Short term effect of antimicrobial photodynamic therapy and probiotic L. salivarius WB21 on halitosis: A controlled and randomized clinical trial.

OBJECTIVE: This study aimed to evaluate the effect of antimicrobial photodynamic therapy (aPDT) and the use of probiotics on the treatment of halitosis. METHODS: Fifty-two participants, aged from 18 to 25 years, exhaling sulfhydride (H2S) ≥ 112 ppb were selected. They were allocated into 4 groups (n = 13): Group 1: tongue scraper; Group 2: treated once with aPDT; Group 3: probiotic capsule containing Lactobacillus salivarius WB21 (6.7 x 108 CFU) and xylitol (280mg), 3 times a day after meals, for 14 days; Group 4: treated once with aPDT and with the probiotic capsule for 14 days. Halimetry with gas chromatography (clinical evaluation) and microbiological samples were collected from the dorsum of the tongue before and after aPDT, as well as after 7, 14, and 30 days. The clinical data failed to follow a normal distribution; therefore, comparisons were made using the Kruskal-Wallis test (independent measures) and Friedman ANOVA (dependent measures) followed by appropriate posthoc tests, when necessary. For the microbiological data, seeing as the data failed to follow a normal distribution, the Kruskal-Wallis rank sum test was performed with Dunn's post-test. The significance level was α = 0.05. RESULTS: Clinical results (halimetry) showed an immediate significant reduction in halitosis with aPDT (p = 0.0008) and/or tongue scraper (p = 0.0006). Probiotics showed no difference in relation to the initial levels (p = 0.7530). No significant differences were found in the control appointments. The amount of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola were not altered throughout the analysis (p = 0.1616, p = 0.2829 and p = 0.2882, respectively). CONCLUSION: There was an immediate clinical reduction of halitosis with aPDT and tongue scraping, but there was no reduction in the number of bacteria throughout the study, or differences in the control times, both in the clinical and microbiological results. New clinical trials are necessary to better assess the tested therapies. TRIAL REGISTRATION: Clinical Trials NCT03996044.

Comparative study between photodynamic therapy with urucum + Led and probiotics in halitosis reduction-protocol for a controlled clinical trial.

BACKGROUND: Halitosis is a term that defines any foul odor emanating from the oral cavity. The origin may be local or systemic. The aim of the proposed protocol is to determine whether treatment with antimicrobial photodynamic therapy (aPDT) and treatment with probiotics are effective at eliminating halitosis. MATERIALS AND METHODS: Eighty-eight patients, from 18 to 25 years old with a diagnosis of halitosis (H2S≥112 ppb, determined by gas chromatography) will be randomly allocated to four groups (n = 22) that will receive different treatments: Group 1 -treatment with teeth brushing, dental floss and tongue scraper; Group 2 -brushing, dental floss and aPDT; Group 3 -brushing, dental floss and probiotics; Group 4 -brushing, flossing, aPDT and probiotics. The results of the halimetry will be compared before, immediately after, seven days and thirty days after treatment. The microbiological analysis of the coated tongue will be performed at these same times. The normality of the data will be determined using the Shapiro-Wilk test. Data with normal distribution will be analyzed using analysis of variance (ANOVA). Non-parametric data will be analyzed using the Kruskal-Wallis test. The Wilcoxon test will be used to analyze the results of each treatment at the different evaluation periods. CLINICAL TRAIL REGISTRATION: NCT03996044.

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)

Probiotics as an Adjunct Therapy for the Treatment of Halitosis, Dental Caries and Periodontitis.

Probiotics and prebiotics are popular among consumers worldwide as natural approaches to prevent gastrointestinal diseases. The effects of their consumption on the gastrointestinal system have been extensively investigated. Recently, the efficacy of probiotics and prebiotics has been evaluated against naturally developing microbiome imbalance in the human body, such as in the oral cavity, skin, female urogenital tract, and respiratory tract. This review examines the scientific data related to the effects of probiotics on the treatment of diseases occurring in the oral cavity. Probiotics can effectively prevent and treat some infectious diseases in the oral cavity, such as halitosis and periodontitis, and can reduce the development of dental caries and the concentration of harmful bacteria, according to clinical studies. The results of this meta-analysis also suggest the use of probiotics to treat halitosis and periodontitis. However, the evidence may be inconclusive due in part to the use of a wide range of probiotics, non-standardized study design, small population size, poor quality reports, and inconsistent data. Therefore, future studies should homogenize terms and definitions for primary and secondary outcomes, increase the number of volunteers/patients in in vitro tests and clinical studies, and include an evaluation of the combined use of pre- and probiotics.

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.

Halitosis: fisiología y enfrentamiento / Halitosis: physiology and approach

La halitosis corresponde a una enfermedad muy prevalente en nuestro medio. Presentando gran importancia en nuestra sociedad actual, debido a los altos estándares de higiene e importancia de la imagen propia, puede traer consecuencias psicológicas importantes a quienes la padecen. Más del 85% de la halitosis se debe a la acción de bacterias anaerobias, quienes a través de la degradación de proteínas producen compuestos llamados CSV, que producen el mal olor. El 98% de las causas de halitosis se debe a enfermedades donde es necesaria la evaluación de profesionales de la salud bucal y otorrinolaringólogos, quienes deben trabajar en conjunto para una recuperación óptima del problema. Las mediciones organolépticas siguen siendo el gold standard. Aquí se presenta un novedoso método de screening medidor, el medidor B/B, el que ha mostrado buenos resultados. Se muestra en esta revisión un algoritmo diagnóstico propuesto en la Revista de Otorrinolaringología de Brasil, quienes recomiendan este protocolo diagnóstico para minimizar costos y optimizar recursos. Permitiendo un tratamiento adecuado y buen pronóstico.

Halitosis is a very prevalent disease in our environment, with great importance in our society, due to the high standards of hygiene and the importance of self-image, it can bring important suffer and psychological consequences. Over 85 % of halitosis is produced by the action of anaerobic bacteria, who through protein degradation produce the liberation of compounds called CSV that produce odor. A 98% of the causes of halitosis are due to diseases where the assessment of oral health professionals and otolaryngologists is important, and who must work together for optimal recovery of the problem. The organoleptic measurements remain the "gold standard." In this review a novel method of screening meter is presented, the meter B/ B, which has shown good results. This papers shown a proposed a ENT diagnostic algorithm, who recommend a diagnostic protocol to minimize costs and optimize resources, allowing proper treatment and good prognosis.

Repercusión social de la halitosis / Social impact of halitosis

La halitosis es un motivo de consulta frecuente al que se enfrenta el médico en la atención primaria. Es un síntoma de múltiples enfermedades estomatológicas, pero se debe plantear un diagnóstico diferencial con otras afecciones (extrabucales, sistémicas y psicológicas), que también la ocasionan. Además de las medidas generales sintomáticas (higiene bucal), también se indica un tratamiento específico según la causa de esta. Teniendo en cuenta las repercusiones sociales, económicas y sanitarias que implica, se exponen algunos aspectos generales sobre el tema(AU)

Halitosis is a reason of frequent visit which the doctor faces in the primary care. It is a symptom of multiple stomatological diseases, but a differential diagnosis with other disorders should be considered (extraoral, systemic and psychological disorders), which also cause it. Besides the symptomatic general measures (oral hygiene), an specific treatment is also indicated according to its cause. Keeping in mind the social, economic and health impact that it causes, some general aspects are exposed on the topic(AU)

Halitosis en otorrinolaringología / Halitosis in otolaryngology

La halitosis es una afección muy prevalence en la población mundial que genera un gran impacto en la calidad de vida de los pacientes y es un motivo frecuente de consulta en la práctica clínica diaria en otorrinolaringología, presentándonos un gran desafío para el manejo de esta condición. En general se considera que es exclusiva de la odontología, por lo que resulta interesante revisar en este artículo los factores etiológicos involucrados y los avances en diagnóstico y tratamiento.

Halitosis is a very prevalent disease in the world population that generates a great impact on the quality of life of patients and is a frequent complaint in daily clinical practice in otolaryngology, presenting us with a great challenge for the management of this condition. It is generally considered to be exclusive of dentistry, so it is interesting to review in this article the etiological factors involved and advances in diagnosis and treatment.

The promise of probiotics in dentistry / A promessa dos probióticos em Odontologia

The aim of this review is to examine the potential mechanisms of probiotic bacteria in the oral cavity and to summarize the observed effects of probiotics with regard to oral health. Additionally, safety concerns and future aspects are briefly considered. Data sources: Studies suggest that probiotics may function not only by direct inhibition of—or enhanced competition with—pathogenic micro-organisms, but also by more subtle mechanisms including modulation of the mucosal immune system. Clinical studies reporting the anticariogenic effects of probiotics and their use in the treatment of periodontal disease and in the treatment of halitosis and Candida albicans have been identified. Study selection: The studies focus on probiotic Lactobacilli and Bifidobacteria genera that are most used in various probiotic products. Conclusions: Although direct recommendations for the use of oral probiotics cannot yet be given, scientific evidence so far indicates that probiotic therapy may be a reality in dentistry in the future...

O objetivo desta revisão é analisar os mecanismos potenciais de bactérias probióticas na cavidade oral e resumir os efeitos observados de probióticos em relação à saúde oral. Além disso, preocupações com a segurança e os aspectos futuros são brevemente considerados. Fontes de dados: Estudos sugerem que os probióticos podem funcionar não só pela inibição direta – ou aumento da concorrência com – os micro-organismos patogênicos, mas também por mecanismos mais sutis, incluindo a modulação do sistema imunológico da mucosa. Foram identificados estudos clínicos relatando os efeitos anticariogênicos dos probióticos e sua utilização no tratamento de doenças periodontais e no tratamento de halitose e Candida albicans. Seleção dos estudos: Os estudos focam os probióticos lactobacilos e bifidobactérias, que são os mais utilizados em vários produtos probióticos. Conclusões: Apesar de não haver ainda possibilidade de se recomendar diretamente o uso de pro¬bióticos orais, as evidências científicas até o momento indicam que a terapia probiótica pode ser uma realidade na Odontologia no futuro...

Efeito do tratamento periodontal full-mouth e convencional na redução da halitose / Effect of periodontal treatment full-mouth and conventional in the reduction of halitosis

A halitose se caracterizada pela emanação de um odor desagradável onde cerca de 90% de se origina dentro da cavidade oral. Estudos têm demonstrado uma relação direta entre a doença periodontal e o odor ofensivo do hálito. O presente estudo teve como objetivo avaliar a frequência e distribuição de halitose em um grupo de pacientes com doença periodontal em um estudo transversal observacional (n=112) e, em um estudo intervencionista, avaliar o efeito do tratamento periodontal full-mouth e convencional na redução da halitose em um grupo de pacientes com doença periodontal. Os pacientes responderam a uma anamnese, tiveram seu hálito mensurado pelo halímetro e teste organoléptico, além de realizados Índice de placa visível, Índice de sangramento gengival, Índice de saburra lingual e exame periodontal completo. No estudo 2, os pacientes foram submetidos a seis distintas formas de tratamento: terapia periodontal em sessão única, terapia convencional em quadrantes e, um grupo controle, com somente instrução de higiene oral. Todas as modalidades subdivididas: com e sem raspagem lingual diária. No primeiro estudo os resultados mostraram que, tanto para teste organoléptico quanto para o halímetro, houve maior grau de halitose nos grupos de idades mais avançadas, nos que relataram sangramento gengival e escovação menos que três vezes ao dia. Ainda no teste organoléptico a escovação de língua gerou diferença estatística. Não houve diferença estatística entre as medidas de halitose entre teste organoléptico e halímetro. Foram encontrados aproximadamente 75% de pacientes periodontais com halitose. No segundo estudo os resultados mostraram superioridade conforme análise do halímetro para 30, 60 e 90 dias para os grupos de raspagem em sessão única contra raspagem por quadrantes. Sendo todos os grupos superiores ao controle. Não houve diferença na abordagem com ou sem a raspagem de língua. De acordo com o teste...

Halitosis is characterized by the emission of an unpleasant odor about 90% originates in the oral cavity. Studies have shown a direct relationship between periodontal disease and the offensive odor of breath. The present study aimed to determine the prevalence of halitosis in patients with periodontal disease in an observational cross-sectional study (n = 112) and, in an intervention study, the patients have had six distinct forms of treatment (n = 90) to verify the efficacy of full- vs. partial-mouth disinfection in the control of halitosis. Patients answered an interview, they have had their breath collected by halimeter, they have evaluated by organoleptic test, and visible plaque index, gingival bleeding index, index of tongue coating and periodontal examination. In the second step, patients have been submitted to six different forms of treatment: periodontal therapy in one session, conventional therapy in quadrants, and the control group, with only oral hygiene instruction. All types split: with and without tongue scraping daily. The first study results shown for both organoleptic test as halimeter, a greater degree of halitosis in the older age groups, we have reported that gum bleeding and brushing less than three times per day. Still in organoleptic test brushing of tongue generated statistical difference. There was no statistical difference between the measures between halitosis and organoleptic test halimeter. There was about 75% og periodontal patients with halitosis. In the second study the results shown the superiority analysis as halimeter for 30, 60 and 90 days for groups of scraping in single session against scraping by quadrants. Being all groups superior from control. There was no difference in approach with or without tongue scraping. According to the organoleptic test, there was no difference between the four types of periodontal treatment compared to the control groups. The same...

Efeito do tratamento periodontal full-mouth e convencional na redução da halitose / Effect of periodontal treatment full-mouth and conventional in the reduction of halitosis

A halitose se caracterizada pela emanação de um odor desagradável onde cerca de 90% de se origina dentro da cavidade oral. Estudos têm demonstrado uma relação direta entre a doença periodontal e o odor ofensivo do hálito. O presente estudo teve como objetivo avaliar a frequência e distribuição de halitose em um grupo de pacientes com doença periodontal em um estudo transversal observacional (n=112) e, em um estudo intervencionista, avaliar o efeito do tratamento periodontal full-mouth e convencional na redução da halitose em um grupo de pacientes com doença periodontal. Os pacientes responderam a uma anamnese, tiveram seu hálito mensurado pelo halímetro e teste organoléptico, além de realizados Índice de placa visível, Índice de sangramento gengival, Índice de saburra lingual e exame periodontal completo. No estudo 2, os pacientes foram submetidos a seis distintas formas de tratamento: terapia periodontal em sessão única, terapia convencional em quadrantes e, um grupo controle, com somente instrução de higiene oral. Todas as modalidades subdivididas: com e sem raspagem lingual diária. No primeiro estudo os resultados mostraram que, tanto para teste organoléptico quanto para o halímetro, houve maior grau de halitose nos grupos de idades mais avançadas, nos que relataram sangramento gengival e escovação menos que três vezes ao dia. Ainda no teste organoléptico a escovação de língua gerou diferença estatística. Não houve diferença estatística entre as medidas de halitose entre teste organoléptico e halímetro. Foram encontrados aproximadamente 75% de pacientes periodontais com halitose. No segundo estudo os resultados mostraram superioridade conforme análise do halímetro para 30, 60 e 90 dias para os grupos de raspagem em sessão única contra raspagem por quadrantes. Sendo todos os grupos superiores ao controle. Não houve diferença na abordagem com ou sem a raspagem de língua. De acordo com o teste ...

Halitosis is characterized by the emission of an unpleasant odor about 90% originates in the oral cavity. Studies have shown a direct relationship between periodontal disease and the offensive odor of breath. The present study aimed to determine the prevalence of halitosis in patients with periodontal disease in an observational cross-sectional study (n = 112) and, in an intervention study, the patients have had six distinct forms of treatment (n = 90) to verify the efficacy of full- vs. partial-mouth disinfection in the control of halitosis. Patients answered an interview, they have had their breath collected by halimeter, they have evaluated by organoleptic test, and visible plaque index, gingival bleeding index, index of tongue coating and periodontal examination. In the second step, patients have been submitted to six different forms of treatment: periodontal therapy in one session, conventional therapy in quadrants, and the control group, with only oral hygiene instruction. All types split: with and without tongue scraping daily. The first study results shown for both organoleptic test as halimeter, a greater degree of halitosis in the older age groups, we have reported that gum bleeding and brushing less than three times per day. Still in organoleptic test brushing of tongue generated statistical difference. There was no statistical difference between the measures between halitosis and organoleptic test halimeter. There was about 75% og periodontal patients with halitosis. In the second study the results shown the superiority analysis as halimeter for 30, 60 and 90 days for groups of scraping in single session against scraping by quadrants. Being all groups superior from control. There was no difference in approach with or without tongue scraping. According to the organoleptic test, there was no difference between the four types of periodontal treatment compared to the control groups. The same ...

Effect of gingivitis treatment on the breath of chronic periodontitis patients.

PURPOSE: The present study assessed halitosis after treatment of gingivitis by using different diagnostic modalities. MATERIALS AND METHODS: A total of 27 patients (47 ± 7 years old; 14 women, 13 men) diagnosed with chronic periodontitis underwent supragingival mechanical debridement (day 0). Measurement of volatile sulfur compounds (VSC), visual analogue scale (VAS) and organoleptic assessment, visible plaque index (VPI) and gingival bleeding index (GBI) were obtained at baseline (prior to treatment of gingivitis) and then after 30, 90, and 180 days. The Friedman test was used to compare outcome data at days 0, 30, 90, and 180. Post-hoc comparison (tongue cleaning and non-cleaning) was performed using the Student t test for VSC and VAS and the Mann-Whitney test for organoleptic measurements. The level of significance was set at 5%. RESULTS: VSC and VAS means (days 0 and 180) were, respectively, 463.41 ppb (± 496.12 ppb) and 245.96 ppb (± 301.51 ppb) and 6.28 cm (± 2.23 cm) and 5.03 cm (± 2.01 cm). The frequency of high organoleptic scores (3 to 5) declined from 96.29% (day 0) to 81.48% (day 30), with a reduction of around 50% at day 180. Post-hoc comparison did not reveal any significant differences between the indicators analysed. CONCLUSION: Supragingival plaque control reduced halitosis in patients with periodontitis, but tongue cleaning vs no tongue cleaning did not yield different results.

Avaliação clínica de um dentifrício à base de dióxido de cloro na redução dos compostos sulfurados voláteis / Clinical assessment of a toothpaste based chlorine dioxide in the reduction of volatile sulfur compounds

A halitose é, na maioria das vezes, um problema originado na cavidade oral e tem como principal contribuinte os compostos sulfurados voláteis (CSV), que são formados a partir da quebra de aminoácidos por bactérias orais. 0 objetivo desse estudo foi avaliar a capacidade de um novo dentifrício contendo dióxido de cloro em reduzir os níveis de CSV. Esse estudo consistiu de uma avaliação duplo-cega, randomizada, placebo-controlada e cruzada, de dez voluntários saudáveis, onde a halitose foi induzida através do bochecho de cis-teína e três dentifrícios foram utilizados na forma de solução para bochecho, um teste à base de dióxido de cloro, placebo e digluconato de clorexidina a 0,12%. Para a aferição dos níveis de CSV foi utilizado um halímetro. No período pós-bochecho, a taxa de redução do dentifrício teste foi superior ao placebo e inferior à clorexidina. Já nos períodos após uma, duas e três horas, a taxa de redução do dentifrício teste foi similar à clorexidina, sendo ambas superiores estatisticamente ao placebo, concluindo-se que o dentifrício teste foi capaz de reduzir os níveis de CSV quando comparado ao placebo, se comportando de forma similar à solução de clorexidina a 0,12% após uma, duas e três horas ao bochecho.

Halitosis: an overview of epidemiology, etiology and clinical management.

Halitosis is an unpleasant condition that causes social restraint. Studies worldwide indicate a high prevalence of moderate halitosis, whereas severe cases are restricted to around 5% of the populations. The etiological chain of halitosis relates to the presence of odoriferous substances in exhaled air, especially the volatile sulphur compounds (VSC) produced by bacteria. The organoleptic diagnosis is the gold standard and clinical management includes oral approaches, especially periodontal treatment and oral hygiene instructions, including the tongue. When oral strategies are not successful, referral to physicians is warranted.

Halitosis: an overview of epidemiology, etiology and clinical management

Halitosis is an unpleasant condition that causes social restraint. Studies worldwide indicate a high prevalence of moderate halitosis, whereas severe cases are restricted to around 5 percent of the populations. The etiological chain of halitosis relates to the presence of odoriferous substances in exhaled air, especially the volatile sulphur compounds (VSC) produced by bacteria. The organoleptic diagnosis is the gold standard and clinical management includes oral approaches, especially periodontal treatment and oral hygiene instructions, including the tongue. When oral strategies are not successful, referral to physicians is warranted.

Halitosis: revisión, estudio y prevención de la microflora asociada / Halitosis: review, study and prevention of the associated microflora

Existen muchas personas que presentan halitosis o mal aliento, encontrándose casi un tercio de la población en esta situación. Suetiología puede relacionarse con enfermedades sistémicas, psicológicas, la acción de medicamentos administrados, pero fundamentalmente a la actividad de las bacterias orales en especial bacilos gran negativos anaerobios (pigmentados), localizadospreferentemente en el dorso de la lengua. Consideramos que una buena higiene influye favorablemente en su eliminación. Existen diferentes métodos de limpieza: cepillo, enjuagatorios, utilización de limpia lenguas. El propósito de este trabajo consistió enuna revisión de este tema y en profundizar en el conocimiento de la colonización de los microorganismos de la cavidad oral, productores de compuestos sulfurados volátiles. Estudiamos la diferencia cuantitativa de microorganismos (UFC-unidad formadora de colonias) presentes en el dorso de lengua antes y después del uso de limpia lenguas.

There are many persons who experience halitosis or bad breath. Nearly a third part of the population has got this situation. It can be due to different causes, among them the administration of certain medicines, but essentially the most usually cause is theoral bacterial activity of gram negative rods (brown to black colonies on blood agar) that are on the tongue dorsum. We consider that a good hygiene can eliminate the bad breath. There are different cleaning methods: brushing, mouthrinses and tongue scrapins. The purpose of this study was a review of the halitosis and also consisted to get better in the knowledge of oralmicroorganisms that produce volatile sulfur compounds. We studied the difference (UFC-unit colony form) of the microflora of the tongue dorsum, before and after the use of the tongue dorsum scrapins.

Clinical knowledge of dentists and physicians on the diagnosis and treatment of the patient complaining of halitosis / Conhecimento clínico de dentistas e médicos sobre diagnóstico e tratamento do paciente com queixa de halitose

PURPOSE: To evaluate the knowledge of dentists and physicians about the diagnosis and treatment of the patient complaining of halitosis. METHODS: Data were collected from a sample of healthcare professionals (81 dentists and 19 physicians) from the city of João Pessoa, Brazil. A structured questionnaire was used to record the professional knowledge about halitosis: frequency, diagnosis, treatment and predisposing factors. RESULTS: Physicians and dentists reported overall different responses based on their clinical knowledge and practice: patient's complaint of halitosis (63 percent and 38 percent for physicians and dentists, respectively); halitosis as the main complaint (42 percent and 23 percent); perception of halitosis among patients (10 percent and 67 percent), professional information to the patient about the halitosis (58 percent and 89 percent). Periodontal disease, poor oral hygiene and caries were regarded as the most common causes of halitosis for dentists, but physicians believed that oral cavity changes, sinusitis and reflux disease were the main etiological factors. CONCLUSION: The results suggest that there is not a high agreement between dentists and physicians regarding halitosis diagnosis and treatment.

OBJETIVO: Avaliar o conhecimento de dentistas e médicos sobre o diagnóstico e tratamento do paciente com queixa de halitose. METODOLOGIA: Os dados foram coletados em uma amostra de profissionais de saúde (81 dentistas e 19 médicos) na cidade de João Pessoa, Brasil. Um questionário estruturado foi utilizado para registrar o conhecimento profissional clínico sobre halitose: frequência, diagnóstico, tratamento e fatores predisponentes. RESULTADOS: Médicos e dentistas relataram em geral diferentes respostas com base em eu conhecimento e prática clínica: queixa de halitose entre os pacientes (63 por cento e 38 por cento para médicos e dentistas, respectivamente); halitose como queixa principal (42 por cento e 23 por cento); percepção da halitose entre os pacientes (10 por cento e 67 por cento); informação profissional ao paciente sobre a halitose (58 por cento e 89 por cento); realização do tratamento da halitose pelo profissional (68 por cento e 65 por cento). Os dentistas apontaram doença periodontal, higiene bucal deficiente e cárie como as causas comuns de halitose, enquanto que os médicos relataram alterações bucais, sinusite e doença por refluxo como os principais fatores etiológicos. CONCLUSÃO: Os resultados sugerem que não há alta concordância entre médicos e dentistas sobre fatores relacionados ao diagnóstico e tratamento da halitose.

Probiotics in dentistry: review of the current status / Probiótica em odontologia: revisão do estado atual da questão

Objective: The aim of this comprehensive review is to present an update about the current status ofprobiotics in terms of its application in the fi eld of dentistry. Background: The concept of administrationof benefi cial bacteria with a view to replace harmful microbes with useful ones has been revived bythe probiotic concept. The main fi eld of research has been in the gastrointestinal tract. However, pastfew years has seen investigation of probiotics from the oral health perspective. Probiotic approach hasshown promising results in oral cavity with respect to control of chronic disease such as dental caries,periodontitis, and recurring problems like halitosis and candidial infections. Control of biofi lm formationon voice prosthesis has also been documented. Conclusion: Despite the immense potential of probiotics,data is still defi cient on the probiotic action in the oral cavity. Further double-blind, randomized,placebo-controlled trials are needed before any concrete clinical recommendations can be made.

Objetivo: O objetivo desta revisão compreensiva é apresentar uma atualização (estado da arte) dos conhecimentosa respeito da probiótica, em termos de sua aplicação no campo da odontologia. Fundamento: O conceito da administraçãode bactérias benéfi cas com a intenção de substituir micróbios patogênicos foi redescoberto pelo conceitode probiótica. Seu principal campo de pesquisa tem sido no trato gastrointestinal. Entretanto, nos últimos anos a probiótica tem sido investigada pela perspectiva da saúde bucal. A abordagem probiótica tem mostrado resultadospromissores em doenças crônicas, tais como a cárie dentária, a periodontite e problemas recorrentes como halitosee infecções por Cândida. O controle da formação de biofi lme em próteses auxiliares da fonação tem sido bem documentado.Conclusão: Apesar do grande potencial da probiótica, os dados ainda são escassos a respeito da açãoprobiótica na boca. Estudos duplo cegos, randomizados e com controle por placebos ainda são necessários antes querecomendações clínicas possam ser feitas.

Non-surgical treatment of gingival overgrowth induced by nifedipine: a case report on an elderly patient.

Drug-induced gingival overgrowth (DIGO) is a significant problem for periodontologists and this side effect is frequently associated with three particular drugs: phenytoin, cyclosporin A and nifedipine. A case report of gingival overgrowth induced by nifedipine in an elderly patient treated with non-surgical periodontal therapy is described. A 75-year-old male with generalised gingival overgrowth reported the problem of oral malodour and significant gingival bleeding. The medical history revealed a controlled hypertensive state and Cerebral Vascular Accident (CVA) 3 years prior to consultation. The diagnosis was gingival overgrowth associated with nifedipine, no other risk factors being identified. The patient had been taking nifedipine for 18 months, but after the consultation with the patient's doctor, nifedipine was suspended, as the hypertension was controlled. Treatment consisted of meticulous oral hygiene instruction, scaling, root surface instrumentation and prophylaxis. Six months after the first intervention, clinical parameters revealed a significant improvement with a considerable reduction in gingival overgrowth, demonstrating the effect of non-surgical periodontal therapy in severe cases of gingival overgrowth. Non-surgical treatment of DIGO is a far less invasive technique than surgical approaches and has demonstrated an impressively positive treatment response. It should therefore be considered as a first treatment option for DIGO.