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PubMed1997

Reduction of oral malodor by oxidizing lozenges.

The main purpose of the study was to examine the anti-malodor properties of oxidizing lozenges, as compared to breath mints and chewing gum. Healthy, young adult volunteers (N = 123; mean age 24.5 years) were measured for oral malodor-related parameters (whole mouth odor measured by 2 judges; tongue dorsum posterior odor using the spoon test; volatile sulphide levels; salivary levels of cadaverine and putrescine; and 2 versions of an oral rinse test) on the first afternoon of the study. They were then assigned randomly to one of 6 groups (2 brands of breath mints, chewing gum with no active ingredients, regular and full-strength oxidizing lozenges, and a no-treatment control), and instructed to employ the treatment before bedtime, the next morning, and in the early afternoon 3 hours prior to measurements, which were carried out 24 hours following baseline measurements. Volunteers also estimated the level of their own whole mouth and tongue odors at baseline and post-treatment. The data showed that, among treatments, only the full-strength oxidizing lozenge significantly reduced tongue dorsum malodor, as determined by the spoon test. The full-strength lozenge also yielded a significant increase in the modified oral rinse test, presumably due, at least in part, to residual oxidizing activity retained in the oral cavity. Self-estimations of whole mouth and tongue malodor by volunteers were significantly correlated with corresponding-judge assessments, suggesting some degree of objectivity in assessing one's own oral malodor.

Administration, Oral↗
PubMed1998

The effect of a 1-stage full-mouth disinfection on oral malodor and microbial colonization of the tongue in periodontitis. A pilot study.

Oral malodor affects a large proportion of the population and may be the cause of a significant social and psychological handicap. This pilot study aimed to examine whether a 1-stage full-mouth disinfection in periodontitis patients (scaling and root planing of all pockets within 24 hours together with the application of chlorhexidine to all intra-oral niches followed by chlorhexidine mouth rinsing for 2 months) resulted in a significant improvement in malodor when compared to a fractionated periodontal therapy (consecutive root planings per quadrant, at a 1 to 2 week interval). The baseline and outcome data concerning oral malodor were linked to the presence of tongue coating and to its roughness (fissures). Twenty-four patients with severe periodontitis were randomly allocated to test and control groups. At baseline and after 1 and 2 months, the concentration of volatile sulfur compounds (VSC) in the mouth was measured and organoleptic ratings (expired air and total mouth air) were given. Plaque samples were collected from the dorsum of the tongue to calculate the number of colony forming units (CFU) per ml (anaerobic culturing) as well as the number of pigmented CFU/ml. Both the baseline organoleptic ratings and the VSC scores correlated well with the presence of tongue coating but not with the tongue roughness. Because a correlation between tongue coating and its microbial load could not be detected, it was hypothesized that the tongue coating per se, and not the bacteria, might be responsible for the malodor. The 1-stage full-mouth disinfection resulted in a faster and additional reduction in the organoleptic ratings of the oral malodor, even after 2 months. This might be explained by the improved periodontal outcome and/or the more significant reduction in the CFU/ml of pigmented species. In contrast to the organoleptic ratings, which were significantly reduced in both treatment groups (when compared to baseline), the VSC levels remained unchanged. This pilot study indicates that a 1-stage full-mouth disinfection has, in comparison to a standard periodontal therapy, additional beneficial effects in the treatment of oral malodor.

Adult↗
PubMed2001

Relationship between sulcular sulfide level and oral malodor in subjects with periodontal disease.

BACKGROUND: The relationship between oral malodor and sulfide levels in periodontal pockets (pS) has not yet been determined. The aims of this study were: 1) to identify the correlation among oral malodor, pS levels, and the BANA (benzoyl-DL-arginine-naphthylamide) test and 2) to recognize the interaction between oral malodor, demographic factors, tongue coating, and periodontal condition. METHODS: Eighty-one periodontal patients participated in this study. A portable sulfide monitor and organoleptic method were used to evaluate oral malodor. Demographic data included age, gender, race, and smoking habits. The volume of tongue coating and periodontal condition for all teeth were assessed. The pS levels of 3 different radiographic bone loss (RBL) sites: RBL < 2 mm, healthy; RBL > or = 2 to < 4 mm; low to moderate; RBL > or = 4 mm, severe, were measured using an industrial sulcular sulfide-monitoring device. Subgingival plaque samples from the above 3 sites and tongue scraping were examined by the BANA test. RESULTS: The volume of tongue coating (P<0.001), extent of periodontal disease (P<0.05), pS levels of the sites with low to moderate bone loss (P<0.05), and BANA score of tongue scrapings (P<0.05) were significantly associated with oral malodor. Stepwise multiple regression analysis examined the degree of association between oral malodor and potential explanatory variables. The volume of tongue coating and percent of sites BOP (bleeding on probing) were significantly associated with oral malodor. Females and smoking habit were negatively correlated with organoleptic measurements. CONCLUSIONS: The pS level of the representative sites with low to moderate bone loss demonstrated a modest association with oral malodor. Oral malodor in periodontal patients was primarily associated with tongue coating and gingival inflammation.

Adult↗
PubMed2002

The effect of removable partial dentures on periodontal health of abutment and non-abutment teeth.

BACKGROUND: A removable partial denture (RPD) is a common treatment available for restoration of partially edentulous ridges. Longitudinal studies indicate that RPDs have been associated with increased gingivitis, periodontitis, and abutment mobility. METHODS: A total of 205 patients with RPDs participated in this study. There were 80 males and 125 females aged 38 to 89, with 123 maxillary and 138 mandibular RPDs. Patients were wearing existing RPDs for different periods ranging from 1 to 10 years. A two-part questionnaire was devised for this study. In the first part, patients answered questions on gender; age; smoking habits; denture age; denture wearing habits; mouth odor; and problems with food accumulating under the denture base, on the outside surface of the denture, and on the outside surface of remaining teeth after eating. The Kennedy classification, material, denture support, denture base shape, and number of teeth in contact, number of existing clasps, and occlusal rests were categorized. The quality of denture construction was also evaluated. In the second part of the questionnaire, baseline recordings of plaque (PI), gingival (GI), and calculus (CI) indexes were made, and Tarbet index (TI), as well as probing depth (PD), gingival recession (GR), and tooth mobility (TM) were measured, both on abutment and non-abutment teeth. RESULTS: Significant differences (P <0.01) were noted for PI, Cl, GI, PD, TM, and GR between abutment and non-abutment teeth, with abutment teeth showing more disease. CONCLUSIONS: RPD design plays an important role in the state of the periodontium. Appropriate design and good oral hygiene may decrease the appearance of periodontal disease.

Adult↗
PubMed2003

A salivary incubation test for evaluation of oral malodor: a pilot study.

BACKGROUND: Breath odor is scored by different techniques, each with its own shortcomings. Organoleptic ratings are uncomfortable for the patient, subjective, influenced by external parameters including food and cosmetics, and especially lack international calibration. Portable sulphide monitors are relatively expensive and neglect several major malodorous molecules (e.g., butyric and propionic acids, putrescine, and cadaverine). Gas chromatography necessitates expensive devices and experienced technicians. This pilot study explored the applicability of a new technique (saliva incubation) by comparing its discrimination power, in a morning bad breath inhibition study of antiseptics, to those of hydrogen sulphide (H2S) measurement devices and organoleptic ratings. METHODS: After a professional cleaning, 8 periodontally healthy students abstained from all means of mechanical plaque control for 5 experimental periods of 7 days, with intervening washout periods of at least 2 weeks. During each experimental period, the students rinsed only twice daily with different antiseptics. At day 7, morning breath was scored clinically (volatile sulphide compound [VSC] level and organoleptic ratings), and 1.5 ml of saliva was collected and divided between 3 glass tubes that were sealed and incubated (37 degrees C, anaerobic chamber). Immediately after collection and after 3 and 6 hours of incubation, the headspace air in one of the tubes was examined for VSC production and organoleptic measurements. RESULTS: The investigations of the incubated saliva correlated well with the 7-day intraoral VSC recordings and organoleptic ratings (P < or = 0.005). Moreover, evaluations showed a similar interproduct ranking for their efficacy in malodor control. The power analyses indicated a higher discrimination power for the saliva incubation test than for the intraoral registrations. CONCLUSIONS: The strong correlation between odor production of incubated saliva and clinical assessments suggests that the saliva incubation test may be used as an indirect method to measure oral malodor and can be employed to investigate the antimalodor effectiveness of oral hygiene products.

Adult↗
PubMed2006

Assessment of treatment responses to dental flossing in twins.

BACKGROUND: The purpose of this study was to assess treatment responses to dental flossing in twins. METHODS: The study was a two-treatment, examiner-blind, randomized parallel group, controlled study. Fifty-one twin pairs between 12 and 21 years of age were randomized to a 2-week supervised and unsupervised treatment regimen consisting of 1) tongue brushing and toothbrushing (TB) and 2) TB + flossing (TB + Fl). Clinical endpoints were gingival bleeding (papillary bleeding score [PBS]) and oral malodor (levels of volatile sulfur compounds [VSC]). Analysis of variance and covariance methodologies were employed to analyze the data. RESULTS: Baseline average PBS values were 1.352 and 1.345 for the TB + Fl and TB groups, respectively (P=0.937). After 2 weeks of treatment, the TB + Fl group had a statistically significant decrease in PBS values of 0.558 (41.5% versus baseline), whereas the TB group showed no improvement from baseline. The change from baseline for the TB + Fl group was superior to that for the TB group (P<0.001). Similar findings were observed for the number of baseline papillary bleeding sites. Baseline average intraoral halimeter values were 45.91 and 41.75 for the TB+Fl and TB groups, respectively (P=0.504). Both treatment regimens demonstrated highly statistically significant reductions in intraoral halimeter values versus baseline (all P<0.001) and the difference between treatment groups was not statistically significant (P=0.339). Similar findings were found for expired air. CONCLUSIONS: In a well-matched twin cohort, tongue and toothbrushing plus flossing significantly decreased gingival bleeding after 2 weeks.

Adolescent↗
PubMed2006

Periodontitis as a manifestation of chronic benign neutropenia.

BACKGROUND: A subcategory of chronic neutropenia is chronic benign neutropenia, which is characterized by a prolonged non-cyclic neutropenia as the sole abnormality, with no underlying disease to which the neutropenia can be attributed. Chronic neutropenia is defined as a low absolute neutrophil count for >6 months. In this presentation, periodontitis seems to be the sole manifestation of a juvenile patient with chronic benign neutropenia. A 7-year-old white male presented with periodontitis of the primary dentition and early tooth loss. His medical and dental history was otherwise unremarkable. Suspecting some systemic illness as the underlying cause, the patient was referred for a medical consultation and a series of blood tests. METHODS: Blood analyses included a complete blood count (CBC), sequential multiple analyzer 24 (SMA 24), glycated hemoglobin levels, and screening for anti-white blood cell antibodies. Blood levels of calcium, vitamin D, dihydroxyvitamin-D, phosphorus, and alkaline phosphatase were also measured. Liver function tests were performed. RESULTS: Following analysis of recent and previous blood test results, a diagnosis of chronic benign neutropenia was assigned. The patient's periodontal condition was treated with scaling and root planing, oral hygiene instruction, and antimicrobial mouthrinses. Three-month recall visits were recommended as a follow-up protocol. CONCLUSIONS: This case represents the importance of diagnosing periodontal disease as a possible indicator of underlying systemic disease. When a patient presents with an unusual, generalized form of periodontal disease, screening for systemic disorders is required, as the oral condition may be the first or only manifestation of a systemic abnormality. This case also illustrates the reason for the change in classification of such a condition to periodontitis as a manifestation of systemic disease. This condition was previously classified as prepubertal periodontitis, a disease diagnosis that focused on the patient's age at the onset of the disease rather than the etiology.

Aggressive Periodontitis↗
PubMed1990

[A study of the effectiveness of denture cleanser on human breath].

The purpose of this study is to measure the human breathes of denture wearers by using breath sensor, and to evaluate the influence of denture cleansing. The following results were obtained. 1. There is a possibility that the human breathes of full denture wearers may originate from their dentures. 2. There is a possibility that the cleansed dentures may cover the smell of the patient's oral mucosa itself and may reduce the apparent human breathes. Anyhow, the human breathes of denture wearers reduce significantly by using the denture cleanser.

Breath Tests↗
PubMed2005

Evaluation of the respiratory elimination kinetics of selenium after oral administration in sheep.

OBJECTIVE: To evaluate the respiratory excretion and elimination kinetics of organic and inorganic selenium after oral administration in sheep. ANIMALS: 38 crossbred sheep. PROCEDURES: Selenium was administered PO to sheep as a single dose of 0, 1, 2, 3, or 4 mg/kg as sodium selenite or selenomethionine. Expired air was collected and analyzed from all sheep at 4, 8, and 16 hours after administration. RESULTS: Clinical signs consistent with selenium intoxication were seen in treatment groups given sodium selenite but not in treatment groups given the equivalent amount of selenium as selenomethionine. However, a distinct garlic-like odor was evident in the breath of all sheep receiving 2 to 4 mg of selenium/kg. The intensity of odor in the breath did not correlate with clinical signs in affected animals receiving sodium selenite treatment. CONCLUSIONS AND CLINICAL RELEVANCE: The concentration of selenium in expired air was greater in sheep receiving selenium as selenomethionine than sodium selenite. The concentration of selenium in expired air from sheep receiving high doses of selenium (3 and 4 mg of selenium/kg) was larger and selenium was expired for a longer duration than the concentration of selenium in expired air from sheep receiving low doses of selenium (1 and 2 mg of selenium/kg).

Administration, Oral↗
PubMed2000

Self-perception of breath odor: role of body image and psychopathologic traits.

Oral malodor is a common complaint in Western society and is an important reason why adults seek dental counsel. In the present study, an attempt was made to evaluate the contribution of psychopathologic traits and of body-image char acteristics on participants' self-perception of breath odor. 60 participants without any specific complaint concerning breath odor (55% men: M age 35.5 yr., SD= 10) were evaluated. Variables included self-evaluation of participants' own breath odor (gener ally and current), an organoleptic evaluation of an impartial judge of odor, measurement of the volatile sulfide level in the oral cavity, and questionnaires referring to psychopathologic symptoms and body-image characteristics. Stepwise regression analysis showed that in addition to impartial measurements, self-perception of breath odor among noncomplaining subjects can be predicted by their feelings and attitudes toward the body and by their hostility.

Adult↗