clinical symptoms improved only slightly, and autoantibody titers decreased only marginally. We therefore initiated an immunoapheresis regimen with the use of sheep anti-human-IgG bead-formed agarose gel (Sepharose; Pharmacia Biotech Comp, Vienna, Austria), which led to the disappearance of circulating autoantibodies and the patient's recovery. CONCLUSION: Immunoapheresis may represent a novel therapeutic option for patients with paraneoplastic pemphigus who show little improvement after curative treatment of their neoplasms.

Adolescent↗
PubMed2004

Low-dose excimer 308-nm laser for the treatment of oral lichen planus.

BACKGROUND: Lichen planus is a difficult-to-treat chronic inflammatory disorder that affects mucous membranes, causing inanition, halitosis, and dyspareunia. OBJECTIVE: To evaluate the novel use of low-dose 308-nm excimer laser radiation for the treatment of symptomatic oral lichen planus (OLP). DESIGN: A single-center, before-after trial. SETTING: Academic clinical research center. PATIENTS: Nine patients with symptomatic, biopsy-proven OLP, unresponsive to conventional therapies, were recruited from the dermatology clinics of the Massachusetts General Hospital in Boston. Eight participants completed the entire study, and 1, despite early improvement, did not complete the study because of hospitalization for an unrelated reason. Intervention With a narrow, fiberoptic handpiece to target precisely only diseased sites, 308-nm excimer laser radiation was delivered at an initial dose of 100 mJ/cm(2) once a week. MAIN OUTCOME MEASURE: A visual analog scale was used to grade subjective disease severity. Clinical improvement was graded in quartiles as follows: poor (<25%), fair (25%-50%), good (51%-75%), and excellent (>75%). Follow-up visits occurred for up to 18 months. A paired t test was performed to evaluate efficacy of treatment. RESULTS: Treatments were painless and well tolerated. Five patients demonstrated overall excellent clinical and subjective improvement after 7 treatments. Two participants with nonerosive OLP were deemed fair responders. The only poor responder in the study also had chronic active hepatitis C infection. Overall improvement was statistically significant (P<.05), and for the responders, remission times ranged from 2 to 17 months. Conclusion Low-dose treatment with the excimer 308-nm laser can be very effective in treating symptomatic and especially erosive OLP, an otherwise notoriously difficult-to-control disease.

Adult↗
PubMed1997

Efficacy of adenoidectomy in relieving symptoms of chronic sinusitis in children.

OBJECTIVE: To determine the efficacy of adenoidectomy in relieving symptoms of chronic sinusitis in children. DESIGN: Retrospective case series. SETTING: Tertiary care center. PATIENTS: Symptoms of chronic sinusitis were studied in 48 consecutive patients who underwent adenoidectomy or adenotonsillectomy between October 1993 and May 1995. Children with cystic fibrosis or those who underwent concurrent endoscopic sinus surgery were excluded. Patient ages ranged from 1 to 12 years. Four patients were unavailable for follow-up and did not complete the study. MAIN OUTCOME MEASURES: Patients' charts were reviewed for the presence of preoperative symptoms, including rhinorrhea, nasal congestion, headache, postnasal drainage, cough, halitosis, and irritability. Also recorded were mouth breathing, fevers, and frequent antibiotic use. Telephone interviews with the patients' caregivers were conducted to collect information following the surgery regarding the presence of the same symptoms as well as an estimate of overall improvement. Follow-up ranged from 5 months to 2 years. RESULTS: The most frequently reported symptoms before surgery were rhinorrhea, nasal congestion, mouth breathing, and frequent antibiotic use (35, 37, 34, and 38 patients, respectively). These numbers decreased following surgery to 18, 20, 11, and 10 patients, respectively. The average number of symptoms experienced by each patient decreased from 5.3 to 2.9. Complete or near symptom resolution was reported in 25 (58%) of 43 patients. Some improvement was reported in another 9 patients (21%). Minimal or no improvement was reported in 9 patients (21%). To date, only 3 patients have gone on to have endoscopic sinus surgery. CONCLUSION: In the majority of cases, symptoms of chronic sinusitis in children are relieved by adenoidectomy.

Adenoidectomy↗
PubMed2002

Indications for tonsillectomy and adenoidectomy.

OBJECTIVE: To review recent clinical trials that provide a foundation on which clinicians can base decisions regarding adenotonsillar surgery for their patients. STUDY DESIGN: Review. METHODS: An evidence-based approach was used to review recent clinical trials addressing indications for adenotonsillectomy, tonsillectomy, and adenoidectomy. RESULTS: Absolute indications for tonsillectomy and adenoidectomy include adenotonsillar hyperplasia with obstructive sleep apnea, failure to thrive, or abnormal dentofacial growth; suspicion of malignant disease; and (for tonsillectomy) hemorrhagic tonsillitis. Relative indications for both procedures are adenotonsillar hyperplasia with upper airway obstruction, dysphagia, or speech impairment, and halitosis. Otitis media and recurrent or chronic rhinosinusitis or adenoiditis are relative indications for adenoidectomy but not tonsillectomy. Recurrent or chronic pharyngotonsillitis, peritonsillar abscess, and streptococcal carriage are relative indications for tonsillectomy but not adenoidectomy. CONCLUSION: Good clinical evidence regarding indications for tonsillectomy and adenoidectomy is available. Clinicians should make recommendations for surgery on the basis of this evidence.

Adenoidectomy↗
PubMed2002

Toxicological studies on Laccase from Myceliophthora thermophila expressed in Aspergillus oryzae.

The bioindustrially produced enzyme laccase can be used in different technical and food applications to facilitate processes. It can be added to different oral care products such as mouthwash, toothpaste, mints, and gums to prevent halitosis. Laccase, produced by submerged fermentation of Aspergillus oryzae, containing a gene originating from Myceliophthora thermophila, was subject to a series of toxicological tests to document its safety in use. It was not found to be mutagenic in the Salmonella typhimurium reverse mutation assay, nor did it cause chromosomal aberrations in cultured human lymphocytes. No evidence of inhalation toxicity or skin and eye irritation was found. There was no evidence of possible skin sensitization in a human skin sensitization test when Laccase was tested at 10% (w/v): thus Laccase would appear to have a low skin sensitization potential. Oral administration to rats of up to 10.0 mL/kg body wt/day (equivalent to a total organic solids dosage of 1.72 g/kg body wt/day) for 13 weeks did not cause any adverse effect.

Administration, Inhalation↗