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PubMed1991

Reproducibility and sensitivity of oral malodor measurements with a portable sulphide monitor.

Forty-one subjects with bad breath were assessed for oral malodor and periodontal status on three occasions, at intervals of approximately one week. Oral malodor was assessed by measurement of peak and steady-state volatile sulphide levels with a portable sulphide monitor and by organoleptic measurement of whole-mouth, tongue dorsum, and interproximal dental odors by two independent judges. Reproducibility of measurements, assessed by paired t tests and Kappa testing, demonstrated no significant differences between any of the test results from the first and second appointments. Steady-state sulphide levels were the most reproducible of all tests. The ability of the tests to detect an expected reduction of malodor following a 0.2% chlorhexidine mouthrinse regimen was investigated by comparison of test values between the second and third appointments. Following the mouthrinsing treatment, 43% reductions of peak, 47% reductions of steady-state volatile sulphide levels, and 15-58% reductions in all other measurement categories were observed. The majority of the participants (22/41) had no pockets greater than 5 mm and exhibited both moderate gingival inflammation (Mean Gingival Index = 1.17) and moderate plaque accumulation (Mean Plaque Index = 1.84). Plaque Index and presence of pockets greater than 7 mm were weakly related to sulphide measurements. Whereas assessment of steady-state sulphide levels by the sulphide monitor does not constitute a direct measure of oral malodor, its relation to organoleptic measurement, superior reproducibility, objectivity, and sensitivity support the use of the sulphide monitor in clinical studies.

Breath Tests↗
PubMed1994

Correlation between the BANA test and oral malodor parameters.

The purpose of the present investigation was to test the association between the BANA test (Perioscan, Oral-B), and oral malodor parameters. The subject population consisted of 52 Israeli adults, 43 of whom complained of oral malodor. Oral malodor measurements consisted of peak and steady-state volatile sulphide measurement by a portable sulphide monitor (Interscan Corp., model 1170), as well as organoleptic measurements of malodor from whole mouth, tongue, and saliva. Samples for the BANA test were obtained from four loci (shallow pocket, deep pocket, tongue dorsum, saliva); results were scored as negative (0), weak (1), or strong (2). BANA scores were significantly associated with odor-judge ratings, with the highest association obtained when BANA saliva scores and odor-judge saliva assessment were compared (r = 0.500; p < 0.001). BANA tests from the different loci were not significantly associated with sulphide monitor levels. Stepwise multiple-regression analysis of odor-judge measurements in terms of sulphide levels and average BANA scores showed that both log peak sulphide levels as well as BANA scores were significantly factored into the equations, yielding, in all cases, highly significant correlations (multiple r = 0.57, 0.50, and 0.59, respectively, with significance levels of 0.0001, 0.001, and < 0.0001, for whole mouth, tongue, and saliva malodor, respectively). The results suggest that the BANA scores are associated with a component of oral malodor which is independent of volatile sulphide measurements and suggest its use as an adjunct test to volatile sulphide measurement.

Adolescent↗
PubMed1994

Cadaverine as a putative component of oral malodor.

Whereas previous studies have shown correlations between volatile sulphur compounds (VSC) and bad breath levels, it is probable that other compounds found in the oral cavity may contribute to oral malodor. In the present investigation, the possibility that diamines (cadaverine and putrescine) are associated with oral malodor parameters was assessed. Saliva samples from 52 subjects were analyzed for cadaverine and putrescine by HPLC. Oral malodor of whole mouth, tongue, and saliva of the subjects was recorded by an experienced judge on a continuous 10-cm scale; peak and steady-state VSC intraoral levels were measured by the Interscan 1170 sulphide monitor. Log-transformed VSC and diamine levels were compared with odor judge measurements by Pearson analysis and stepwise forward multiple regression. Putrescine scores were not significantly associated with odor judge parameters or with VSC levels (p > 0.1). However, highly significant correlations (p < or = 0.003) were found between cadaverine levels and all three odor judge assessments. In contrast, associations between cadaverine and VSC measurements were non-significant. In an attempt to correlate odor judge results in terms of both VSC and diamines, we carried out stepwise forward multiple regression. Results showed that VSC and cadaverine both factor significantly in explaining each of the odor judge measurements, with multiple r values ranging from 0.545 (p = 0.0002) to 0.604 (p < 0.0001). The results suggest that cadaverine levels are associated with oral malodor, and that this association may be independent of VSC.

Adolescent↗
PubMed1997

Isolation of Enterobacteriaceae from the mouth and potential association with malodor.

Bad breath is a common phenomenon, usually the result of bacterial metabolism in the oral cavity. It is generally accepted that Gram-negative bacteria are responsible for this problem, largely through degradation of proteinaceous substances. In initial experiments, screening of malodorous isolates following outgrowth of samples obtained from saliva, periodontal pockets, and the tongue dorsum yielded enterobacterial isolates. Clinical studies were conducted to examine the prevalence of such bacteria in four different populations: orthodontic patients, malodor clinic patients, complete-denture wearers, and a healthy young population. The prevalence of Enterobacteriaceae in the oral cavities of the denture-wearing population was very high (48.0%) as compared with the other groups: 27.1% in the malodor clinic patients, 16.4% in the normal population, and 13% among orthodontic patients. Isolates of Klebsiella and Enterobacter emitted foul odors in vitro which resembled bad breath, with concomitant production of volatile sulfides and cadaverine, both compounds related to bad breath. When incubated on a sterile denture, enterobacterial isolates produced typical denture foul odor. Isolates exhibited cell-surface hydrophobic properties when tested for adhesion to acryl and aggregation with ammonium sulphate. The results, taken together, suggest that Klebsiella and related Enterobacteriaceae may play a role in denture malodor.

Adolescent↗
PubMed1992

The efficacy of perioperative antibiotic therapy on recovery following tonsillectomy in adults: randomized double-blind placebo-controlled trial.

One hundred and one adult patients undergoing tonsillectomy for chronic/recurrent tonsillitis completed a prospective, randomized, double-blind, placebo-controlled study in which ticarcillin disodium and clavulanate potassium (Timentin) or placebo was administered intravenously at the time of surgery and for 12 hours postoperatively. The patients than received oral amoxicillin and clavulanate potassium (Augmentin) therapy or placebo for an additional seven days. Each patient kept a daily log to assess the incidence and severity of postoperative symptoms. Tonsillar core tissue at the time of surgery, as well as tonsillar fossa cultures after 7 days of treatment, were obtained. Those patients who received antibiotics fared consistently better in the immediate postoperative period compared with the placebo group. Specifically, patients in the antibiotic group experienced significantly less mouth odor, were able to tolerate a regular diet sooner, and resumed their normal activities earlier than did patients who received placebo. Patients who received antibiotics experienced fewer days with mouth odor (p = 0.004). In addition, on postoperative days 3 to 5, the antibiotic group was eating a regular diet (p = 0.05) and had returned to their routine activities earlier (p = 0.045) when compared with the placebo group. Perioperative antibiotic therapy was well tolerated and was effective in minimizing symptoms after tonsillectomy.

Adolescent↗
PubMed1998

Oral malodor and its relevance to periodontal disease in the dog.

Oral malodor has been studied extensively in humans but very little work has been done in dogs where it constitutes a significant problem. In this article we review its causes, methods of detection, and strategies for preventing it. Oral malodor arises from microbial metabolism of exogenous and endogenous proteinaceous substrates in the oral cavity and is exacerbated by periodontal disease and poor oral hygiene. Gram negative bacteria found in plaque, in periodontal pockets, and on the dorsum of the tongue are primarily responsible for odor production. The volatile sulfur compounds (VSCs) hydrogen sulfide and methyl mercaptan, which are produced by these bacteria, are not only primarily responsible for the objectionable odor but have been implicated in the pathogenesis of periodontal disease. Assessment of malodor by portable sulfide monitors correlates well with organoleptic measurements. Reduction of microbial load in the oral cavity due to good oral hygiene practices (such as tooth-brushing) or by the use of appropriate diets or chews may reduce malodor formation.

Animals↗
PubMed1998

Studies of oral malodor in the dog.

We compared currently used methods for assessing oral malodor and found a significant, positive correlation between the concentration of volatile sulfur compounds (VSCs) in breath and the human perception of malodor, but only within a limited range of VSC production. Daily tooth-brushing from an early age maintains a low and consistent level of oral malodor that does not differ significantly throughout the day. In contrast, dogs with elevated concentrations of VSC production suffer from the highest level of malodor early in the morning, prior to feeding and daily activities. Even in older dogs, periodontal therapy can result in a substantial reduction of oral malodor that remains significantly below pre-treatment values for up to 3 months after treatment.

Animals↗
PubMed1999

Effect of a new dental hygiene chew on periodontal health in dogs.

A study was undertaken to determine the effect of a new dental hygiene chew on periodontal health in the dog. The textural properties of this chew are different from previously tested dental hygiene products. The accumulation of dental deposits, development of oral malodor, and development of gingivitis were assessed in two groups of dogs; one fed a dry diet only, and the other fed the same dry diet supplemented by the daily addition of the new dental hygiene chew. Daily addition of the chew to the dry diet was effective in reducing plaque and calculus accumulation on the tooth surfaces, and also reduced the severity of gingivitis and oral malodor as compared to feeding the dry diet only.

Animal Feed↗
PubMed1999

Long-term effects of a dental hygiene chew on the periodontal health of dogs.

The objective of the study was to investigate the long-term effects of feeding a dental hygiene chew that has been shown to be effective in promoting periodontal health in dogs in short-term studies. Oral malodor, calculus, and plaque scores were still significantly lower after 21 months in the group that was receiving the dental hygiene chew, although gingivitis scores no longer differed significantly. There were no reports of any adverse reactions during the study. The results of the study support that feeding of the dental hygiene chew six days per week reduces accumulation of dental deposits, helps maintain periodontal health, and increases the time interval between professional periodontal intervention.

Animal Feed↗
PubMed1990

Oral malodor.

Explore the source record for details and available documents.

Amino Acids↗
PubMed2004

Study on the organoleptic intensity scale for measuring oral malodor.

The 0-5 organoleptic scale is used widely in breath research and in trials to measure the efficacy of anti-odor agents. However, the precise relationship between odor scores and gas concentrations of target odorants is unknown. The purpose of this study was to relate mean organoleptic scores from odor judges (n = 7) for pure odorants (n = 8) representative of those found in oral malodor. Judges used a common 0-5 scale to report the odor intensity of sample sets in random order of concentration. Regression analysis of data showed that odor score was proportional to the log concentration of odorant, and comparison of slopes showed H(2)S to be the most significant in terms of odor power. Detection thresholds (mol.dm(-3)) were: Skatole (7.2 x 10(-13)) < methylmercaptan (1.0 x 10(-11)) < trimethylamine (1.8 x 10(-11)) < isovalerate (1.8 x 10(-11)) < butyrate (2.3 x 10(-10)) < hydrogen sulphide (6.4 x 10(-10)) < putrescine (9.1 x 10(-10)) < dimethyl disulphide (5.9 x 10(-8)). The study demonstrates the exponential nature of the olfactory response and shows that any single compound's contribution to malodor depends on odor power and threshold in addition to concentration.

Butyrates↗
PubMed2004

Clinical assessment of oral malodor by the electronic nose system.

A recently developed electronic nose has not yet been clinically applied to evaluations of oral malodor. This investigation sought to determine whether an electronic nose could clinically assess oral malodor. Twenty-nine healthy adults and 49 patients were assessed by results of an actual organoleptic test, a score representing malodor strength with an electronic nose in "top-note" mode (top-note score), and measurements of volatile sulfur compound (VSC) concentrations. The correlation coefficient between top-note and actual organoleptic scores (r = 0.71) was comparable with the log VSC and actual organoleptic scores (r = 0.63). However, the area under the receiver-operating characteristic plots for top-note score was significantly larger than that for log VSC. In logistic regression analyses with top-note score as a dependent variable, probing depth, tongue coating, and plaque control record each had independent associations. Our findings suggest that the top-note score from an electronic nose examination may be useful for the clinical evaluation of oral malodor.

Adult↗
PubMed2006

Streptococcus salivarius promotes mucin putrefaction and malodor production by Porphyromonas gingivalis.

Although the contribution of the oral microbiota to oral malodor is well-documented, the potential role of Gram-positive micro-organisms is unclear. In the current study, we tested the hypothesis that Gram-positive micro-organisms contribute to malodor production by deglycosylating oral glycoproteins, rendering them susceptible to subsequent proteolysis. To this end, we examined the effect of Streptococcus salivarius on Porphyromonas gingivalis-mediated putrefaction of a model glycoprotein (pig gastric mucin). Malodor was scored by two odor judges, and volatile sulfides were determined with the use of a sulfide monitor. Mucin degradation was followed by electrophoresis on SDS-PAGE. Results showed that the addition of S. salivarius or beta-galactosidase promoted mucin degradation and concomitant malodor production. Addition of glycosidic inhibitors (p-APTG and glucose) inhibited this process. These results suggest that Gram-positive micro-organisms such as S. salivarius contribute to oral malodor production by deglycosylating salivary glycoproteins, thus exposing their protein core to further degradation by Gram-negative micro-organisms.

Animals↗
PubMed2001

The benefits of toothpaste--real or imagined? The effectiveness of toothpaste in the control of plaque, gingivitis, periodontitis, calculus and oral malodour.

Toothbrushing with toothpaste is the most widely used method of home dental care for the populations of the Western world. The traditional role of toothpaste is primarily cosmetic, in aiding the cleaning of teeth and producing fresh breath. Today, however, formulations contain ingredients which may also help oral health by way of reducing dental plaque and improving gingival/periodontal health. This article provides a short review on the usefulness of these chemicals when used primarily in toothpastes.

Anti-Infective Agents, Local↗
PubMed1996

Clinical assessment of bad breath: current concepts.

Bad breath typically originates in the mouth, often from the back of the tongue. Nasal problems also can cause bad breath; odor generated in this manner can be easily distinguished from mouth odor by comparing the odor exiting the mouth and nose. In most cases, good professional oral care combined with a daily regimen of oral hygiene--including interdental cleaning, deep tongue cleaning and optional use of an efficacious mouthrinse---will lead to improvement. This article discusses common causes of oral malodor as well as methods to assess the extent of the problem.

Dental Prophylaxis↗