Accuracy of two methods to detect the presence of halitosis: the volatile sulfur compounds concentration in the mouth air and the information from a close person.

This study aimed to analyze the accuracy of two methods for detecting halitosis, the organoleptic assessment by a trained professional (OA) with volatile sulfur compounds (VSC) measurement via Halimeter® (Interscan Corporation) and information obtained from a close person (ICP). Participants were patients and companions who visited a university hospital over one year period to perform digestive endoscopy. A total of 138 participants were included in the VSC test, whose 115 were also included in the ICP test. ROC curves were constructed to establish the best VSC cut-off points. The prevalence of halitosis was 12% (95%CI: 7% to 18%) and 9% (95%CI 3% to 14%) for the OA and ICP, respectively. At the cut-off point >80 parts per billion (ppb) VSC, the prevalence of halitosis was 18% (95%CI: 12% to 25%). At the cut-off point >65 ppb VSC, sensitivity and specificity were 94% and 76%, respectively. At the cut-off point >140 ppb, sensitivity was 47% and specificity 96%. For the ICP, sensitivity was 14% and specificity 92%. VSC presents high sensitivity at the cut-off point of >65 ppb and high specificity at the cut-off point of >140 ppb. ICP had high specificity, but low sensitivity. The OA can express either occasional or chronic bad breath, whereas the ICP can be a potential instrument to detect chronic halitosis.

Comparative study between photodynamic therapy and the use of probiotics in the reduction of halitosis in mouth breathing children: Study protocol for a randomized controlled clinical trial.

INTRODUCTION: Halitosis is a term that defines any odor or foul smell the emanates from the oral cavity, the origin of which may be local or systemic. One of the causes of local or oral halitosis is low salivary flow and dry mouth, which is also one of the complaints of individuals with the mouth-breathing habit. The aim of this study is to determine the effectiveness of antimicrobial photodynamic therapy (aPDT) and the use of probiotics for the treatment of halitosis in mouth-breathing children. METHODS: Fifty-two children between 7 and 12 years of age with a diagnosis of mouth breathing and halitosis determined through an interview and clinical examination will be selected. The participants will be divided into 4 groups: Group 1-treatment with brushing, dental floss and tongue scraper; Group 2-brushing, dental floss and aPDT applied to the dorsum and middle third of the tongue; Group 3-brushing, dental floss and probiotics; Group 4-brushing, dental floss, aPDT and probiotics. The use of a breath meter and microbiological analysis of the tongue coating will be performed before, immediately after treatment and 7 days after treatment. The quantitative analysis will involve counts of colony-forming bacteria per milliliter and real-time polymerase chain reaction. The normality of the data will be determined using the Shapiro-Wilk test. Parametric data will be submitted to analysis of variance and nonparametric data will be compared using the Kruskal-Wallis test. The results of each treatment in the different periods of the study will be compared using the Wilcoxon test. DISCUSSION: Due to the low level of evidence, studies are needed to determine whether treatment with aPDT using annatto as the photosensitizer and blue led as the light source is effective at diminishing halitosis in mouth-breathing children.

Prevalence and associated factors of self-reported halitosis among institutionalized adolescents: Cross-sectional study.

OBJECTIVE: To assess the prevalence and associated factors of self-reported halitosis in institutionalized adolescents in a city in southern Brazil. METHODS: This cross-sectional study involved male institutionalized adolescents, aged 15-19 years old, at the Socio-Educational Assistance Center in the city of Passo Fundo, Brazil. Data collection was performed by a research team composed of two interviewers, two clinical examiners of oral health and two examiners of salivary flow. A structured questionnaire was applied, which included demographical, socioeconomical, general health behaviour, presence of health problems and oral health self-perception variables. Decayed, Missing, Filled Index was used for the clinical examination. The salivary flow collection was performed using the mechanically stimulated total saliva method, in which only the liquid component was measured. RESULTS: The prevalence of self-reported halitosis in this sample was 51.5% (n = 35). In the final multivariate analysis, halitosis was significantly associated with the non-white racial group (prevalence ratio [RP]:1.703; 95% confidence interval [95%CI]:1.101-2.634), use of crack (RP:1.857; 95%CI:1.270-2.714) and number of decayed teeth (PR: 1.123; 95%CI:1.008-1.252). The use of alcohol and access to dental care in the last 12 months were not significantly associated with self-reported halitosis. CONCLUSION: It was concluded that non-white and crack-user youngsters had a high occurrence of self-reported halitosis. Higher rates of dental caries are also associated with halitosis.

Case-control study related to the use of L-cysteine in the differential diagnosis of oral halitosis.

Oral halitosis is characterized by a foul, unpleasant breath that emanates from the oral cavity due to local or systemic conditions. Approximately 90% of offensive odors are caused by volatile sulfur compounds (VSCs). L-cysteine, used as a test solution to control bad breath, induces the formation of VSCs and serves as a preliminary rinse. The study aim was to investigate the effectiveness of L-cysteine solution in differentiating the origin of oral halitosis using a gas chromatography apparatus. Methods: In total, 37 patients with an average age of 49.56 years were evaluated and divided into two groups: halimetry before the use of L-cysteine (n= 37) and halimetry after the use of L-cysteine (n= 37). Patients over 18 years of age, without severe systemic health impairment or infectious/contagious diseases, and who did not use medicines that influenced their breath were included. Halimetry was performed using the OralCroma™ device. In the halimetry before the use of L-cysteine group, 5.40%, 5.40%, and 64.86% of the patients had high levels of sulfide, methyl mercaptan, and dimethyl sulfide, respectively. After the use of L-cysteine, 48.64%, 8.10%, and 37.84% of the patients had high levels of sulfide, methyl mercaptan, and dimethyl sulfide. In this study, L-cysteine proved to be important for the assessment of oral halitosis and effective in differentiating the origin of oral halitosis; therefore, this compound could be used for the differential diagnosis of oral halitosis origin using the OralChroma™ device.

Effect of Photodynamic Therapy on Halitosis: A Systematic Review of Randomized Controlled Trials.

BACKGROUND: This systematic review aimed to assess the effectiveness and safety of aPDT for the treatment of halitosis. METHODS: Search strategies were conducted in October 2021 without language or data restrictions, on the following databases: MEDLINE, EMBASE, CENTRAL, LILACS and BBO, as well as a manual search. Randomized clinical trials (RCTs) with parallel design were considered for inclusion, assessing individuals (adolescents and adults) with a clinical diagnosis of halitosis treated with photodynamic therapy (aPDT). Primary outcomes assessed were halitosis measurements, adverse events and quality of life. The risk of bias for each included study was evaluated with the Cochrane Risk of Bias tool and the certainty of the body of the evidence was assessed with the GRADe approach. RESULTS: Six RCTs (total of 225 participants) were included and due to clinical diversities it was not possible to group the outcome data in meta-analyses. Based on very low-certainty evidence (GRADE) the results showed that, when compared to tongue scraper, aPDT seems to promote a little to no difference in reducing halitosis and in the microbiological analysis. No adverse events were reported. Considering aPDT combined with tongue scraper, better outcome results were observed when compared to tongue scraper alone. CONCLUSIONS: Based on very low-certainty evidence, the findings of this review are uncertain about the effects of aPDT for halitosis control. Further RCTs with higher number of participants and long term assessments need to be conducted to support the use of this intervention. The protocol was registered in the PROSPERO database (number: CRD42020215319) on 19 November 2020-retrospectively registered.

Effect of antimicrobial photodynamic therapy with red led and methylene blue on the reduction of halitosis: controlled microbiological clinical trial.

To determine the effect of antimicrobial photodynamic therapy (aPDT) using a red light-emitting diode (LED) on the reduction of halitosis and microbiological levels in the tongue coating immediately after irradiation, 7, 14, and 30 days after treatment. Forty-five young adults diagnosed with halitosis were allocated to three groups: G1, aPDT with 0.005% methylene blue and red LED (660 nm, four irradiation points, 90 s per point, power of 400 mW, 36 J per point, radiant exposure of 95 J/cm2, continuous wave); G2, tongue scraping; and G3, tongue scraping and aPDT. Gas chromatography was performed before and immediately after treatment, as well as at the different follow-up times. Microbiological samples were collected at the same times from the dorsum of the tongue, and bacteria were quantified in the samples using real-time PCRq. The Wilcoxon test was used for the intragroup analyses, and the Kruskal-Wallis test was used for the intergroup analyses. In the intragroup analyses, differences were found before and immediately after treatment in all groups (p < 0.05). The effect was maintained after 7 days only in the tongue scraping group (p < 0.05). In the intergroup analysis, no statistically significant differences were found among the groups (p > 0.05). For the microbiological analyses, no statistically significant differences were found in the groups/bacteria that were analyzed (p > 0.05). aPDT using a red LED and 0.005% methylene blue caused an immediate reduction in halitosis, but the effect was not maintained after 7, 14, or 30 days. No reduction occurred in the number of bacteria investigated or the quantification of universal 16S rRNA. ClinicalTrials.gov Identifier: NCT03656419.

Prevalencia de halitosis en niños y su asociación con la higiene bucal, caries dental, saburra lingual, tipo de respiración, edad y sexo / Prevalence of halitosis in children and its association with oral hygiene, dental caries, tongue coating, type of breathing, age, and sex

Resumen La halitosis es considerada como una condición anómala frecuente en la salud bucal y se define como un olor desagradable que emite la cavidad oral, nariz, vías respiratorias o aparato digestivo. Objetivo: Determinar la prevalencia de halitosis y su relación con los factores asociados como: higiene oral, caries, placa lingual, tipo de respiración, edad y sexo en niños de 5 a 12 años que asisten a la Escuela Giordano Bruno, de la Provincia de Pichincha - Ecuador. Materiales y métodos: Estudio observacional, descriptivo, transversal realizado en una población de 178 estudiantes de 5 a 12 años, la muestra fue de 122 niños seleccionados mediante un muestreo probabilístico. Se solicitó el consentimiento informado para participar en el estudio. La prevalencia de halitosis se evaluó con un monitor que detecta compuestos volátiles de sulfuro. Los factores asociados se midieron por medio del IHOS, el índice de lengua saburral de Winkel, la prueba con el espejo bucal y el índice ceo-d y CPO-D. Los datos se analizaron con la prueba de Chi cuadrado con un valor de significación de 0,05 y un Análisis de Regresión Logística Binaria. Resultados: La prevalencia de halitosis fue del 50% en los niños y se relacionó con saburralingual, higiene bucal, edad y sexo (p<0,05), pero no hubo asociación entre la halitosis, el tipo de respiración y la presencia de caries dental. Los niños que presentan saburra lingual tienen 177 veces mayor riesgo de presentar halitosis mientras que los que muestran una higiene bucal regular tienen 205 veces más riesgo de presentar halitosis. Conclusión: La prevalencia de halitosis en niños es alta y los principales factores de riesgo son la saburra lingual y la higiene bucal regular.

Abstract Halitosis is considered a frequent anomaly in oral health that is defined as an unpleasant odor that emits from the oral cavity, nose, respiratory tract or digestive system. Objective: To determine the prevalence of halitosis and its relationship with associated factors such as: oral hygiene, tooth decay, tongue plaque, type of breathing, age and sex in children aged 5 to 12 years who attend the Giordano Bruno School of the Province of Pichincha - Ecuador. Materials and methods: Observational, descriptive, cross-sectional study carried out in a population of 178 students aged 5 to 12 years, the sample consisted of 122 children selected through probability sampling. Informed consent was requested to participate in the study. The prevalence of halitosis was evaluated with a monitor that detects volatile sulfur compounds and the associated factors were measured by means of the IHOS, the Winkel coated tongue index, the oral mirror test and the ceo-d and CPO-D index. The data were analyzed with the Chi square test with a significance value of 0.05 and a Binary Logistic Regression Analysis. Results: The prevalence of halitosis was 50% in children and it was related to tongue coating, oral hygiene, age, and sex (p <0.05), there was no association between halitosis, type of respiration and the presence of dental caries. Children with tongue coating have a 177 times greater risk of halitosis, while children with regular oral hygiene have a 205 times greater risk of halitosis. Conclusion: The prevalence of halitosis in children is high and the main risk factors are tongue coating and regular oral hygiene.

Accuracy of a portable breath meter test for the detection of halitosis in children and adolescents.

OBJECTIVES: This study aimed to determine the accuracy of the Breath-Alert™ portable breath meter (BA) for the detection of halitosis in children and adolescents, considering the organoleptic test (OT) as the gold standard in this assessment. METHODS: A cross-sectional study was conducted on 150 children (aged 6-12 years). OT was performed by three independent examiners on a single occasion, obtaining three scores of 0-5 points on the Rosenberg's organoleptic scale. The median of the three evaluations for each child was used for analysis. BA was used according to the manufacturer's instructions, with breath odor scored from 0-5 points. Scores ≥2 on both tests were considered indicative of halitosis. RESULTS: A total of 26 (17.3%) and 23 (15.3%) children were detected with halitosis on the OT and BA tests, respectively. The sensitivity and specificity of the BA scores for the detection of halitosis were 80.76% and 98.38%, respectively. The positive and negative predictive values for BA were 91.3% and 96.06%, respectively. CONCLUSION: In the present study involving children, who require fast, practical examinations, BA proved to be an auxiliary tool to OT for the detection of halitosis in the practice of pediatric dentistry, demonstrating high sensitivity and specificity.

Halitose: etiologia, diagnóstico e tratamento / Halitosis: etiología, diagnóstico y tratamiento / Halitosis: etiology, diagnosis and treatment

RESUMO Introdução: A halitose é um sinal da presença de mau cheiro ofensivo ao olfato humano, geralmente é provocada pela falta de higiene ou estilo de vida e afeta milhares de pessoas em todo o mundo. Objetivo: Realizar uma revisão de literatura a respeito da etiologia, diagnóstico e tratamento da halitose buscando proporcionar um maior embasamento cientifico com informações atualizadas para os profissionais da área. Métodos: O estudo caracterizou-se por uma busca de artigos na base de dados eletrônicos PubMed, Lilacs, Google Acadêmico e Scielo publicados entre 2014 e 2019, em inglês, português e espanhol. Foram consultados 52 trabalhos, destes, 28 foram selecionados após uma criteriosa filtragem. Análise e integração das informações: Diversas etiologias advindas da cavidade bucal podem provocar a halitose. Existem vários exames complementares para auxílio diagnóstico da halitose, tais como testes sialométricos, organoléptico e a análise de presença de saburra para o diagnóstico. Há diversos protocolos instituídos para o tratamento da halitose, desde procedimentos preventivos a curativos. Conclusão: No que concerne a etiologia, a halitose pode ocorrer por fatores fisiológicos ou patológicos; 90 porcento dos casos tem como origem a cavidade oral, podendo estar associada ao biofilme dentário, cárie, língua saburrosa, próteses mal adaptadas e cicatrização tecidual. O diagnóstico deve ser realizado por meio de um exame clínico criterioso. A utilização de questionários para colher informações como frequência, duração, quantidade de vezes que aparece no mesmo dia, hábitos e medicamentos utilizados ajudarão na elucidação do caso. O sucesso do tratamento depende do diagnóstico e da implementação de uma terapia relacionada com a causa-efeito e de uma abordagem multidisciplinar racional que se torna essencial para a obtenção de bons resultados, com objetivo de melhorar a saúde oral, bem como, seus efeitos individuais e sociais(AU)

RESUMEN Introducción: Halitosis o mal olor es ofensivo al olfato humano, generalmente es provocada por la falta de higiene o estilo de vida y afecta a miles de personas en todo el mundo. Objetivo: Llevar a cabo una revisión de la literatura sobre la etiología, el diagnóstico y el tratamiento de la halitosis buscando proporcionar una mayor base científica con información actualizada para los profesionales en el campo. Métodos: El estudio se caracterizó por una búsqueda de artículos en la base de datos electrónica PubMed, Lilacs, Google Scholar y SciELO publicados entre 2014 y 2019, en inglés, portugués y español. Se consultaron 52 documentos, de los cuales 28 fueron seleccionados después de un filtrado cuidadoso. Análisis e integración de las informaciones: Diversas etiologías provenientes de la cavidad bucal pueden provocar la halitosis. Existen varios exámenes complementarios para ayudar a diagnosticar la halitosis, tales como pruebas sialométricas, organolépticas y el análisis de presencia de saburra para el diagnóstico. Hay varios protocolos instituidos para el tratamiento de la halitosis, desde procedimientos preventivos a curativos. Conclusiones: En cuanto a la etiología de la halitosis puede ocurrir debido a factores fisiológicos o patológicos. Aunque el 90 por ciento de los casos se originan en la cavidad bucal y pueden estar asociados con biopelículas dentales, caries, toques de lengua, prótesis mal adaptadas y cicatrización de tejidos. El diagnóstico debe hacerse mediante un examen clínico cuidadoso. El uso de cuestionarios para recopilar información como la frecuencia, la duración, la cantidad de veces que aparece el mismo día, los hábitos y los medicamentos utilizados ayudarán a dilucidar el caso. El tratamiento exitoso depende del diagnóstico y la implementación de la terapia de causa y efecto y de un enfoque multidisciplinario racional que es esencial para obtener resultados exitosos para mejorar la salud bucal y sus efectos individuales y social(AU)

ABSTRACT Introduction: Oral halitosis or malodor is offensive to the human sense of smell. It is often the result of poor hygiene or lifestyle and affects thousands of people worldwide. Objective: Conduct a literature review about the etiology, diagnosis and treatment of halitosis with the purpose of contributing a broader scientific basis of updated information for professionals in the field. Methods: The study was characterized by a search for papers published in the electronic databases PubMed, Lilacs, Google Scholar and Scielo between 2014 and 2019 in English, Portuguese or Spanish. A total 52 papers were consulted, of which 28 were selected after careful filtering. Data analysis and integration: Halitosis may be due to a variety of oral cavity etiologies. Several complementary tests are available which help diagnose halitosis, e.g. sialometric tests, organoleptic tests and analysis of the presence of saburra for the diagnosis. Several protocols have been implemented for the treatment of halitosis. These range from preventive to healing procedures. Conclusions: The etiology of halitosis may be due to physiological or pathological factors. Although 90 percent of the cases originate in the oral cavity and may be associated with dental biofilm, caries, tongue saburra, ill-fitted prostheses or tissue scarring, diagnosis should be based on careful clinical examination. Using questionnaires to gather information such as frequency, duration, number of times it appears on the same day, habits and medications will help elucidate the case. Successful treatment depends on the diagnosis and implementation of a cause-and-effect therapy and a rational multidisciplinary approach which is essential to obtain positive outcomes and improve oral health as well as its individual and social effects(AU)

Self-reported halitosis in a sample of Brazilians: Prevalence, associated risk predictors and accuracy estimates with clinical diagnosis.

AIMS: To evaluate the prevalence of self-reported halitosis and its predictors, and to determine the accuracy estimates of self-reported measures with clinical evaluation of halitosis. MATERIALS AND METHODS: This cross-sectional study comprised 5,420 individuals (teaching staff, administrative personnel and ongoing students from Federal University of Minas Gerais), who answered a structured questionnaire containing sociodemographic, medical and dental data, and self-reported halitosis measures. A subsample (n = 159) underwent halitosis assessment through the organoleptic method. Predictors for self-reported halitosis were determined through univariate and multivariate analyses. Accuracy estimates of self-reported measures were evaluated in this subsample. RESULTS: Prevalence of self-reported halitosis varied from approximately 4%-35%, depending on the self-reported measure. Self-reported halitosis was mainly associated with socio-economic variables (age, gender, educational level), parameters of oral health (gingival bleeding, gingival infections, tongue coating, general oral health evaluation) and impacts on daily activities (family/social environment and intimate relations). Specificity values for self-reported halitosis measures were determined to be high for clinical (organoleptic score ≥2) and strong (organoleptic score ≥4) halitosis. Combinations of self-reported measures retrieved useful accuracy estimates for strong halitosis. CONCLUSION: Prevalence rates of self-reported halitosis may be considered moderate. Accuracy diagnostic estimates were determined to be useful, with good prediction for non-diseased individuals.

Accuracy of a portable breath meter test for the detection of halitosis in children and adolescents

OBJECTIVES: This study aimed to determine the accuracy of the Breath-Alert™ portable breath meter (BA) for the detection of halitosis in children and adolescents, considering the organoleptic test (OT) as the gold standard in this assessment. METHODS: A cross-sectional study was conducted on 150 children (aged 6-12 years). OT was performed by three independent examiners on a single occasion, obtaining three scores of 0-5 points on the Rosenberg's organoleptic scale. The median of the three evaluations for each child was used for analysis. BA was used according to the manufacturer's instructions, with breath odor scored from 0-5 points. Scores ≥2 on both tests were considered indicative of halitosis. RESULTS: A total of 26 (17.3%) and 23 (15.3%) children were detected with halitosis on the OT and BA tests, respectively. The sensitivity and specificity of the BA scores for the detection of halitosis were 80.76% and 98.38%, respectively. The positive and negative predictive values for BA were 91.3% and 96.06%, respectively. CONCLUSION: In the present study involving children, who require fast, practical examinations, BA proved to be an auxiliary tool to OT for the detection of halitosis in the practice of pediatric dentistry, demonstrating high sensitivity and specificity.

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.

Estudo longitudinal da halitose por meio da cromatografia gasosa / Longitudinal study of halitosis through gas chromatography

Objetivos: correlacionar os exames organolépticos (método subjetivo) e a cromatografia gasosa (método objetivo) para diagnóstico conclusivo da halitose e avaliar o comportamento dos compostos sulfurados voláteis (CSVs) durante o manuseio clínico desta patologia. Metodologia: estudo longitudinal com 19 pacientes submetidos ao diagnóstico de halitose, com exames organolépticos (EOt1) e cromatografia gasosa (ECGt1) realizados durante a consulta inicial, com todos os pacientes oriundos do município de Ijuí, Rio Grande do Sul. Todos os 38 exames complementares foram confrontados entre si, por meio do teste estatístico Qui-Quadrado de independência. Para acompanhamento clínico da efetividade do tratamento da halitose e, consequentemente, análise do comportamento dos CSVs, outros quatro exames de cromatografia gasosa (ECGt2, ECGt3, ECGt4 e ECGt5) foram realizados para cada paciente, e todos (95) comparados entre si, pelo teste de Wilcoxon. Resultados: a correlação entre EOt1 e ECGt1 obteve concordância em 78,9% dos casos, indicando forte associação (p = 0,002) entre ambos. Ao avaliar a monitorização dos compostos sulfurados H2S, CH3SH e (CH3)2S, todos envolvidos em alguma fase da gênese da halitose, houve significativa redução de todos os compostos. Conclusões: os exames de cromatografia gasosa (objetivo) e organoléptico (subjetivo) são equivalentes para diagnóstico inicial da halitose, pois apresentaram correlação estatística significante. Em relação à monitorização do tratamento da halitose, a cromatografia gasosa se mostrou eficiente, apresentando altos índices de redução de todos os CSVs. (AU)

Objectives: To correlate organoleptic evaluations (subjective method) and gas chromatography (objective method) for the conclusive diagnosis of halitosis and to examine the behavior of volatile sulfur compounds (VSC) during the clinical management of this pathology. Methodology: Longitudinal study with 19 patients diagnosed with halitosis through organoleptic evaluations (EOt1) and gas chromatography (ECGt1), both applied during the initial appointment. All patients were from the city of Ijuí, located in the state of Rio Grande do Sul, Brazil. All 38 complementary analyses were compared using the chi-square test of independence. Regarding the clinical follow-up on the effectiveness of halitosis treatment, and consequently the analysis of VSC behavior, four other gas chromatography tests (ECGt2, ECGt3, ECGt4, and ECGt5) were conducted with each patient, and all (95) were compared using the Wilcoxon test. Results: The correlation between EOt1 and ECGt1 showed concordance in 78.9% of cases, indicating a strong association (p=0.002). The evaluation of the monitoring of sulfate compounds H2S, CH3SH, and (CH3) 2S, which are all involved in some phase of the halitosis genesis, showed a significant reduction of all compounds. Conclusions: The gas and chromatography and organoleptic tests are equivalent for the initial diagnosis of halitosis because they presented significant statistical correlation. Regarding the monitoring of halitosis treatment, gas chromatography was efficient, presenting high reduction rates of all VSC. (AU)

Compounded Orodispersible Films with Natural Ingredients for Halitosis: A Clinical Experience.

Halitosis can be described as unpleasant odors emanating from the oral cavity. It is usually associated with decomposition action of bacteria present mainly on the back of the tongue and periodontal pockets, and able to produce volatile sulfur compounds. We conducted a study at the Faculty of Dentistry, Federal University of Juiz de Fora and evaluated the therapeutic effect of two natural extracts, Camellia sinensis (green tea) and resveratrol in the form of oral polymer films, to control halitosis. Fifty volunteers (students of health courses) participated in the research after orientation and signing the informed consent form. The anamnesis was made by researchers. The physical examination was made to verify the inclusion criteria. Each participant received 45 polymeric films to be consumed in 15 days (3 films per day). Measurements of the volatile sulfur compound levels were performed using a halimeter in two stages: 1) before use and 2) 15 days after the first administration. Results showed a statistically significant reduction in volatile sulfur compound levels in 71.79% of the volunteers. We concluded that the compounded orodispersible films containing green tea and resveratrol demonstrated excellent results in reducing halitosis.

Photodynamic therapy with Bixa orellana extract and LED for the reduction of halitosis: study protocol for a randomized, microbiological and clinical trial.

BACKGROUND: Halitosis is an unpleasant breath odour that can interfere with the professional life, social life and quality of life of people who suffer from it. A modality of treatment that has been increasing in dentistry is antimicrobial photodynamic therapy (aPDT). Bixa orellana, popularly known as "urucum" is a plant native to Brazil. The seeds are used to produce a dye that is largely used in the food, textile, paint and cosmetic industries. The aim of this study is to verify whether aPDT with Bixa orellana extract and blue light-emitting diodes (LEDs) is effective in reducing halitosis. This method will also be compared with tongue scraping, the most commonly used conventional method for tongue coating removal, and the association of both methods will be evaluated. METHODS/DESIGN: A randomized clinical trial will be conducted at the dental clinic of the Universidade Nove de Julho. Thirty-nine patients will be divided by block randomization into three groups (n = 13) according to the treatment to be performed. In Group 1, tongue scraping will be performed by the same operator in all patients for analysis of the immediate results. Patients will also be instructed on how to use the scraper at home. Group 2 will be treated with aPDT with Bixa orellana extract and the LED light curing device: Valo Cordless Ultradent®. Six points in the tongue dorsum with a distance of 1 cm between them will be irradiated. The apparatus will be pre-calibrated at wavelength 395-480 nm for 20 s and 9.6 J per point. In Group 3, patients will be submitted to the tongue scraping procedure, as well as to the previously explained aPDT. Oral air collection with the Oral Chroma™ and microbiological collections of the tongue coating shall be done before, immediately after and 7 days after treatment for comparison. DISCUSSION: Halitosis treatment is a topic that still needs attention. The results of this trial could support decision-making by clinicians regarding aPDT using blue LEDs for treating halitosis on a daily basis, as most dentists already have this light source in their offices. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03346460 . Registered on 17 November 2017.

Quiste óseo traumático mandibular: reporte de caso y revisión de la literatura / Mandibular traumatic bone cyst: case report and literature review

El Quiste Óseo Traumático de la mandíbula es una cavidad intraósea sin revestimiento epitelial, considerado Pseudoquiste. Ha recibido diversas denominaciones debido a su etiología y patogenia inciertas, como Quiste Óseo Traumático, Quiste Óseo Solitario, Quiste Óseo Idiopático, entre otros. Es una lesión asintomática, que a menudo se diagnostica accidentalmente durante el examen radiológico de rutina, como una radiolucencia unilocular con bordes festoneados cuando está localizado entre las raíces dentarias. Presentamos un caso raro de Quiste Óseo Traumático en la sínfisis mandíbular, identificado radiográficamente, en una paciente de 14 años sin historia clara de trauma, diagnosticado y tratado con éxito.

The Traumatic Bone Cyst of the mandible is an intraosseous cavity without an epithelial lining, considered a pseudocyst. It has received various names due to its uncertain etiology and pathogenesis, such as Traumatic Bone Cyst, Solitary Bone Cyst, Idiopathic Bone Cyst, among others. It is an asymptomatic lesion, which is often diagnosed accidentally during routine radiological examination, as a unilocular radiolucency with scalloped edges when located between the dental roots. We present a rare case of Traumatic Bone Cysts in the mandibular symphysis, identified radiologically, in a 14-year-old patient without clear history of trauma, diagnosed and successfully treated .

Assessment of the accuracy of portable monitors for halitosis evaluation in subjects without malodor complaint. Are they reliable for clinical practice?

Halitosis is defined as a foul odor emanated from the oral cavity, with great impact in quality of life and social restraints. Recently, the use of Breath Alert™ in research increased significantly. Halimeter™, another portable device, is often used in clinical practice. Nevertheless, not many studies have verified the accuracy and compared the results of both devices simultaneously. OBJECTIVE: To verify the accuracy of Breath Alert™ and Halimeter™ in patients without chief complaint of halitosis, using the organoleptic test (OT) as "gold standard." The second aim was to verify whether their concomitant use could enhance the diagnostic accuracy of halitosis. MATERIAL AND METHODS: A cross-sectional analytical study was performed. The quality of expired air of 34 subjects without chief complaint of halitosis was assessed. Two experienced examiners carried out the OT. Afterward, a third blinded examiner performed Halimeter™ (HT) and Breath Alert™ (BA) tests. RESULTS: The OT identified halitosis in 21 subjects (62%). The area under the ROC curve (95% confidence interval) was 0.67 (0.48-0.85) and 0.54 (0.34-0.75) for HT and BA, respectively. The accuracy for HT and BA was 59% and 47%, respectively. The combined usage of HT and BA provided 11 positive results, being 9 subjects (43%) out of the total of 21 positive cases. CONCLUSIONS: Halimeter™ and Breath Alert™ were not able to diagnose halitosis in non-complainer subjects at the same level as the organoleptic examination, since their accuracy were low. Our results suggest that such portable devices are not reliable tools to assess halitosis and may neglect or misdiagnose a considerable number of patients in clinical practice.

Assessment of the accuracy of portable monitors for halitosis evaluation in subjects without malodor complaint. Are they reliable for clinical practice?

Abstract Halitosis is defined as a foul odor emanated from the oral cavity, with great impact in quality of life and social restraints. Recently, the use of Breath Alert™ in research increased significantly. Halimeter™, another portable device, is often used in clinical practice. Nevertheless, not many studies have verified the accuracy and compared the results of both devices simultaneously. Objective: To verify the accuracy of Breath Alert™ and Halimeter™ in patients without chief complaint of halitosis, using the organoleptic test (OT) as "gold standard." The second aim was to verify whether their concomitant use could enhance the diagnostic accuracy of halitosis. Material and Methods: A cross-sectional analytical study was performed. The quality of expired air of 34 subjects without chief complaint of halitosis was assessed. Two experienced examiners carried out the OT. Afterward, a third blinded examiner performed Halimeter™ (HT) and Breath Alert™ (BA) tests. Results: The OT identified halitosis in 21 subjects (62%). The area under the ROC curve (95% confidence interval) was 0.67 (0.48-0.85) and 0.54 (0.34-0.75) for HT and BA, respectively. The accuracy for HT and BA was 59% and 47%, respectively. The combined usage of HT and BA provided 11 positive results, being 9 subjects (43%) out of the total of 21 positive cases. Conclusions: Halimeter™ and Breath Alert™ were not able to diagnose halitosis in non-complainer subjects at the same level as the organoleptic examination, since their accuracy were low. Our results suggest that such portable devices are not reliable tools to assess halitosis and may neglect or misdiagnose a considerable number of patients in clinical practice.

Effect of non-surgical periodontal treatment by full-mouth disinfection or scaling and root planing per quadrant in halitosis-a randomized controlled clinical trial.

OBJECTIVE: The objective of this study was to compare the effect of one-stage full-mouth disinfection (FMD) and conventional quadrant scaling in four weekly sessions (QS) on periodontal clinical parameters and halitosis among individuals with advanced chronic periodontitis. MATERIALS AND METHODS: In this randomized controlled clinical trial, 30 individuals were divided into two groups: FMD (n = 15) and QS (n = 15). The following data were collected at the baseline and 90 days after treatment: plaque index, tongue-coating index (TCI), bleeding on probing, probing depth, and clinical attachment level. Halimetry was performed by the organoleptic method, and the levels of volatile sulfur compounds (H2S and CH3SH) were measured by gas chromatography. The Chi-square, Fisher's exact, the Mann-Whitney, the McNemar, and the Wilcoxon tests were used for statistical analysis. RESULTS: Both groups showed statistically significant improvements in periodontal clinical parameters, reduction in TCI, organoleptic scores, and in CH3SH levels between times. However, major reduction was observed in FMD group. CONCLUSION: Non-surgical periodontal therapy, regardless of the protocol, was effective in improving periodontal clinical status of individuals, decreasing organoleptic scores and CH3SH levels between times, as well as reducing halitosis. CLINICAL RELEVANCE: This study contributed to the knowledge that non-surgical periodontal therapy, whether by FMD or QS, was effective in reducing halitosis in individuals with advanced chronic periodontitis.

Prevalence of self-reported halitosis and associated factors in adolescents from Southern Brazil.

The aim of this study was to assess the prevalence of selfreported halitosis and associated factors in adolescents from Passo Fundo, Brazil. Additionally, we studied adolescents' concern with their own breath and whether anyone had ever told them that they had halitosis. A crosssectional observational survey was conducted on 15to 19year old high school students from public and private schools in the city of Passo Fundo, Brazil. The random sample consisted of 736 adolescents from 20 schools. An interview with a structured questionnaire was administered. The prevalence of selfreported halitosis and associated factors was analyzed by either the chisquare test or Fisher's exact test. The prevalence of selfreported halitosis was 39.67%. The mother's level of education was associated with the outcome. Gender and behavioral habits were not associated with selfreported halitosis. Halitosis reported by others presented a prevalence of 10.73% and was associated to male gender and oral hygiene habits. Individuals with less toothbrushing frequency and no use of dental floss were associated to halitosis reported by others. It was observed that 88.58% of the participants are concerned with halitosis. It is concluded that there is high prevalence of selfreported halitosis, which is associated with a socioeconomic pattern. Most adolescents report concern with their own breath.

O objetivo do presente estudo foi verificar a prevalência de halitose autorreportada e fatores associados em adolescentes de Passo Fundo, Brasil. Além disso, foram verificados a preocupação dos adolescentes com o seu próprio hálito e se eles já foram avisados por alguém sobre essa condição em qualquer momento de suas vidas. Esse estudo transversal envolveu estudantes do ensino médio, da rede pública e privada, com idades entre 15 e 19 anos, da cidade de Passo Fundo, Brasil. Uma amostra randômica de 736 adolescentes de 20 escolas foi utilizada. Um questionário estruturado foi aplicado. A prevalência de halitose autorreportada e fatores associados foram analisados por quiquadrado ou teste exato de Fischer. A prevalência de halitose autorreportada foi de 39,67%. O nível educacional da mãe foi associado com esse desfecho. Gênero e hábitos comportamentais não estiveram associados com halitose autorreportada. Apenas 10,37% dos adolescentes reportadam que outras pessoas indicaram a existência desse problema, sendo associada com o gênero masculino e com hábitos de higiene bucal. Os indivíduos que reportaram menor frequência de escovação dentária e ausência do uso de fio dental apresentaram associações com a advertência da halitose por outras pessoas. Foi observado que 88,58% dos participantes são preocupados com o próprio hálito. Concluiuse que a halitose autorreportada apresenta alta prevalência e está associada com fatores socioeconômicos. Advertência sobre mau hálito por outras pessoas foi relatada apenas por uma minoria, sendo associado com o gênero masculino e hábitos de higiene bucal. A maioria dos adolescentes reportou preocuparse com o próprio hálito.