Preliminary investigation of a combined herbal extract of Aruncus dioicus, Cirsium nipponicum, and Ocimum basilicum for halitosis.

BACKGROUND: Halitosis, the unpleasant odor in the oral cavity, has garnered increased attention and concern due to the growing significance of social interaction. SGE-107, a blend of 3 botanical drugs-Korean goat's beard, Cirsium tanakae, and Basil-with caffeic acid as its indicator component. This study aims to investigate the efficacy of SGE-107 in treating halitosis in patients with mild gastrointestinal symptoms. METHODS: We enrolled 25 participants with oral malodor and dyspeptic symptoms. We assessed the severity of halitosis using the visual analog scale. Throughout a 4-week period of administering SGE-107, we evaluated both objective and subjective parameters, including the halitosis-associated life-quality test, the Korean gastrointestinal symptom rating scale, levels of volatile sulfur compounds, salivary flow rate, oral moisture, tongue index, Winkel tongue coating index, and tongue temperature. RESULTS: After the intervention period, both the visual analog scale (5.88 ±â€…1.03 vs 2.38 ±â€…0.93, P < .001) and the scores of the halitosis-associated life-quality test (31.21 ±â€…11.78 vs 13.83 ±â€…6.38, P < .001) showed significant reductions. The proportion of participants with abnormal levels of methyl mercaptan (a volatile sulfur compound) also significantly decreased (17, 70.8% vs 9, 37.5%, P = .039). Furthermore, there were significant improvements in reflux, constipation, diarrhea, and the total scores on the Korean gastrointestinal symptom rating scale. Throughout the study period, only 2 participants experienced mild adverse events. CONCLUSION: SGE-107 appears to be a safe and effective treatment for halitosis-associated with gastrointestinal symptoms; nevertheless, the limited sample size necessitates further large-scale randomized, controlled studies to confirm our findings.

Antimicrobial Effects of Edible Mixed Herbal Extracts on Oral Microorganisms: An In Vitro Study.

Background and Objectives: The oral cavity is inhabited by pathogenic bacteria, whose growth can be inhibited by synthetic oral drugs, including antibiotics and other chemical compounds. Natural antimicrobial substances that elicit fewer negative side effects may serve as alternatives to synthetic agents for long-term use. Thus, the aim of this study was to evaluate the effects of edible mixed herbal extracts on the growth of oral pathogenic bacteria. Materials and Methods: The yield of each herbal extract was as follows: 5% Schizonepeta tenuifolia Briq (STB), 10.94% Mentha piperascens (MP), 5.47% Acanthopanax sessiliflorus Seem (AS), and 10.66% Glycyrrhiza uralensis (GU). The herbal extracts used included 0.5 mg/mL STB, 1.5 mg/mL MP, 1.5 mg/mL AS, and 2.0 mg/mL GU. Antimicrobial tests, morphological analyses (using scanning electron microscopy), microbial surface hydrophobicity measurements, and oral malodor reduction tests were performed using each extract. Statistical analyses were performed with IBM® SPSS® (version 24), using paired t-tests. Results: The mixed herbal extracts significantly inhibited the growth of Streptococcus mutans, Enterococcus faecalis, Candida albicans, and Porphyromonas gingivalis compared to the control (p < 0.001). Scanning electron microscopy results further revealed altered cellular morphology in the groups treated with the mixed herbal extracts. Additionally, the hydrophobicity assay results showed that the mixed herbal extracts reduced the oral adhesion capacities of bacteria (p < 0.001). Administration of the mixed herbal extracts also reduced the levels of volatile sulfur compounds, the main contributors to oral malodor (p < 0.001). Conclusions: Edible mixed herbal extracts can effectively eliminate oral pathogens and may be useful for improving oral health. The herbal extracts used were effective against all species of oral pathogens studied in this report.

The impact of aromatherapy-based oral care on oral conditions, salivary pH, and halitosis in older adults with dementia: Pilot study.

Inadequate oral care and poor oral health in older adults are known to increase the risk of dementia. Dementia patients residing in long-term care facilities are especially vulnerable to oral diseases due to their care-resistant behavior. This study aimed to investigate the effects of a 7-day oral care program based on an aroma solution in 58 dementia patients (29 each in the experimental and control groups) admitted to a long-term care hospital in South Korea. The experimental group received oral care with a solution containing peppermint, tea tree, and lemon essential oils, and the control group with a saline solution. The effectiveness of oral care was assessed by the participants' oral condition, salivary pH, and halitosis. The experimental group showed significant improvements (P<.001) in all three outcomes, indicating that oral care with an aroma solution can improve the oral health of older dementia patients residing in long-term care facilities.

The Effect of Mouthwash with Sambucus williamsii var. coreana Extract on Halitosis: A Randomised, Double-Blind, Placebo-Controlled Study.

PURPOSE: To clinically assess the effects of a mouthwash containing an extract of Sambucus williamsii var. coreana, a natural ingredient, on halitosis and halitosis-causing bacteria. MATERIALS AND METHODS: This randomised, double-blind, placebo-controlled study included 77 participants. The experiment was conducted at Misoplant Dental Clinic in Busan, South Korea. Participants were divided into two groups: a control group consisting of 38 participants, to who whom a saline gargle was administered 1x/day for 30 s, and an experimental group consisting of 39 participants, who used a mouthwash containing Sambucus williamsii var. coreana extract 1x/day for 30 s for 1 day or 5 days. Halitosis was measured for 30 s in the absence of brushing or moisture. A sterile #15 paper point was placed in the gingival sulcus for 10 s, after which it was analysed using the polymerase chain reaction (PCR) method. The measurement time points were defined as follows: 'baseline': before starting the gargling routine; '1 day of treatment': immediately after gargling once on day 1; '5 days of treatment ': after gargling once a day for 5 days. Clinical results were statistically analysed using SPSS 24.0 for Windows. RESULTS: Compared to the control group, halitosis clearly decreased in the experimental groups '5 days of treatment' and '1 day of treatment' (p < 0.05). There were statistically significant differences in the levels of halitosis-causing bacteria between the two groups; bacterial concentration in the experimental group decreased statistically significantly from day 1 to day 5 day of gargling with Sambucus williamsii var. coreana extract (p < 0.05). Accordingly, we clinically verified that Sambucus williamsii var. coreana has antibacterial effects against oral bacteria. CONCLUSION: The application of Sambucus williamsii var. coreana extracts effectively reduced halitosis and halitosis-causing bacteria. Therefore, mouthwashes containing Sambucus williamsii var. coreana extract can be used as an effective substitute for chemical formulations for treating halitosis.

Alternative therapies in controlling oral malodour: a systematic review.

Is there a role for alternative therapies in controlling intra-oral halitosis? Treatments other than tongue cleaning and anti-halitosis products containing zinc, chlorhexidine and cetylpyridinium chloride were considered as alternative therapies. Four databases were searched (PubMed, EMBASE, Web of Science and The Cochrane Library). Inclusion criteria were: examination of alternative halitosis therapies, study population with oral malodour, a (negative or positive) control group and evaluation of breath odour via organoleptic and/or instrumental assessment. Data were extracted for descriptive analysis. The screening of 7656 titles led to the inclusion of 26 articles. Analysis showed heterogeneity concerning the population of interest (from cysteine-induced to genuine halitosis), the examined treatment and the reported outcomes. This made a meta-analysis impossible. Essential oils, fluoride-containing products and herbal substances were the most studied. Results varied enormously and none of the active ingredients had an unambiguously positive effect on the malodour. The risk of bias was assessed as high in all articles. Given the fact that little evidence was found for each of the investigated treatments, it could be concluded that there is currently insufficient evidence that alternative therapies are of added value in the treatment of halitosis.Clinical relevanceScientific rationale:Halitosis is a common problem causing social isolation. Out of embarrassment, patients search the internet, leading to many questions about alternative solutions (e.g. oil pulling, herbs). This is the first systematic review on these alternative therapies.Principal findings: Results varied among studies. Some promising results were found for fluoride-containing toothpastes and probiotics. For other products (such as herbal and antibacterial products and essential oils) results were inconsistent. Long-term follow-up studies on these products are scarce. Moreover, the quality of the studies was poor.Practical implications:No clear evidence was found to support a certain alternative anti-halitosis therapy.

Revisão de literatura: halitose e tratamento homeopático

Trabalho realizado a partir de revisão bibliográfica com objetivo de mapear as manifestações da halitose e analisar as possibilidades de tratamento de acordo com a medicina tradicional e homeopática. Foram utilizados artigos científicos obtidos através da plataforma pubmed, além da pesquisa na literatura homeopática tradicional. O tratamento não tradicional abordado neste estudo, baseia-se nos princípios da cura homeopática. De acordo com o princípio da similitude, o medicamento de escolha para o tratamento homeopático para a halitose, deve ser individualizado e baseado na totalidade sintomática do indivíduo. Sendo assim, o medicamento escolhido deve apresentar efeitos semelhantes aos sintomas da doença a ser tratada e assim estimular, nos indivíduos que administrarem tal medicamento, reação contra sua própria patologia. Novos estudos são necessários para se estabelecer um consenso para o tratamento tradicional da halitose. Em relação ao manejo homeopático, o tratamento ainda apresenta- se pouco documentado pelo baixo volume de publicações científicas na área.(AU)

Paper carried out from a bibliographical review with the objective of mapping the manifestations of halitosis and analyzing the possibilities of treatment according to traditional and homeopathic medicine. Scientific articles obtained through the pubmed platform were used and also a research in traditional homeopathic literature was made.The non-traditional treatment covered in this study is based on the principles of homeopathic healing. According to the principle of similarity, the medicine of choice for the homeopathic treatment of halitosis must be individualized and based on the individual's symptomatic totality. Therefore, the chosen medication must have effects similar to the symptoms of the disease to be treated and thus stimulate, in individuals who administer such medication, a reaction against their own pathology. Further studies are needed to establish a consensus for the traditional treatment of halitosis. Regarding homeopathic management, the treatment is still poorly documented due to the low volume of scientific publications in the area.(AU)

Effect of essential oils on oral halitosis treatment: a review.

Halitosis is a very common condition which may affect up to 30% of the population. In about 90% of the cases, halitosis originates in the mouth due to inadequate plaque control, periodontal disease, dry mouth, faulty restorations, and in particular due to excessive bacterial growth. Oral malodor is mainly caused by a microbial degradation of amino acids into volatile, bad-smelling gases (volatile sulfur compounds - VSCs). Management of oral malodor is directed primarily at managing and reducing the VSC-producing bacteria count as well as masking the odor. Essential oils have been used for this purpose in traditional medicine for centuries. In the present review, data on the antimicrobial activity of essential oils against relevant oral VSC-producing bacteria are compiled and compared. Additionally, other positive aspects of essential oils with regard to oral odor are considered.

Probiotics-A complete oral healthcare package.

Probiotics are living bacterial cells that have significant therapeutic potential for treating human infectious diseases. There is a huge market for probiotics in the pharmaceutical sector. They have been frequently used to treat the gastrointestinal diseases and improve gut immunity. In this review, the strains currently in use for manufacturing oral probiotic formulations are discussed. The review further recommends the use of probiotics for the control of various oral health disorders, like dental caries, periodontitis, gingivitis, halitosis, burning mouth syndrome, and oral cancer. Finally, this review also explores the use of various commercial probiotic products in maintaining oral health, their market values, and government acts and regulations that are relevant to the production and marketing of probiotics. Probiotics have tremendous therapeutic potential and more in-depth research must be done on these beneficial bacteria to make them one of the leading drugs in treating oral disorders.

Drug-related Halitosis: A Systematic Review.

PURPOSE: Halitosis is an unpleasant breath odor which can be bothersome to individuals. Extra-oral halitosis is a type of halitosis caused by systemic conditions, bloodborne diseases, or pharmaceutical therapy. It is not related to local factors in the oral cavity. This systematic review aimed to identify the medications that can cause extra-oral halitosis. MATERIALS AND METHODS: This study was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA). We searched online databases and also included hand searching to find relevant articles. Two authors independently performed the screening, data extraction and quality assessment of the included articles using the Cochrane Collaboration assessment tool. RESULTS: Thirty-four studies met the eligibility criteria. The medications which can cause extra-oral halitosis were categorised into 10 groups: acid reducers, aminothiols, anticholinergics, antidepressants, antifungals, antihistamines and steroids, antispasmodics, chemotherapeutic agents, dietary supplements, and organosulfur substances. CONCLUSION: Pharmaceutical therapy is a potential source of extra-oral halitosis. This finding can help clinicians detect the probable causes of halitosis. Further studies are needed to definitely determine the role of various medications in causing extra-oral halitosis.

Reduction of Halitosis by a Tablet Containing Weissella cibaria CMU: A Randomized, Double-Blind, Placebo-Controlled Study.

Halitosis is referred to as an unpleasant odor coming from the mouth. Recently, probiotics have been studied as an alternative prevention for halitosis. The aim of this study was to evaluate the effects of probiotic bacterium Weissella cibaria Chonnam Medical University (CMU)-containing tablets (1 × 108 colony forming units [CFU]/g) on oral malodor. The randomized, double-blind, placebo-controlled trial was conducted in 92 healthy adults (20-39 years of age) with bad breath. All subjects were randomly assigned to a test (probiotic, n = 49) or control (placebo, n = 43) group after dental scaling and root planing. The tablets were taken once daily for 8 weeks. Measurements included an organoleptic test (OLT), volatile sulfur compounds (VSC), bad breath improvement (BBI) scores, and the oral colonization of W. cibaria CMU. This study also assessed safety variables of adverse reactions, vital signs, and the findings of hematology and blood chemistry. Most of the variables were measured at baseline, 4, and 8 weeks. Safety-related variables were measured at baseline and 8 weeks. At week 4, a significant decrease in OLT and VSC results was observed in the test group while BBI scores were significantly reduced at week 8 (P < .05). Statistically significant intergroup differences were observed for changes in W. cibaria number at weeks 4 and 8. No safety issues were encountered in either group. These results indicate that W. cibaria CMU tablets could be a safe and useful oral care product for controlling bad breath.

Antimicrobial photodynamic therapy with Bixa orellana extract and blue LED in the reduction of halitosis-A randomized, controlled clinical trial.

BACKGROUND: This study aimed to evaluate the reduction of halitosis when using antimicrobial photodynamic therapy (aPDT) with Bixa orellana extract and blue light-emitting diode (LED). METHODS: Forty-four UNINOVE students or employees with a diagnosis of sulfide (H2S) ≥ 112 ppb in gas chromatography were selected. The patients were randomly divided in groups: Group 1 (n = 15): aPDT with annatto and LED; Group 2 (n = 14): tongue scraping; Group 3 (n = 15): tongue scraping and aPDT. For aPDT, a wasBixa orellana extract used in a concentration of 20 % w/v (Fórmula e Ação®, São Paulo, Brazil) on the tongue for 2 min, associated with a blue-violet LED (Valo Cordless Ultradent® Products, Inc., South Jordan, UT, USA) (395-480 nm). Six points were irradiated on the back of the tongue, at wavelength 395-480 nm for 20 s, energy of 9.6 J and radiant energy of 6.37 J/cm2 per point. The results were compared before, immediately after treatment and 7 days after. The Friedman test was used for the intragroup analysis and the Kruskal Wallis test for the intergroup analysis. RESULTS: In all groups, there was a difference between baseline and the value immediately after the treatment. In Groups 1 and 3, there was no difference between the baseline and the 7 days control. CONCLUSION: There was an immediate reduction of halitosis, but the reduction was not maintained after 7days.

Effectiveness of an oral care tablet containing kiwifruit powder in reducing oral bacteria in tongue coating: A crossover trial.

OBJECTIVES: The aim of this study was to investigate the effect of an oral care tablet containing kiwifruit powder on oral bacteria in tongue coating compared with tongue brushing. MATERIAL AND METHODS: Thirty-two healthy, young adults were enrolled, and a crossover clinical trial was conducted. The volatile sulfur compound (VSC) concentration, Winkel tongue-coating index (WTCI), and the number of total bacteria in addition to Fusobacterium nucleatum in tongue coating were measured. We instructed subjects to remove tongue coating by tongue brush for Intervention I, to keep the oral care tablet containing kiwifruit powder on the tongue dorsum and to let it dissolve naturally for Intervention II, and three oral care tablets 1 day before the measurement for Intervention III. RESULTS: There were significant differences in terms of the level of H2 S, VSC, and WTCI at Intervention I and all evaluation values at Intervention II. There were significant differences in terms of the level of H2 S, VSC, WTCI, the number of total bacteria, and F. nucleatum at Intervention III. The value of WTCI, the number of bacteria, and F. nucleatum decreased significantly after taking the oral care tablets than after tongue brushing. When compared with Interventions I and III, Intervention III showed the effective results; there were significant differences in the number of total bacteria and F. nucleatum between tongue brushing and taking tablets. CONCLUSIONS: These results suggested that the oral care tablet containing kiwifruit powder could be effective in reducing total bacteria and F. nucleatum in tongue coating when compared with tongue brushing.

Potential antibacterial and anti-halitosis activity of medicinal plants against oral bacteria.

This study aimed to evaluate the in vitro activity of the crude extracts obtained from Caesalpinia ferrea Mart. (Jucá), Cinnamomum cassia B. (Cinnamon), Mallow sylvestris L. (Mallow), Punica granatum L. (Pomegranate), Rosmarinus officinalis L. (Rosemary), Aeolanthus suaveolens (Als.) Spreng. (Macassá), Sysygium aromaticum L. (Clove), and Tamarindus indica L. (Tamarind) against oral microorganisms (e.g., Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia, and Parvimonas micra) that produce volatile sulfur compounds (VSC). The pure extracts were placed in culture medium for the diffusion test in agar. The Minimum Inhibitory Concentration (MIC) was determined by the microdilution method, and microbial growth was assayed with resazurin. Total polyphenols in the extracts were measured by using the Prussian Blue Method. For the salivary sediment test, the sediments were exposed to the Jucá and Pomegranate extracts, which was followed by incubation and organoleptic measurements with a monitor (Halimeter®) at 1-, 2-, 4-, and 24 -h intervals. The diffusion test revealed mixed results for the extracts. When the zone of inhibition was present, it ranged from 1.6-10.3 mm. The Pomegranate extract was the only extract that inhibited all the evaluated microorganisms; the MIC values ranged from 50 to 400 µg/mL. The Pomegranate and Jucá extracts presented higher levels of polyphenols, 7.3 % and 3.9 %, respectively, and less VSC formation as compared to the negative control. In conclusion, the extracts display antimicrobial activity against the tested microorganisms. The investigated plants have the potential to reduce the main substances related to halitosis of oral origin.

Interventions for managing halitosis.

BACKGROUND: Halitosis or bad breath is a symptom in which a noticeably unpleasant breath odour is present due to an underlying oral or systemic disease. 50% to 60% of the world population has experienced this problem which can lead to social stigma and loss of self-confidence. Multiple interventions have been tried to control halitosis ranging from mouthwashes and toothpastes to lasers. This new Cochrane Review incorporates Cochrane Reviews previously published on tongue scraping and mouthrinses for halitosis. OBJECTIVES: The objectives of this review were to assess the effects of various interventions used to control halitosis due to oral diseases only. We excluded studies including patients with halitosis secondary to systemic disease and halitosis-masking interventions. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 8 April 2019), the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 3) in the Cochrane Library (searched 8 April 2019), MEDLINE Ovid (1946 to 8 April 2019), and Embase Ovid (1980 to 8 April 2019). We also searched LILACS BIREME (1982 to 19 April 2019), the National Database of Indian Medical Journals (1985 to 19 April 2019), OpenGrey (1992 to 19 April 2019), and CINAHL EBSCO (1937 to 19 April 2019). The US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (8 April 2019), the World Health Organization International Clinical Trials Registry Platform (8 April 2019), the ISRCTN Registry (19 April 2019), the Clinical Trials Registry - India (19 April 2019), were searched for ongoing trials. We also searched the cross-references of included studies and systematic reviews published on the topic. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: We included randomised controlled trials (RCTs) which involved adults over the age of 16, and any intervention for managing halitosis compared to another or placebo, or no intervention. The active interventions or controls were administered over a minimum of one week and with no upper time limit. We excluded quasi-randomised trials, trials comparing the results for less than one week follow-up, and studies including advanced periodontitis. DATA COLLECTION AND ANALYSIS: Two pairs of review authors independently selected trials, extracted data, and assessed risk of bias. We estimated mean differences (MDs) for continuous data, with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: We included 44 trials in the review with 1809 participants comparing an intervention with a placebo or a control. The age of participants ranged from 17 to 77 years. Most of the trials reported on short-term follow-up (ranging from one week to four weeks). Only one trial reported long-term follow-up (three months). Three studies were at low overall risk of bias, 16 at high overall risk of bias, and the remaining 25 at unclear overall risk of bias. We compared different types of interventions which were categorised as mechanical debridement, chewing gums, systemic deodorising agents, topical agents, toothpastes, mouthrinse/mouthwash, tablets, and combination methods. Mechanical debridement: for mechanical tongue cleaning versus no tongue cleaning, the evidence was very uncertain for the outcome dentist-reported organoleptic test (OLT) scores (MD -0.20, 95% CI -0.34 to -0.07; 2 trials, 46 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Chewing gums: for 0.6% eucalyptus chewing gum versus placebo chewing gum, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.10, 95% CI -0.31 to 0.11; 1 trial, 65 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Systemic deodorising agents: for 1000 mg champignon versus placebo, the evidence was very uncertain for the outcome patient-reported visual analogue scale (VAS) scores (MD -1.07, 95% CI -14.51 to 12.37; 1 trial, 40 participants; very low-certainty evidence). No data were reported for dentist-reported OLT score or adverse events. Topical agents: for hinokitiol gel versus placebo gel, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.27, 95% CI -1.26 to 0.72; 1 trial, 18 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Toothpastes: for 0.3% triclosan toothpaste versus control toothpaste, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -3.48, 95% CI -3.77 to -3.19; 1 trial, 81 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Mouthrinse/mouthwash: for mouthwash containing chlorhexidine and zinc acetate versus placebo mouthwash, the evidence was very uncertain for the outcome dentist-reported OLT scores (MD -0.20, 95% CI -0.58 to 0.18; 1 trial, 44 participants; very low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. Tablets: no data were reported on key outcomes for this comparison. Combination methods: for brushing plus cetylpyridium mouthwash versus brushing, the evidence was uncertain for the outcome dentist-reported OLT scores (MD -0.48, 95% CI -0.72 to -0.24; 1 trial, 70 participants; low-certainty evidence). No data were reported for patient-reported OLT score or adverse events. AUTHORS' CONCLUSIONS: We found low- to very low-certainty evidence to support the effectiveness of interventions for managing halitosis compared to placebo or control for the OLT and patient-reported outcomes tested. We were unable to draw any conclusions regarding the superiority of any intervention or concentration. Well-planned RCTs need to be conducted by standardising the interventions and concentrations.

Evaluation of halitosis in adult patients after treatment with photodynamic therapy associated with periodontal treatment: Protocol for a randomized, controlled, single-blinded trial with 3-month follow up.

RATIONALE: Halitosis is an unpleasant odor that emanates from the mouth. Studies show halitosis returns in a week, after treatment with PDT. Probably, bacteria living in the periodontal sulcus could recolonize the dorsum of the tongue. Until nowadays, there are no study in adult population that associates halitosis and periodontal treatment with follow-up evaluation. The aim of this randomized, controlled, single-blinded clinical trial is to treat oral halitosis in healthy adults with photodynamic therapy (PDT), associated with periodontal treatment and follow them up for 3 months. PATIENT CONCERNS:: the concerns assessments will be done over the study using anamnesis interviews and specific questionnaire. DIAGNOSES:: halitosis will be evaluated by OralChroma. INTERVENTIONS: The participants (n = 40) with halitosis will be randomized into 2 groups: G1-treatment with PDT (n = 20) or G2-cleaning of the tongue with a tongue scraper (n = 20). OUTCOMES: Halitosis will be evaluated by measuring volatile sulfur compounds using gas chromatography. After the treatments, a second evaluation will be performed, along with a microbiological analysis (RT-PCR) for the identification of the bacteria T. denticola. The assessment of halitosis and the microbiological analysis will be repeated. After that, patients will receive periodontal treatment. The participants will return after 1 week and 3 months for an additional evaluation. Quality of life will be measured by Oral Health Impact Profile questionnaire (OHIP-14). LESSONS: This protocol will determine the effectiveness of phototherapy regarding the reduction of halitosis in adults. clinicaltrials.gov NCT03996915. ETHICS AND DISSEMINATION: This protocol received approval from the Human Research Ethics Committee of Universidade Nove de Julho (certificate number: 3.257.104). The data will be published in a peer-reviewed periodical.

Improved antibacterial effects of alkali-transformed saponin from quinoa husks against halitosis-related bacteria.

BACKGROUND: Quinoa is a food crop native to the Andes. The process of dehulling quinoa can produce approximately 8-12% husk, which is often discarded because it contains bitter saponin. Saponin derived from quinoa has been reported to exhibit anti-inflammatory and antifungal activity. However, the antibacterial effects of quinoa saponin against halitosis-related bacteria are still unclear. METHODS: In this study, quinoa saponin (QS) and alkali-transformed saponin (ATS) were separated by AB-2 resin to obtain QS-30, QS-80, ATS-30 and ATS-80. Halitosis-related bacteria included Porphyromonas gingivalis (P. gingivalis), Clostridium perfringens (C. perfringens) and Fusobacterium nucleatum (F. nucleatum). The MIC and MBC were determined using gradient dilutions in 96-well plates, and the saponins were identified by HPLC and mass spectrometry. The changes in membrane integrity were tested using a microplate reader, the membrane potential was tested by spectrofluorometry, and the morphological characteristics were examined using a transmission electron microscope to explore the antibacterial mechanisms. RESULTS: Antibacterial assays indicated that QS-80 and ATS-80 showed inhibitory activity. In addition, ATS-80 exerted a stronger inhibitory effect than QS-80, especially against Fusobacterium nucleatum, with a lower minimum inhibitory concentration (31.3 µg/mL) and a lower minimum bactericidal concentration (125 µg/mL). ATS-80 destroyed the bacterial membrane structure, leading to bacterial death. CONCLUSIONS: Based on the excellent antibacterial activity and economic prospects of quinoa husk, ATS-80 could be used as an antibacterial agent to treat halitosis.

Translation, Transcultural Adaptation and Validation of the Halitosis Associated Life-Quality Test for Use in Brazilian Adolescents

Objective: To perform the transcultural adaptation to Brazil and validation of the Halitosis Associated Life-quality Test (HALT) for use in adolescents. Material and Methods: Students aged 12 to 15 years, of both sexes, with healthy permanent dentition, attending public schools in Piracicaba, Brazil, were selected for this study. The HALT was translated, backtranslated, reviewed by an expert committee and submitted to a pre-test. In the first phase (n = 13), 15% of the sample did not understand items 2, 12 and 15; therefore, these items were reformulated and resubmitted to 13 adolescents. The version with a sociocultural adaptation was self-applied by 56 adolescents (64% females, 13.4 ± 1.0 years), of whom 25 participated in the test-retest. The presence of visible biofilm, gingival bleeding, calculus and tongue coating, was evaluated. Selfperception of halitosis after exhalation/breathing was assessed by a single question. Results: The HALT score ranged from 0 to 62 points (mean = 10.1±13.4) and the floor effect was 5.4%. Internal consistency was excellent (Cronbach's alpha = 0.92) and reproducibility was moderate (Intraclass Correlation Coefficient = 0.59). Individuals with "excessive" tongue coating had a higher HALT score than those with mild and/or moderate coating (p<0.001). Multiple linear regression analysis indicated that only the male sex was related to a higher HALT score (p<0.05). Conclusion: The Brazilian Portuguese version of the HALT was easily understood by adolescents. Those with greater tongue coating accumulation reported more frequently the presence of halitosis, which was only associated to male sex.

Effect of IgY on Periodontitis and Halitosis Induced by Fusobacterium nucleatum.

Fusobacterium nucleatum is a morbific agent in periodontitis and halitosis. Egg yolk antibody (IgY) was obtained from egg yolks from chickens stimulated with F. nucleatum. This study was to assess the effectiveness of IgY on periodontitis and halitosis caused by F. nucleatum in vitro and in vivo. The growth of F. nucleatum was inhibited (p <0. 05) by different concentrations of IgY in vitro and the results of a Halimeter show volatile sulfur compounds (VSCs) were reduced to 904 ± 57 ppb at a concentration 40 mg/ml of IgY. The changes of fatty acids of F. nucleatum were determined using GC-MS. The scores for odor index of rat saliva were decreased. The major constituent of volatile organic compounds (VOCs) including short-chain acids decreased 46.2% in 10 mg/ml IgY, ammonia decreased 70% in 40 mg/ml IgY, while aldehydes and olefine ketones were almost unchanged. The ELISA assay revealed that IL-6 and TNF-α were decreased after 4 weeks' IgY treatment. Morphometric (X-ray) and histological analyses (HE) showed that IgY reduced alveolar bone loss and collagen fibers became orderly in rat models. As a result, IgY may have the potential to treat periodontitis and halitosis.

Effects of Lactobacillus salivarius WB21 combined with green tea catechins on dental caries, periodontitis, and oral malodor.

OBJECTIVE: To evaluate the combined use of Lactobacillus salivarius WB21 and (-)-epigallocatechin gallate (EGCg) for oral health maintenance. DESIGN: The effects of L. salivarius WB21 on growth of Streptococcus mutans, the insoluble glucan produced by S. mutans, and on growth of Porphyromonas gingivalis were evaluated in vitro. In addition, the susceptibility of five oral pathogenic bacteria and L. salivarius WB21 to EGCg, the inhibiting effect of EGCg on methyl mercaptan, and the effects of L. salivarius WB21 and EGCg in combination on growth of P. gingivalis were examined. RESULTS: Lactobacillus salivarius WB21 showed concentration-dependent inhibition of the growth of S. mutans. Addition of L. salivarius WB21 inhibited production of the insoluble glucan by S. mutans (p < 0.001). A filtrate of L. salivarius WB21 culture solution inhibited growth of P. gingivalis (p < 0.001 vs. control), and this effect was enhanced when it was used in combination with EGCg (p < 0.001 vs. the addition of L. salivarius WB21). In addition, EGCg directly inhibited methyl mercaptan in a concentration-dependent manner (p < 0.001). Concerning bacterial susceptibility to EGCg, growth of P. gingivalis, Prevotella intermedia, and Fusobacterium nucleatum was inhibited at 2.5 mg/mL of EGCg, while that of L. salivarius WB21 was inhibited at 25 mg/mL EGCg. CONCLUSIONS: Our results imply that L. salivarius WB21 may be useful for controlling dental caries, periodontitis, and oral malodor. In addition, the effects of L. salivarius WB21 on periodontitis and oral malodor may be synergistically enhanced by use in combination with EGCg.

An open-label, interventional, single-center, prospective clinical study to evaluate the efficacy and safety of "AHPL/AYTAB/1514" in patients suffering from halitosis.

OBJECTIVES: The main objective of the study was to assess the efficacy and safety of AHPL/AYTAB/1514 tablet in patients suffering from halitosis. METHODOLOGY: Fifty four patients were recruited in the study. Patients were advised to take maximum two tablets or at least one tablet four times a day (depending on tolerability of the drug) orally for 60 days. Patients were called for follow-up on day 15, 30, 45, 60, and 75. Data describing quantitative measures were expressed as mean ± standard deviation comparison of variables representing categorical data were performed using Chi-square test, Student's t-test, or Wilcoxon Sign Rank test. RESULTS: At the end of the treatment, significant reduction in halitosis, gingivitis index, and dental plaque index was observed. Even after stoppage of treatment for 15 days after 60 days of treatment, there was no relapse in halitosis. Few patients experienced sore throat, cough, and common cold during the study, which were resolved with the treatment of AHPL/AYTAB/1514 tablet. No significant change in vital parameters and most of the safety laboratory parameters were observed. No staining on tooth was observed in any patient. Almost all patients showed excellent improvement as per global evaluation done by the physician and patient. Almost all patients showed excellent tolerability to the study drug. Few patients showed mild AE, which were resolved without stoppage of study drug. CONCLUSION: The study provides good evidence in support of the efficacy and safety of the AHPL/AYTAB/1514 tablet in halitosis.