Halitosis en otorrinolaringología: una revisión de la literatura / Halitosis in otolaryngology: a review of the literature

RESUMEN La halitosis es un motivo de consulta frecuente y que puede repercutir de gran manera en la calidad de vida de quien la presenta. Puede dividirse en halitosis genuina, pseudohalitosis y halitofobia. De las halitosis genuinas, cerca del 90% son secundarias a patología de la cavidad oral. En otorrinolaringología, las principales causas responden a tonsilolitiasis, patología rinosinusal y cuerpos extraños nasales. Existen distintos métodos diagnósticos que permiten medir e identificar la halitosis, con sus beneficios y desventajas. Las medidas generales de higiene oral, así como intervenciones específicas deben estar basadas en la evidencia a cargo de un equipo multidisciplinario que permita garantizar mejores resultados.

ABSTRACT Halitosis is a frequent health problem, that can have a huge impact in the quality of life of those affected. It can be classified as genuine halitosis, pseudohalitosis and halitophobia. Of genuine halitosis, approximately 90% is originated from the oral cavity. In otorhinolaryngology, most frequent causes are tonsiloliths, rhinosinusitis and nasal foreign bodies. There are different diagnostic methods, each one with its benefits and disadvantages. General measures of oral hygiene, as specific interventions must be evidence-based in charge of a multidisciplinary team that guarantees better results.

Oral malodor-reducing effects by oral feeding of Weissella cibaria CMU in Beagle dogs / 대한수의학회지

This study assessed the effects of Weissella cibaria (W. cibaria) CMU on oral health in male and female beagles (n = 18) by measuring oral malodor and periodontal disease-related parameters (calculus, plaque, and gingivitis indices). Oral malodor and indicators of periodontal disease were assessed in five treatment groups: negative control (scaling and 0.24 mg of maltodextrin, n = 3), positive control (0.24 mg of maltodextrin, n = 3), and W. cibaria CMU groups (each n = 4) at low (CMU-L, 2 × 10⁷ colony forming unit [CFU]), medium (CMU-M, 2 × 10⁸ CFU), and high (CMU-H, 2 × 10⁹ CFU) concentrations. After feeding with W. cibaria CMU for 6 weeks, total volatile sulfur compound concentrations in the CMU-L (2.0 ± 1.04 ng/10 mL), CMU-M (2.4 ± 1.05 ng/10 mL), and CMU-H (2.6 ± 1.33 ng/10 mL)groups were significantly lower than in the positive control group (3.2 ± 1.65 ng/10 mL). Also, CMU-L (1.4 ± 0.83 ng/10 mL) and CMU-H (1.9 ± 1.14 ng/10 mL) groups had methyl mercaptan levels lower than that in the positive control group (2.4 ± 1.21 ng/10 mL) at week 2. The plaque index was significantly lower in the CMU-H group (4.5 ± 0.28) than in the positive control group (5.9 ± 1.08) at week 6. W. cibaria CMU could be useful as a novel oral hygiene probiotics for reducing volatile sulfur compounds production and inhibiting plaque growth in companion animals.

Two mechanisms of oral malodor inhibition by zinc ions

Abstract Objectives The aim of this study was to reveal the mechanisms by which zinc ions inhibit oral malodor. Material and Methods The direct binding of zinc ions to gaseous hydrogen sulfide (H2S) was assessed in comparison with other metal ions. Nine metal chlorides and six metal acetates were examined. To understand the strength of H2S volatilization inhibition, the minimum concentration needed to inhibit H2S volatilization was determined using serial dilution methods. Subsequently, the inhibitory activities of zinc ions on the growth of six oral bacterial strains related to volatile sulfur compound (VSC) production and three strains not related to VSC production were evaluated. Results Aqueous solutions of ZnCl2, CdCl2, CuCl2, (CH3COO)2Zn, (CH3COO)2Cd, (CH3COO)2Cu, and CH3COOAg inhibited H2S volatilization almost entirely. The strengths of H2S volatilization inhibition were in the order Ag+ > Cd2+ > Cu2+ > Zn2+. The effect of zinc ions on the growth of oral bacteria was strain-dependent. Fusobacterium nucleatum ATCC 25586 was the most sensitive, as it was suppressed by medium containing 0.001% zinc ions. Conclusions Zinc ions have an inhibitory effect on oral malodor involving the two mechanisms of direct binding with gaseous H2S and suppressing the growth of VSC-producing oral bacteria.

The effect of oil pulling with rice bran oil, sesame oil, and chlorhexidine mouth rinsing on halitosis among pregnant women: A comparative interventional study.

Context: Rice bran oil, owing to its potential antioxidant benefits, could be an effective and novel alternative to sesame oil for oil pulling. As it is safe and a growingly popular edible oil, it may be acceptable during pregnancy, especially in the Indian context where women may be hesitant to use chemical plaque control methods for preventing halitosis. Aims: The present study was conducted to compare the effects of oil pulling with rice bran oil, oil pulling with sesame oil, and oil pulling with chlorhexidine mouth rinsing on reducing halitosis among pregnant women. Settings and Design: Thirty pregnant women who attended the Gynecology Outpatient Department (OPD) of Muslim Medical Hospital, Haran Khana Road, Pani Gate, Vadodara, Gujarat, India, were recruited in the present randomized double-blind interventional study. Subjects and Methods: Eligible pregnant women individuals who gave consent for the study were randomly allocated to receive the interventions under investigation. Halitosis was measured at baseline and after 14 days of intervention using TANITA breath checker HC-212M-BL. Statistical Analysis Used: Data entry was done in Microsoft Excel 2007, and statistical analysis was performed using SPSS version 17. Wilcoxon signed rank tests were used to interpret the differences in baseline and postintervention halitosis levels. One-way ANOVA was done to compare the mean reduction in halitosis scores of the three intervention groups. Results: There was a statistically significant reduction in the grades of halitosis at baseline and 14 days after intervention for all the three groups. There was no statistically significant difference between chlorhexidine mouth rinsing, oil pulling with sesame oil, and oil pulling with rice bran oil in halitosis reduction. Conclusions: Rice bran oil when used in oil pulling was effective in reducing halitosis. It performed comparably and marginally superior to other agents tested in the study when change in halitosis postintervention was considered.

Effects of Kaki (Persimmon) Extract-containing Diet on Levels of Volatile Sulfur Compounds in Oral Gas and Feces, as well as on Subjective Fecal Odor, in Healthy Adults / 日本補完代替医療学会誌

<b>Objectives:</b> To examine in two tests the potential of kaki (persimmon) extract-containing diet (KE diet) to reduce malodorous volatile sulfur compounds (VSC), such as hydrogen sulfide (H₂S), methyl mercaptan (CH₃SH) and dimethyl sulfide (CH₃SCH₃), as well as on subjective fecal odor on healthy adults.<br> <b>Methods:</b> In the first test, 11 subjects were given garlic-containing soup. For a period of time, they were given a single dose of KE diet (150 mg as kaki extract) with water, and only water for the rest of the study period. Two hours after the administration, oral gas samples were collected from individual subjects and analyzed for VSC. In the second test, 14 subjects were given a single dose of KE diet for 7 days. Fecal samples were collected from individual subjects before and after the 7-day KE diet intervention. Levels of VSC were determined and the magnitude of subjective fecal odor was estimated based on ratings in the self-administered questionnaire.<br> <b>Results:</b> Levels of CH₃SCH₃ in oral gas were significantly lowered when subjects were on a KE diet. On the other hand, although decreases in the level of any VSC in feces before and after the 7-day KE diet intake did not reach a statistical significance, subjective fecal odor significantly improved by the KE diet intake.<br> <b>Conclusion:</b> KE diet appears to have a beneficial effect on VSC-associated oral malodor and subjective fecal odor.<br>

Oral Malodor-A Menace To Periodontist.

Oral malodor significantly affects our daily social life. It affects a large population and is a psychological setback to those suffering from it. This common disease has been really ignored for too long by periodontists, even though the most common cause is related to subgingival microbiota and coating of the tongue. It has been proved that a link exists between oral malodor and periodontal disease. Similar processes exist for the development of oral malodor and the progression of periodontitis. Compounds associated with oral malodor like volatile sulfur compounds (VSC’s) are mainly produced by the gram negative, anaerobic bacteria associated with periodontitis. These VSC may further contribute to the etiology and pathogenesis of periodontal disease, so the purpose of this review article was to correlate the relationship between oral malodor and adult periodontitis.

Unmasking oral malodor: A review.

Oral malodor is one of the major growing concern of patients today as it is fundamental to their overall personality. Although the majority of malodor is of oral origin, there are multiple other systemic causes that have to be addressed. Correct diagnosis of the cause of the malodor and prompt treatment can render the patient satisfied. There have been newer developments in faster and more efficient detection of the levels of malodor, and an array of treatment options are present in the market today. It is crucial for the dentist to have a sound understanding of this prevalent oral condition and provide effective intervention programs. This article reviews the various causes and the diagnostic modalities which will help us treat this multifaceted condition.

Halitosis: a review of basic principles

Halitosis, also known as bad breath or oral malodor, is the general term used to describe any disagreeable odor in expired air, regardless of whether the odorous substances originate from oral or non-oral sources. Bad breath can be detrimental to one’s self-image and confidence, causing social, emotional and psychological anxiety. This paper provides a comprehensive review of the historical background, prevalence, social aspects and pathological causes of halitosis as well as the dental professional’s responsibility.

The effect of a full mouth disinfection on oral malodor in chronic periodontitis patients / 대한치주과학회지

Halitosis, defined as an unpleasant oral odor, is a commonly experienced condition with a variety of etiological factors and may cause a significant social or psychological handicap to those suffering from it. In most cases, halitosis originates within the oral cavity itself and patients with periodontal disease often suffer from oral malodor. The most common cause of this disease is related to microbiota which reside on the tongue and in the periodontal pocket. This study was undertaken to examine the effect of full mouth disinfection including tongue scraping on oral malodor in a group of patients with chronic periodontitis. The relationship between halitosis and oral health status was also investigated. The volatile sulfur compounds (VSC) scores were significantly correlated with Plaque Index, Bleeding Index, pocket depth, and tongue coating score. The organoleptic ratings were significantly associated with Plaque Index, Bleeding Index, and tongue coating score. The VSC scores and organoleptic ratings correlated strongly with each other. Full mouth disinfection resulted in a significant reduction in the VSC scores, organoleptic ratings, and self-perception of malodor up to 12 weeks. This study indicates that in patients with chronic periodontitis, a full mouth disinfection including tongue scraping has a significant effect in the treatment of oral malodor.

The change of oral volatile sulfur compounds(VSC) concentration after periodontal treatment / 대한치주과학회지

Oral malodor may cause a significant social or psychological handicap to those suffering from it. Oral malodor has been correlated with the concentration of volatile sulfur compounds (VSC) produced in the oral cavity. Specific bacteria identified in the production of VSC have been reported and many of these bacteria are commonly suspected periodontal pathogens. The aim of this study was to estimate the change of the VSC concentration after periodontal treatment. Twenty subjects with probing depth (PD) > or =5mm (experimental group) and 20 subjects with PD <5mm (control group) participated. VSC concentration measurement was made with gas chromatography. VSC concentration was measured at pre-treatment, 2 weeks after scaling and 1 month after periodontal treatment(root planning and flap operation). Maximum probing depth and bleeding on probing(BOP) were also examed at pretreatment and 1 month after periodontal treatment. The conclusions were as follow: 1. In the experimental group VSC concentration and CH3SH/H2S ratio were higher than control group. (p<0.05) 2. Both VSC concentration and CH3SH/H2S ratio showed decrease after periodontal treatment. But only CH3SH/H2S ratio after 1 month periodontal treatment was statistically significantly different from pre-treatment. (p<0.05) 3. CH3SH/H2S ratio tended to be on increase according to maximum probing depth and bleeding on probing. Periodontal disease could be a factor that caused oral malodor and oral malodor could be decreased after periodontal treatment.