Search

Background: Halitosis in children implies psychosocial repercussions. Risk factors associated with this condition are unclear, and detection methods are inaccurate. Aim: To quantify the levels of sulfur‐like compounds in children with asthma and healthy children from a novel validated assay, and to establish the risk factors related to halitosis. Design: One hundred and twenty‐eight individuals (63 healthy and 65 asthmatic) from 3 to 17 years of age were tested using a passive colorimetric sensor to measure the levels of sulfur‐like compounds in breath and saliva. Information was collected on oral hygiene habits, gingival and dental health, breathing type, and dental malocclusion. Results: The mean values of hydrogen sulfide were 4.0 ± 6.8 and 19.7 ± 12.2 ppbv (parts per billion in volume) in the control and asthmatic groups, respectively (p <.001). The presence of higher concentrations of sulfur compounds was significantly associated (p <.05) with the presence of gingival inflammation, tongue coating, dental plaque, mouth breathing, hypomineralization, age, tongue brushing, and the use of dental floss. Conclusion: The level of sulfur in breath and saliva was significantly higher in patients with asthma. These results can serve as a precedent to raise awareness among paediatricians and parents about oral hygiene care in children and adolescents. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Methods Results Conclusion Idiopathic halitosis is occasionally encountered in clinical practice, yet with scarce reports. This work aimed to investigate its features and potential association with low‐grade systemic inflammation (LGSI).This retrospective study reviewed idiopathic halitosis from 2469 halitosis patients and compared them with 63 healthy controls (HCs). Organoleptic score (OLS), exhaled volatile sulfur compounds (VSCs), serum inflammatory cytokines, and fractional exhaled nitric oxide (FeNO200) to indicate LGSI were determined.Totally, 54 (2.19%) idiopathic halitosis patients were identified and they were extraoral. Dimethyl sulfide (DMS) was found to be the primary exhaled VSC. Inflammatory cytokines were slightly elevated in 5.56% (3/54) of idiopathic halitosis compared to none of HCs (p = 0.095). FeNO200 was elevated in 79.63% (43/54) of idiopathic halitosis compared to none of HCs (p < 0.001), with a sensitivity of 79.63% and specificity of 100% for the diagnosis of idiopathic halitosis. The FeNO200 level had positive correlations with OLS (r = 0.871) and DMS level (r = 0.485).Idiopathic halitosis is a rare condition which is closely associated with LGSI and possibly caused by unexplored extraoral pathologies. FeNO200 is recommended for its diagnosis with a high diagnostic power. [ABSTRACT FROM AUTHOR]

Background: Halitosis appears to have significant impacts on quality of life, necessitating reliable assessment tools. The Halitosis Associated Life-Quality Test (HALT) has been validated in various populations, but not among Thai people. While HALT provides a valuable foundation, there is a need for a culturally adapted and expanded instrument for the Thai context. Consequently, this study aimed to develop and validate a comprehensive questionnaire for assessing halitosis-related quality of life in Thai populations, incorporating a Thai version of HALT (T-HALT) as a core component. Materials and methods: This cross-sectional study involved 200 dental patients at Mahidol University. The original HALT was translated into Thai using forward-backward translation. Cultural adaptation and psychometric properties of T-HALT were evaluated through multiple approaches. Content validity was ensured through expert reviews, while face validity was assessed by patient feedback. Reliability was examined via test-retest and internal consistency measures. Criterion and discriminant validity was evaluated by correlating T-HALT scores with self-perceived halitosis and volatile sulfur compound (VSC) measurements, respectively. VSCs were quantified using the OralChroma™ device, which analyzes breath samples collected directly from patients' mouths. Construct validity was assessed through exploratory (EFA) and confirmatory factor analysis (CFA), providing insights into the questionnaire's underlying structure. Results: T-HALT demonstrated excellent internal consistency (Cronbach's alphas = 0.940–0.943) and test-retest reliability (ICC = 0.886). Criterion validity was supported by a significant correlation between T-HALT scores and self-perceived halitosis (r = 0.503, P < 0.001). Discriminant validity was confirmed by the absence of a significant correlation between T-HALT scores and VSC levels (r = 0.071, P = 0.32). EFA revealed a four-factor structure, which was subsequently confirmed by CFA. However, Items 1 and 7 were excluded due to poor standardized factor loadings. Conclusion: T-HALT demonstrates good reliability and validity for assessing halitosis-related quality of life in Thai populations. It performs well as a unidimensional measure, but its multidimensional application requires modifications. Future research should validate a modified version excluding Items 1 and 7 across diverse Thai populations, potentially enhancing its cultural specificity. [ABSTRACT FROM AUTHOR]

Background: Bad breath (halitosis) is a common problem affecting psycho-social wellbeing of young people. We aimed to explore the extent of self-perceived halitosis and associated factors among university students in Dhaka, Bangladesh. Methods: A cross-sectional study was conducted among university students from November 2021 to April 2022. Six private and two public universities were approached. A total of 318 participants were conveniently selected for the study. A self-administered questionnaire was used for data collection. Students unwilling to participate were excluded. Multivariable logistic regression analysis was used to examine factors associated with halitosis. Statistical analysis was conducted using Stata Version 17. Results: A total of 55.97% of students had self-perceived halitosis, with females (74.53%) having a significantly higher proportion than males (36.94%) (p < 0.001). A significantly higher proportion of halitosis was found among participants who were overweight (61%), had obesity (60.77%), smoked cigarette (46.79%), consumed alcohol (71.43%), lacked exercise (66.29%), were on unhealthy diet (57.35%), consumed coffee/tea (61.35%), breathed through mouth (64.60%), brushed tooth infrequently (85.71%), changed toothbrush after 6 months (77.42%), did not use toothpaste (94.74%), did not use/ sometimes used fluoride toothpaste (75.76%), lacked dental floss use (60.85%), did not use toothpick (62.87%), did chew or sometimes chewed sugar-free chewing gum (75.82%), did not clear / cleaned tongue sometimes (76.14%), did use mouth freshener regularly or occasionally (64.97%), did not use or used mouthwash sometimes (58.87%) were also associated with higher self-perceived halitosis (p < 0.05 for all). Students with gum bleeding, swollen gums, dry mouth, dental caries, food accumulation, and tooth sensitivity had a significantly (p < 0.05 for all) higher proportion of self-perceived halitosis (76.85%, 81.82%, 72.50%, 67.78%, 64.13% and 67.40%, respectively) compared to those without this problem. Being female (OR = 5.04; 95% CI: 2.01–12.62; p < 0.001), alcohol consumers (OR 7.35; 95% CI: 1.77–30.50; p = 0.006); not using sugar free chewing gum (OR = 0.25; 95% CI: 0.10–0.58; p = 0.001), lack of tongue cleaning (OR 4.62; 95% CI: 2.16–9.84; p < 0.001), and gum bleeding (OR = 7.43; 95% CI: 3.00-18.35; p < 0.001) were independently associated with halitosis on multivariable regression. Conclusion: This study reveals a high proportion of self-perceived halitosis and relevant factors. There should be more public education on the causes of halitosis and potential management approaches. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted in order to determine the effect on halitosis and the antibacterial effect against halitosis‐causing bacteria of the mouthwash made of the natural material, Glycyrrhiza uralensis (G. uralensis) extract. Materials and Methods: A randomized, double‐blind, placebo‐controlled study was conducted on 60 patients who visited M dental clinic located in Busan, South Korea, excluding those with systemic disease that may induce halitosis. There were 30 patients classified to the saline gargle group and the remaining 30 patients were classified to the G. uralensis extract gargle group. In addition, their level of halitosis and halitosis‐causing bacteria were measured. They visited the dental clinic on a fasted state at baseline before gargle application (Baseline), immediately after gargle application (Treatment) and 5 days after gargle application (After 5 Days). For clinical indicators, participants were tested for halitosis and bacteria immediately after waking up without brushing their teeth and without hydration. Results: The prevalence of halitosis decreased in the G. uralensis extract gargle group compared to the saline gargle group at Treatment and After 5 Days. In cases with pseudo halitosis, there was a significant decrease in halitosis‐causing bacteria when G. uralensis extract gargle was applied (p < 0.05). Conclusions: It was identified that using a mouthwash made with G. uralensis extract is effective for halitosis improvement and reduction of halitosis‐causing bacteria. Therefore, using a mouthwash containing G. uralensis extract, it will be effective in improving bad breath and oral hygiene will be possible. [ABSTRACT FROM AUTHOR]

Research has been conducted to explore the link between oral diseases and numerous exogenous aspects that cause it to enhance bad breath. Oral diseases that cause bad breath consist of oral infections, poor oral hygiene, several foodstuffs, and basic medical conditions. Some of the prevalent oral diseases are periodontitis and gingivitis because they create bad breath resulting from overgrowth of microorganisms in the oral cavity. Apart from the infection in the mouth, halitosis is also triggered by extra oral such as respiratory and gastrointestinal ailments and drugs; all these factors lead to the development of volatile Sulphur compounds as well as other odorizing molecules, which are subsequently spread through the blood and exhaled through the lungs. In addition to situations mentioned above, extra oral factors, for example, respiratory and GI conditions and particular medicines, can cause the production of VSCs as well as additional odorous compounds. The bloodstream serves as a vehicle for these substances, and then the lungs expel them. In general, the connection between oral illness and external factors that contribute to foul breath is intricate. A comprehensive approach to managing bad breath may involve addressing both oral and extra oral factors and addressing any underlying medical conditions. [ABSTRACT FROM AUTHOR]

Halitosis, commonly known as bad breath, significantly impacts an individual's social life, self-esteem, and overall quality of life. While local oral factors predominantly cause halitosis, systemic conditions and hormonal changes, especially during pregnancy, can also influence its occurrence. Conducted at Al-Sader Teaching Hospital in Missan, Iraq, from October 2023 to February 2024, this cross-sectional study involved ninety female participants, divided equally into a patient group of pregnant women aged 20 to 40 years suffering from halitosis and a healthy control group of non-pregnant women. The study meticulously adhered to inclusion and exclusion criteria to ensure a focused and relevant participant pool. Measurements of VSCs and salivary cortisol levels were undertaken using standardized methods and advanced technology. The study found a significant elevation in the levels of cortisol and VSCs among the pregnant group compared to the control group, suggesting that pregnancy-induced hormonal changes and stress response could contribute to or exacerbate conditions leading to halitosis. Elevated cortisol levels and VSCs in pregnant women underscore the multifaceted relationship between pregnancy, hormonal changes, stress, and oral health, particularly concerning halitosis. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this systemic review and meta-analysis was to explore the association between halitosis and periodontitis in observational studies. Materials and methods: A systematic search covered PubMed, Web of Science, Embase, Scopus, and Cochrane Library until August 18, 2023. Nine observational studies (585 cases, 1591 controls) were analyzed using Stata 17, with odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses considered halitosis assessment methods. Results: The review found a positive association between halitosis and periodontitis. Significant differences were observed with organoleptic test (OR = 4.05, 95% CI: 1.76, 9.30, p < 0.01) and volatile sulfur compound readings (OR = 4.52, 95% CI: 1.89, 10.83, p < 0.01). Conclusions: A positive association was observed between halitosis and periodontitis, supported by significant differences in both organoleptic and volatile sulfur compound readings. However, conclusive findings are limited by statistical heterogeneity, emphasizing the need for additional research. Clinical relevance: Understanding the halitosis and periodontitis association is clinically significant, informing potential interventions for improved oral health. Further research is vital to refine understanding and guide effective clinical strategies, acknowledging the limitations in current findings. [ABSTRACT FROM AUTHOR]

Background: To compare photodynamic therapy and the use of probiotics in reducing halitosis assessed through gas chromatography and microbiome analysis. Methods: Participants aged from 18 to 25 years showing sulfide (SH2) ≥ 112 ppb on gas chromatography were selected. They were divided into four treatment groups: Group 1—Tongue Scraping; Group 2—Antimicrobial Photodynamic Therapy (aPDT); Group 3—Probiotics; and Group 4—Antimicrobial Photodynamic Therapy (aPDT) and Probiotics. The halimetry process was performed before, immediately after the treatments, and 7 days, 14 days, and 30 days after the initial collection. The collections for later microbiological analysis were made along with the halimetry for microbiome analysis. Results: Treatment with aPDT or probiotics under these experimental conditions was not able to change the bacteria present in the biofilm of the tongue. Conclusions: More research is needed to know the behavior of the oral microbiome in the presence of halitosis and the effectiveness of new treatments. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of a mouthwash containing Lespedeza cuneata extract (LCE) on halitosis as an alternative to chemical mouthwashes. The effect of this natural mouthwash on halitosis-causing bacteria (HCB) was clinically evaluated. Materials and Methods: A total of 84 subjects among 103 participants were recruited from the M Dental Clinic (Busan, South Korea) in this randomised, double-blind, placebo-controlled study. The participants were divided into two groups: 41 in the saline-gargle group (saline group) and 43 in the LCE-gargle group (LCE group). A week before the experiment, scaling and oral health education were conducted to standardise the subjects' oral condition. For clinical evaluation, halitosis and HCB were evaluated pre-gargle (baseline), immediately after gargling (treatment), and 5 days after gargling (5 days post-treatment). Statistical analysis was performed using SPSS for Windows. Results: The level of subjective improvement was statistically significantly greater in the LCE group than the saline group (p < 0.05). Compared with the saline group, the LCE group showed reduced halitosis after 5 days of application. Furthermore, halitosis statistically significantly decreased over time (p < 0.05). Moreover, the LCE group showed a statistically significant decrease in the number of all six HCBs (p < 0.05). Conclusion: LCE gargle was effective in reducing halitosis both subjectively and objectively, suggesting an antibacterial effect on HCBs in the oral cavity. Thus, LCE, which can be used as a safe mouthwash ingredient, can promote oral health and will be valuable for the oral healthcare product industry. It might also be helpful for people suffering from halitosis. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) directly affects oral health. Yet data about halitosis in young CKD patients and the impact of dental prophylaxis is limited. Therefore, as part of this randomized clinical trial, halitosis in young CKD patients undergoing intensive or standard oral preventive procedures was to be explored. Methods: Three volatile sulfur compounds (hydrogen sulfide, methyl mercaptan and dimethyl sulfide) were measured in 30 young patients with CKD (mean age 14.2 years; 16 males, 14 females). Breath samples were taken after 3 and 6 months and analyzed with selective gas chromatography (OralChroma). Tongue coating (Winkel Index) and clinical indices to determine local inflammation or oral hygiene (Papillary Bleeding Index and Quigley-Hein Index) were assessed. Within an extended anamnesis, patients and their mothers and nurses were questioned about the perceived halitosis. Corresponding quotes were noted verbatim. Patients were randomized to either intensive need-related oral health care measures (oral preventative program, OPP) or a one-stage standard prevention (treatment as usual, TAU). Results: While there were no differences in volatile sulfur compound levels between TAU and OPP at the three time points of measurements (p > 0.05), there was a tendency towards a reduction in dimethyl sulfide and hydrogen sulfide of affected patients within the OPP group over time. Looking at potential differences between both groups with regard to tongue coating, significant differences were observed between baseline and 3 months after study start in the OPP group, and between baseline and 6 months after study start in the TAU group (p < 0.05). The burden of halitosis was frequently reported by patients' mothers and nurses. Conclusions: Young CKD patients regularly suffered from halitosis and dimethyl sulfide was its main source. Preventive measures mainly resulted in a reduction of tongue coating. Trial registration: The German Clinical Trial Register (# DRKS00010580). [ABSTRACT FROM AUTHOR]

Antimicrobial photodynamic therapy (PDT) is a treatment that is gaining popularity in modern clinical medicine. However, little is known about the effect of PDT alone on reducing oral halitosis and the duration of the effect. This trial examined the effect of PDT on the tongue dorsum on reducing oral halitosis and the duration of the effect. This study was approved by the Ethics Committee of Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, and Okayama University Hospital (CRB20-015), and it was registered in the Japan Registry of Clinical Trials (jRCTs061200060). Twenty-two participants were randomly assigned to two groups: an intervention group and control group. PDT was performed in the intervention group using red laser emission and methylene blue gel on the middle and posterior area of the tongue dorsum. The concentration of volatile sulfur compounds, bacterial count on the tongue dorsum, probing pocket depth, bleeding on probing, and simplified oral debris index score were determined before and 1 week after PDT. The Mann–Whitney U test was used to assess the significance of the differences in each parameter between the two groups. We found that the hydrogen sulfide concentration and bacterial count on the tongue dorsum were decreased in the intervention group, but there was no statistically significant difference between the two groups. These results indicated that performing only PDT on the tongue dorsum may not contribute to reducing halitosis. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the antibacterial effectiveness of a combination of ε-poly-L-lysine (ε-PL), funme peptide (FP) as well as domiphen against oral pathogens, and assess the efficacy of a BOP® mouthwash supplemented with this combination in reducing halitosis and supragingival plaque in a clinical trial. Materials and methods: The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the compound against Fusobacterium nucleatum, Porphyromonas gingivalis, Streptococcus mutans, and Aggregatibacter actinomycetemcomitans were determined by the gradient dilution method. Subsequently, the CCK-8 assay was used to detect the toxicity of mouthwash on human gingival fibroblastst, and the effectiveness in reducing halitosis and supragingival plaque of the mouthwash supplemented with the combination was analyzed by a randomized, double-blind, parallel-controlled clinical trial. Results: The combination exhibited significant inhibitory effects on tested oral pathogens with the MIC < 1.56% (v/v) and the MBC < 3.13% (v/v), and the mouthwash containing this combination did not inhibit the viability of human gingival fibroblasts at the test concentrations. The clinical trial showed that the test group displayed notably lower volatile sulfur compounds (VSCs) at 0, 10, 24 h, and 7 d post-mouthwash (P < 0.05), compared with the baseline. After 7 days, the VSC levels of the and control groups were reduced by 50.27% and 32.12%, respectively, and notably cutting severe halitosis by 57.03% in the test group. Additionally, the Plaque Index (PLI) of the test and control group decreased by 54.55% and 8.38%, respectively, and there was a significant difference in PLI between the two groups after 7 days (P < 0.01). Conclusions: The combination of ε-PL, FP and domiphen demonstrated potent inhibitory and bactericidal effects against the tested oral pathogens, and the newly formulated mouthwash added with the combination exhibited anti-dental plaque and anti-halitosis properties in a clinical trial and was safe. Trial registration: The randomized controlled clinical trial was registered on Chinese Clinical Trial Registry (No. ChiCTR2300073816, Date: 21/07/2023). [ABSTRACT FROM AUTHOR]

Background: Diabetes Mellitus is a chronic disease characterized by uncontrolled blood sugar levels, which lead to end-organ damage. While the diagnosis and treatment of its complications have been extensively studied, the effect of Hyperbaric Oxygen Therapy (HBO2) on diabetes-related oral complications remains unexplored. Aim: This prospective clinical study aims to investigate the effect of HBO2 on diabetes-related oral complications. Methods: Twenty patients diagnosed with diabetic foot ulcers and scheduled for HBO2 were included in this study. We recorded stimulated and unstimulated saliva pH, buffering capacity, flow rate, and subjective symptoms such as dry mouth, halitosis, taste loss, difficulty swallowing, and clinical examination findings before HBO2 and after the 21st session. Results: Upon comparing the findings, we observed a significant decrease in dry mouth and halitosis, periodontal disease severity, and healing of candida-related stomatitis and angular cheilitis. Despite not reaching statistical significance for other saliva parameters, the unstimulated salivary flow rate increased to normal limits (0.3-0.4 ml/min) in 6 out of 8 patients with a flow rate of less than 0.25 ml/min. Conclusion: Our study investigated the effect of HBO2 on diabetes-related oral complications for the first time, highlighting symptomatic relief for dry mouth and halitosis. Although our results are insufficient to report a definitive benefit, they underscore the need for further research on the oral health effects of HBO2. [ABSTRACT FROM AUTHOR]

Purpose: Bad breath as one of the problems of human societies can affect people's personal life and social relationships. In severe cases it may lead to depression, decreased self-confidence and sensitivity in interpersonal relationships. As a result, bad breath as a physical and psychological illness should be considered in both medical and psychologic fields. Therefore, this study aimed to investigate the psychopathological aspects related to self-expression of halitosis. Materials and methods: In this cross-sectional descriptive study, a 25- question SCL-25 questionnaire was used to investigate the consequences of halitosis. The Questionnaire was distributed between 222 patients referred to Dental Clinic of Golestan University of Medical Sciences with the entry criteria of 15 year old patients with self-reported of bad breath. The simple sampling method was performed and the data was analyzed using statistical software STATA version 14. Findings: Among 222 participants, 60.8% were women and 39.2% were men. Average overall index of disabling symptoms (GSI) was found to be 1.02±0.55 in the participants, according to which 90.5% were healthy and 9.5% were suspected of having psychological disorders. Paranoid thoughts, sensitivity in interpersonal relationships, obsession and compulsion were in the highest frequency.They showed psychological problems in the studied statistical population according to the determined cut-off point. Moreover, psychological disorders in all dimensions (except obsession, compulsion and depression) were significantly higher among women than men (p. 0.05). Conclusion: In the present research, 9.5% of people showed the possibility of suffering from some degree of psychological disorders and apart from the physiological treatment, the psychological status of patients with halitosis should be carefully evaluated. In addition, psychological intervention should be considered as well. [ABSTRACT FROM AUTHOR]

Background: Recent developments in addressing dental aesthetic concerns, encompassing issues like teeth discoloration and halitosis, underscore the demand for safer alternative solutions. Purpose: This study aims to confirm the effects of lactic acid bacteria (LAB) from kimchi on artificial teeth bleaching and their potential impact in terms of preventing halitosis-related bacteria. Materials and Methods: To evaluate the antimicrobial effects against oral pathogens, disc diffusion tests and broth microdilution methods were used. Additionally, crystal violet analysis was performed to confirm the biofilm inhibition effect. The bleaching effects on stained artificial teeth were analyzed using the CIEDE2000 colorimetric method. Statistical analyses were performed using GraphPad Prism 9 with one-way and two-way ANOVA, with the significance level set at α < 0.05. Results: The strain THK-30, isolated from kimchi, exhibited antibacterial activity against Streptococcus mutans, Porphyromonas gingivalis, and Fusobacterium nucleatum, and was identified as Pediococcus inopinatus. Moreover, THK-30 showed a synergistic antibacterial effect against Gram-negative oral pathogens with 8% sodium hexametaphosphate (SHMP). In the stained artificial teeth bleaching test and artificial teeth biofilm inhibition test, the cell-free supernatant of THK-30 displayed significant teeth bleaching effects and caused the inhibition of biofilm formation, both independently and in combination with SHMP 8%. Conclusions: This study has demonstrated the potential applicability of LAB in teeth discoloration and halitosis. These findings are poised to provide a foundation for the development of research pertaining to the control of oral bacteria. [ABSTRACT FROM AUTHOR]

Aims: Data on halitosis among individuals with Down syndrome (DS) are scarce. The aim was to evaluate factors associated with the occurrence of halitosis reported by parents/caregivers (P/Cs) in individuals with DS. Methods and Results: A cross‐sectional study was conducted in non‐governmental assistance institutions in the State of Minas Gerais—Brazil. P/Cs have answered an electronic questionnaire with sociodemographic, behavioral and oral health data. Factors associated with halitosis were evaluated by multivariate logistic regression. The sample comprised 227 P/Cs (age 48.8 ± 13.2 years; 82.9% mothers) of individuals with DS (age 20.8 ± 13.5 years). The prevalence of halitosis in the total sample was 34.4% (n = 78) and its occurrence was associated: 1) in individuals with DS ≤18 years old (26.2%; n = 27)—negative perception of oral health (OR = 3.91); 2) in individuals with DS > 18 years (41.1%; n = 51)—gingival bleeding (OR = 4.53), absence of tongue brushing (OR = 4.50), negative perception of oral health (OR = 2.72). Conclusions: The occurrence of halitosis in individuals with DS reported by P/Cs was relevant and associated with dental factors, having a negative impact on the perception of oral health. Oral hygiene practices, especially tongue brushing, should be reinforced to prevent and control halitosis. [ABSTRACT FROM AUTHOR]

Objectives: To assess the development of halitosis in participants wearing new removable complete dentures (RCD). Method and materials: Seventy-five completely edentulous patients receiving RCD were recruited. Halitosis was assessed by means of FitScan Breath Checker on the day of denture insertion (T0), as well as after 1 month (T1), and after 2 months (T2). Risk factors were studied using a validated questionnaire about oral and denture hygiene, and tongue scoring followed for each participant. A modified plaque scoring technique assessed the percentage of newly formed biofilms accumulated on all surfaces of the RCD. Results: At T0, 44% of the participants revealed halitosis. This percentage insignificantly increased at T1 (66.7%) and T2 (65.6%), respectively (P > .109). At T1, halitosis was significantly lower among persons who reported tongue brushing compared to refraining participants (14.3% vs 72.6%; P = .002). At T2, halitosis was significantly higher among patients suffering from moderate to heavy tongue coatings compared to those with no or only light coatings (83.3% vs 50.0%; P = .006), those who did wear their dentures during sleeping (77.5% vs 45.8%; P = .010), and those who did not brush their tongues at all (87.5% vs 29.2%; P < .0001). With a 16-fold increased probability (95% CI 10.0 to 23.31; P < .001), the multivariate analysis revealed that non-brushing the tongue was the only variable significantly linked to halitosis at both follow-ups. Conclusion: Non-brushing of tongues as well as sleeping with dentures seems to be the main causes of halitosis in new RCD wearers. [ABSTRACT FROM AUTHOR]

Rheumatoid arthritis (RA) and osteoarthritis (OA) are two different types of arthritis. Within RA, the subsets between seronegative RA (snRA) and seropositive RA (spRA) represent distinct disease entities; however, identifying clear distinguishing markers between them remains a challenge. This study investigated and compared the oral health conditions in patients with RA and OA to clarify the differences from healthy controls. In addition, we investigated the serological characteristics of the patients, the factors that distinguished patients with RA from those with OA, and the main factors that differentiated between snRA and spRA patients. A total of 161 participants (mean age: 52.52 ± 14.57 years, 32 males and 129 females) were enrolled in this study and categorized as: normal (n = 33), OA (n = 31), and RA (n = 97). Patients with RA were divided into the following two subtypes: snRA (n = 18) and spRA (n = 79). Demographics, oral health, and serological characteristics of these patients were compared. The prevalence of periodontal diseases was significantly higher in patients with OA (100%) and RA (92.8%) than in healthy controls (0.0%). However, the presence of periodontal diseases was not utilized as a distinguishing factor between OA and RA. Xerostomia occurred more frequently in patients with RA (84.5%) than in patients with OA (3.2%) and healthy controls (0.0%) (all p < 0.001). ROC analysis revealed that periodontal disease was a very strong predictor in the diagnosis of OA compared to healthy controls, with an AUC value of 1.00 (p < 0.001). Additionally, halitosis (AUC = 0.746, 95% CI 0.621–0.871, p < 0.001) and female sex (AUC = 0.663, 95% CI 0.529–0.797, p < 0.05) were also significant predictors of OA. The strongest predictors of RA diagnosis compared to healthy controls were periodontal diseases (AUC = 0.964), followed by xerostomia (AUC = 0.923), age (AUC = 0.923), female sex (AUC = 0.660), and halitosis (AUC = 0.615) (all p < 0.05). Significant serological predictors of RA were anti-CCP Ab (AUC = 0.808), and RF (AUC = 0.746) (all p < 0.05). In multiple logistic regression analysis, xerostomia (odds ratio, OR: 8124.88, 95% CI 10.37–6368261.97, p-value = 0.008) and Anti-CCP Ab (OR: 671.33, 95% CI 2.18–207,074.02, p = 0.026) were significant predictors for RA compared to OA. When diagnosing spRA compared to snRA, anti-CCP Ab (AUC = 1.000, p < 0.001) and RF (AUC = 0.910, 95%CI 0.854–0.967, p < 0.001) had outstanding predictive performances. Therefore, clinicians and researchers should thoroughly evaluate the oral status of both OA and RA patients, alongside serological factors, and consider these elements as potential predictors. [ABSTRACT FROM AUTHOR]

Halitosis, commonly known as bad breath, is a common condition that affects a significant portion of the population. Volatile molecules resulting from pathological and non-pathological causes from oral or extra-oral sources are known to be responsible for halitosis. While poor oral hygiene is often the primary cause of halitosis, several other factors can contribute to this condition, and most of these causes are ignored. such as problems in the nose and throat and the presence of systemic diseases that affect different parts of the body. These problems can lead to the production of foul-smelling gases that are released through the mouth, resulting in bad breath. Some examples Halitosis producing conditions include sinusitis, tonsillitis, and systemic diseases. In addition to these conditions, certain medications and lifestyle habits, such as smoking and alcohol consumption, can also contribute to halitosis. Halitosis negatively impacts a person's everyday life; the majority of those who complain about it seek treatment at a clinic, however, some halitosis sufferers have no detectable halitosis. Halitosis can be determined using a variety of techniques. Understanding the various causes of halitosis is essential for effective treatment and management of this condition. [ABSTRACT FROM AUTHOR]

Copyright of Brazilian Dental Science is the property of Brazilian Dental Science Journal-ICT-UNESP and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Sinonasal diseases are one of the main causes of foul breath. Disruption of mucus drainage leading to bacterial putrefaction is the leading factor of volatile organic compounds (VOCs) production. Concha bullosa (CB) is also one of the factors affecting mucus drainage. Its effect on foul breath was investigated in this study. Materials and Methods: Sixty patients were included in the study. The participants were selected from those complaining of halitosis, who have CB formation on at least one side, and pathologic VOCs, hydrogen sulfide, methylmercaptan, and dimethylsulfide levels in their OralChroma measurements. The patients were divided into two groups. Surgery was applied to 32 patients, and no treatment was given to 28 patients. The VOCs levels were evaluated using OralChroma. Results: Sixty patients with a mean age of 36.5 years were included in the study. Before and after the operation of concha bullosa and also when the surgical group and control groups were compared, the decrease in methylmercaptan values was shown to be statistically significant (p<0.05). Conclusion: Concha bullosa should be considered in the etiology of halitosis in cases with no determined cause and high methylmercaptan values. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to review halitosis research, discuss its various causes, and propose effective interventions based on the underlying etiologies and mechanisms. The main research question is to identify the primary factors contributing to halitosis and appropriate strategies to address them. Materials and methods: A comprehensive literature review was conducted on halitosis and its associated causes, including oral pathological factors, oral microbial influences, microbial metabolic pathways, gastrointestinal diseases, and gut microbiota dysbiosis. Results: Unhealthy eating habits and an imbalance of microorganisms in the oral cavity and gastrointestinal tract were identified as primary causes of halitosis. Dental caries, periodontal disease, xerostomia, and digestive disorders like gastritis and irritable bowel syndrome were also found to be related to the development of halitosis. Due to poor oral hygiene or antibiotic use, disruption of microbial communities can result in dysbiosis, inflammation, and halitosis. Conclusions: Halitosis is a multifactorial condition with various underlying causes, including oral and systemic diseases. Effective interventions should be tailored based on the specific etiologies and mechanisms involved. Clinical relevance: Understanding the factors contributing to halitosis is crucial for developing appropriate treatment strategies. Enhancing oral hygiene habits, using antimicrobial drugs, or administering probiotics may help regulate oral or intestinal flora, thereby improving halitosis and overall oral health. [ABSTRACT FROM AUTHOR]

Licorice (Radix glycyrrhizae) is a plant root extract widely used in various applications, including cosmetics, food supplements, and traditional medicine. It has a long history of medicinal use in different cultures due to its diverse pharmacological properties. Licorice has traditionally been used for treating gastrointestinal problems, respiratory infections, cough, bronchitis, arthritis, and skin conditions. In recent years, the potential therapeutic benefits of licorice for oral health have gained significant interest. This paper aims to provide a comprehensive review of the effects of licorice extracts and their bioactive components on common oral diseases such as dental caries, periodontitis, halitosis, candidiasis, and recurrent aphthous ulcers. The chemical composition of licorice has shown the presence of several bioactive compounds such as glycyrrhizin, glabridin, isoliquiritigenin (ISL), and licochalcone exhibiting various pharmacological activities, including anti-inflammatory, antimicrobial, antioxidative, and immunomodulatory effects. Interestingly, in certain patients, licorice has shown a promising potential to inhibit the spread of viruses, prevent biofilm formation, reduce inflammation, boost immune responses, alleviate pain, and exert antioxidative effects. In this review, we provide a brief overview of the current understanding of licorice's therapeutic benefits in the treatment of oral ailments, emphasising its potential as an alternative treatment option for oral diseases. Further research is warranted to explore its efficacy, safety, and clinical applications using placebo-controlled clinical trials. [ABSTRACT FROM AUTHOR]

Cigarette smoking and the harmful chemicals released during smoking have negative effects on oral health. As a measure of harm reduction, a new alternative tobacco heating system (THS) has been developed. The aim of the study was to analyze and compare the effects of conventional cigarettes and THS on the oral mucosa, the salivary flow rate (SFR), halitosis, and the load of Candida spp. The study included 20 tobacco heating smokers, 20 conventional cigarette smokers, and 20 nonsmokers. The subjects completed questionnaires on medical information, smoking habits, oral lesions, and symptoms. A clinical examination and SFR test were performed on each subject, followed by an organoleptic assessment of halitosis. Mucosal swabs were collected and cult ured to identify Candida spp. Significant differences were found between the smoking groups in relation to halitosis (p < 0.001; ε2 = 0.624), intraoral findings (p < 0.001; ε2 = 0.507), SFR (p < 0.001; ε2 = 0.0331) and dry mouth for subjective complaints (p = 0.021; ε2 = 0.363). The SFR was significantly lower; however, halitosis, the prevalence of intraoral findings, and dry mouth were significantly higher among smokers, but there were no significant differences between THS and conventional smokers. The present study suggests that THS smoking has similar effects on oral tissues, especially the SFR and halitosis, as conventional cigarette smoking. [ABSTRACT FROM AUTHOR]

This study included 72 participants with oral halitosis (35 men and 37 women), who had been clinically diagnosed and ranged in age from 14 to 70. 95 samples were obtained using sterile paper points (size 30) or sterile cotton swabs, in either aerobic or anaerobic conditions, thioglycolate broth was transported and blood agar was used for culture (for 48–72 hours). The bacteria were recognized by means of biochemical testing, tests for antibiotic susceptibility, and morphological and cultural features. Results revealed that 13 different bacterial species were isolated in this study, including Bacteriodes spp. (26 isolates), Viridans Streptococci (18 isolates), Peptostreptococci (19 isolates), Actinomyces spp. (15 isolates), Porphyromonas spp. (8 isolates), Fusobacterium spp. (9 isolates), Veillonella spp. (5 isolates), Streptococcus spp. (10 (2 isolates). The dominant anaerobic bacterial species and genera in instances of halitosis is the conclusion. [ABSTRACT FROM AUTHOR]

Halitosis is a common condition with a significant impact on individuals' quality of life. The Halitosis Associated Life-Quality Test (HALT) is a reliable instrument for measuring this impact. This study aimed to introduce and validate the Romanian translation of the HALT questionnaire (R-HALT). We hypothesized that the R-HALT would demonstrate good reliability and validity in measuring the impact of halitosis on quality of life among Romanian teenagers and young adults. Our objectives were to translate and adapt the HALT, validate it among a cross-sectional group, and evaluate the extent of halitosis in this population. A multicentric cross-sectional design followed, which was approved by the Ethics Research Committee in Romania. The translation process involved independent translations, retro-translations, expert review, and pre-testing. The psychometric properties were evaluated among 150 patients (mean age 23.6 ± 1.8; 51% males) at dental clinics, including reliability, convergent, and discriminant validity, using accepted statistical measures such as Cronbach's alpha and Intraclass Correlation Coefficient (ICC). The R-HALT revealed strong internal consistency with Cronbach's alpha values ranging from 0.93 to 0.96, and an ICC value of 0.87 (95% CI = 0.70–0.99), demonstrating excellent test–retest reliability. Mean scores of individual items ranged from 0.82 ± 0.94 (Q3) to 3.23 ± 1.15 (Q11). The corrected item–total correlation ranged from 0.30 (Q2) to 0.90 (Q19). Organoleptic test scores diagnosed 41% (62 patients) with a score of 2, with increasing severity in 9% (13 patients) with a score of 5. The R-HALT exhibited robust reliability and validity in assessing the impact of halitosis among Romanian teenagers and young adults. The questionnaire is a strong tool for understanding, diagnosing, and managing halitosis in Romania, ultimately aiming to improve the quality of life of affected individuals. Further studies with diverse populations could enhance the applicability of the R-HALT. [ABSTRACT FROM AUTHOR]

Aim: Probiotic microorganisms, commonly used to bolster gut health, might also have benefits for dental health, according to certain studies. Probiotics (PBs) are associated with reducing cariogenic pathogens and protecting against periodontal diseases, although the exact way they function in the mouth is not fully clear. Our study aimed to explore the use of PBs to improve oral health, focusing on issues such as cavities, gum disease, bad breath, mucositis, and periimplantitis. Materials and Methods: We utilized the Boolean keywords "Probiotics" AND "Oral health" to search the databases of PubMed, Scopus, and Web of Science. The search was restricted to English-language papers published from 1 January 2019 to 13 April 2023. Results: A total of 3460 articles were found through our computerized search. After removing duplicates, reviewing the papers, and determining their relevance, 12 were selected for inclusion. Conclusions: Assessing how bacteria in food or dietary supplements might alter the stable oral microbiota is a complex task. Although probiotic microorganisms have been found to have proven therapeutic benefits, their application in dental health is not yet solidly backed by evidence. Further research is necessary to thoroughly understand the long-term effects of probiotic bacteria on the oral environment, including their ability to colonize and form biofilms. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Hydrogen sulfide (H2S) is the most important compound causing oral malodor, and its concentration is thought to be closely correlated with oral microorganism activity. Therefore, clarifying the correlation between oral microbes and metabolites is important. Methods: This study tested with 16S rRNA gene amplicon and shotgun metagenomic sequencing of oral microorganisms and oral malodor tests. Results: There were different of the microbial taxa between the low and high H2S groups. And in the high H2S group, most of the enriched taxa were genera which abundance was correlated with H2S concentration. Fusobacterium periodonticum and Prevotella nanceiensis were significantly different in coverage breadth and depth and in LPS biosynthesis contributions between the two groups. The contribution of F. periodonticum to sulfur metabolism was significantly different between the two groups, and the relative F. periodonticum abundance was higher in the high H2S group. Conclusions: The H2S content is significantly associated with the oral cavity microorganism composition and abundance. Most microorganisms enriched in people with high H2S levels are associated with oral diseases such as caries and periodontal diseases. [ABSTRACT FROM AUTHOR]

This 1-year multicenter prospective cohort study aimed to determine the association between observable eating and swallowing function factors and outcomes (death/hospitalization or survival) among elderly persons in long-term care insurance facilities in Japan. Baseline assessments of factors, such as language, drooling, halitosis, hypersalivation, tongue movement, perioral muscle function, coughing, respiration after swallowing, rinsing, and oral residue, among others, were conducted. A score of 0 was considered positive, and a score of 1 or 2 was considered negative. Patient age, sex, body mass index, Barthel index, and Clinical Dementia Rating were recorded. The death/hospitalization or survival rates over 1 year were recorded, and patients were allocated into groups depending on the respective outcome (death/hospitalization group or survival group) and baseline characteristics. A total of 986 residents from 32 facilities were included, with 216 in the death/hospitalization group and 770 in the survival group. Language, salivation, halitosis, perioral muscle, coughing, respiration after swallowing, rinsing, and oral residue were significantly associated with the outcomes (p < 0.05). Therefore, routine performance of these simple assessments by caregivers may allow early detection and treatment to prevent death, pneumonia, aspiration, and malnutrition in elderly persons. [ABSTRACT FROM AUTHOR]

Objectives: To assess halitosis parameters using OralChroma™ and the correlation with salivary flow, oral hygiene index, radiation dose, and tongue‐coating index among irradiated head and neck cancer patients compared to patients without cancer. Materials and Methods: This cross‐sectional study enrolled irradiated and non‐irradiated patients divided into two groups. Hydrogen sulfide, methyl mercaptan, and dimethyl sulfide (DMS) levels were measured using a gas chromatograph, and sialometry was performed. The tongue‐coating index and simplified oral hygiene index were also assessed. Results: Thirty‐eight patients were allocated to each group. Volatile sulfur compound levels were above the thresholds in both groups. Non‐irradiated individuals showed higher levels of hydrogen sulfide and dimethyl sulfide. Patients with asialia had an inexpressive tongue‐coating index and increased dimethyl sulfide levels. A decrease in salivary flow rate was followed by a significant increase in volatile sulfur compound levels. Higher doses of radiation to the submandibular salivary glands were associated with higher concentrations of sulfide and methyl mercaptan. Conclusions: Head and neck radiotherapy may be important in the development of halitosis. Irradiated patients with asialia presented insignificant lingual biofilm. Consequently, lower levels of volatile sulfur compounds were detected in this group. Asialia, a severe radiation‐induced hyposalivation, impacted the levels of DMS (extraoral origin). [ABSTRACT FROM AUTHOR]

Halitosis is a term that refers to an unpleasant or foul odour originating from the oral cavity that can be caused by either intra‐oral or extra‐oral factors. Despite the fact that halitosis has multifactorial aetiology, intra‐oral factors play a significant role in the majority of cases. This systematic review assesses halitosis's intra‐oral and extra‐oral associations. An electronic search through MEDLINE (PubMed), Google Scholar and the Wiley Online Library was conducted to identify relevant manuscripts. A keywords‐based search was performed, using the terms 'halitosis', 'bad‐breath', and 'oral malodour causes and aetiology'. Articles published from January 2014 to December 2020 were included. We selected studies evaluating the intra‐oral and extra‐oral factors that induce oral malodour, as well as the factors associated with systemic diseases. Eighty to ninety percent of halitosis is caused by intra‐oral factors, with coated tongue, periodontal diseases and poor oral hygiene practices being the principal factors. Ten to twenty percent of halitosis is induced by extra‐oral factors associated with systemic diseases. Multiple factors can cause halitosis, but most of the aetiology is intra‐oral. Increased medical awareness is needed to determine the actual pathophysiological process of oral malodour in otherwise healthy individuals. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effect of lemon essential oil (LEO) on salivary bacteria and volatile sulfur compound (VSC) production of patients with halitosis. Materials and Methods: Saliva of five patients with halitosis was collected, after adding different concentrations (0.563–9 mg/ml) of LEO, detecting the growth of salivary bacteria, the formation of biofilm, and VSC production, and compare the difference of different concentrations of LEO on bacterial growth and VSC production. 48 volunteers were randomly divided into 4 groups. After gargling with LEO, cetylpyridinium chloride (CPC), chlorhexidine (CHX), and hydrogen peroxide (H2O2) separately measure changes of VSC production and pH values at 30, 45, 60, 90, and 120 min and then compare the differences at different time points within group. Results: Compared with the negative control group, under subinhibitory concentrations of LEO (0.563–2.25 mg/ml), the biofilm formation and VSC production of salivary bacteria in LEO group were significantly inhibited (p < 0.05). Compared with the baseline, the VSC production of subjects decreased after rinsing with the LEO in 60 min (p < 0.05). After gargling with LEO, the pH value rose significantly in 30 min and reverted to the baseline level at 120 min (p < 0.05). Conclusions: Lemon essential oil can inhibit the growth of salivary bacteria and reduce VSC production of patients with halitosis. [ABSTRACT FROM AUTHOR]

Objectives: Bad breath is a condition that negatively affects people's social interactions and quality of life. The aim of this study was to evaluate the effect of thyme mouthwash on intraoral halitosis, gingival index (GI) and plaque index (PI) in patients with gingivitis. Methods: In this retrospective study, 60 gingivitis patients (30 women/30 men) received initial periodontal treatment followed by oral hygiene instructions (OHI) and then were divided into four groups: The control group (C) received only OHI, while chlorhexidine (CHX) mouthwash was prescribed to the CHX group, Zinc acetate and CHX diacetate mouthwash was prescribed to the zinc acetate and CHX diacetate (ZnA) group, and the thyme (T) group was instructed to use thyme mouthwash. GI, PI and volatile sulfur compound (VSC) values were recorded at baseline and at the first week of treatment. Results: The initial values of the recorded parameters did not differ significantly between the groups. In all groups, VSCs, GI and PI decreased after treatment (p = 0.001). There was no significant difference between the PI values of the groups after treatment (p = 0.188). On the contrary, the GI and VSC values after treatment were significantly different between the groups (p = 0.001). GI values were highest in the control group and lowest in the CHX group. In terms of VSCs, a significant difference was found between groups T and C, and between groups T and ZnA (p = 0.001). Conclusion: This study showed that the use of thyme mouthwash after periodontal treatment was effective in improving bad breath and gingivitis in gingivitis patients. [ABSTRACT FROM AUTHOR]

Objective: Morning breath is a temporary and unpleasant malodour sourced from the mouth, which occurs upon awakening. This double‐blind, crossover, randomized clinical trial aimed to evaluate the bad‐breath suppression of three commercially available mouthwashes: Mentadent Professional® Chlorhexidine 0.05% with vitamin C (ChxC), Meridol Alito Sicuro® (SnF2) and CB12® (ZnChx) compared to a placebo (PbO) on morning halitosis. Methods: Thirty‐two subjects refraining from oral hygiene practices for 12 h before the evaluation, performed a 30‐s rinse with 15 ml of mouthwash, followed by a 5‐s gargle, in the evening before bedtime. In order to assess morning halitosis, visual inspection (Winkel Tongue Coating Index), organoleptic (Rosenberg index) and chromatographic measurements were used. Gas chromatography was carried out by means of a dedicated device, the Oral Chroma. The recorded measurements have to be considered solely after the rinse since no data about the pre‐exposure were available. A washout period of 1 week passed between one administration and the next. Results: The mean value of the organoleptic indices after administration of ChxC mouthwash is similar to ZnChx, SnF2 and PbO values. Thus, no statistically significant differences were recorded among the mouthwashes and PbO. Nevertheless, ChxC seems to be more efficient in comparison with the PbO regarding VSCs levels analysed with Oral Chroma, (CH3SH; p = 0.0081) and [(CH3)2 S; p = 0.0003]. Conclusion: Considering our limited sample, instrumental examination demonstrated that the use of the analysed mouthwashes can result in low VSCs levels after 12 h from a single rinse. Furthermore, the highest number of patients (n = 14) were proved to be free from bad smell after using a single administration of ChxC with respect to the other commercial products. The other tested mouthwashes did not show better performances with respect to the placebo after a single rinse. [ABSTRACT FROM AUTHOR]

Objectives Herbal remedies can play a preventive role against oral malodor. This study aimed to investigate the clinical effects of green tea and peppermint mouthwashes on halitosis. Methods In this cross-over, randomized clinical trial, 84 volunteers with an average organoleptic score of ≥2 were enrolled. The volunteers underwent two one-week phases of treatment with either green tea or peppermint mouthwash, divided by a one-week washout period. The main outcomes included the objective and subjective assessments of change in malodor. The organoleptic assessment was considered as the objective measure, while the participants’ self-perception of the taste and smell of the mouthwash was considered as the subjective measure. The Wilcoxon signed-rank test was employed to evaluate the decrease in halitosis severity over a span of seven days for each mouthwash. This test was also used to compare the extent of halitosis reduction between the two mouthwashes. Results Both green tea and peppermint mouthwashes significantly reduced the severity of halitosis (P<0.001). However, there was no significant difference in the reduction of the organoleptic level between the two mouthwashes (P=0.72). Additionally, there was no significant difference between the two groups in terms of self-reported satisfaction (P=0.78). Conclusion Both green tea and peppermint mouthwashes were effective in the management of halitosis. Therefore, either of them could be prescribed for halitosis treatment based on the individual’s taste preference. [ABSTRACT FROM AUTHOR]

Background and Objectives: Halitosis is a condition characterized by unpleasant breath smell that is starting to receive serious scientific attention, considering it reflects on people's social and personal life. While most studies focus on the prevalence of halitosis, its medical etiology, and the psychological impact on adults, there is a lack of evidence regarding the social impact of halitosis on the younger population. Therefore, this systematic review aimed to observe the social and emotional impact that halitosis has on adolescents and young adults. Materials and Methods: The review followed the PRISMA protocol, and four electronic databases (Scopus, Scholar, Web of Science, and ProQuest) were searched. From a total of 593 studies retrieved, only 6 were included in the study after assessing the eligibility criteria. Results: The main results showed that the levels of self-reported halitosis ranged from 23.1% to 77.5%, with an average of 44.7%, indicating a significant heterogeneity among the studies reporting this issue. Adolescents and young adults who experienced bad breath were feeling more anxious and depressed according to the non-standardized questionnaires and the standardized questionnaires (OHIP-14 and SCL-9-R). The respondents were isolated from social interactions and consequently had lower self-esteem and impaired quality of life. Conclusions: The conclusions drawn indicate the need for action on a medical level, as well as on a psychological level, in order to improve people's oral health and help them navigate through the difficulties of maintaining social interactions as they live with halitosis. [ABSTRACT FROM AUTHOR]

Halitosis is a frequent complaint which is estimated to be around 50%-60% of the general population and that carries serious personal and social repercussions. It is estimated that 10%-13% of halitosis causes are extraoral etiology. It originates from the tongue dorsum in patients with a healthy periodontium and good oral hygiene. Most of the causes of halitosis are intraoral origin although many other extraoral systemic etiologies are known. Overt hypothyroidism as a cause of halitosis has never been described in medical literature before. We strongly suggest that hypothyroidism induced hyposalivation gives rise to bacterial overgrowth and eventually halitosis. Two cases with moderate halitosis and overt hypothyroidism who were treated only with thyroxine until achieving euthyroidism are presented in this article. They were both completely recovered from halitosis after 45-50 days and had no complaints after 8 months. [ABSTRACT FROM AUTHOR]

Halitophobia is also known as false halitosis or psychosomatic halitosis. This pseudo-pathology originates from the somatization of the compulsive idea that the patient has bad breath in the absence of oral pathology. A patient addressed dental surgery complaining of a self-diagnosed halitosis. The dental consultation did not find any dental problem that could cause bad breath. She was referred to a general practitioner for further investigations to rule out a general condition. The investigations revealed a perfectly healthy person, without any chronic ailment that could cause bad breath. The patient refused to consult a psychologist or psychiatrist, considering that she does not have a mental health problem. Patients with a suspicion of psychogenic halitosis require psychiatric counseling, and dentists have to be prepared with an efficient strategy for the correct management of these patients. [ABSTRACT FROM AUTHOR]

Regarding oral biofilm aspects, there has been strong evidence for a microbiotic component in the aetiology of halitosis. Many oral microbiota have protheolytic and putative activity, but there have been no studies investigating the association of microbiota in oral biofilms with halitosis. The objective of this study was to determine species of oral microbiota in the periodontal area and dorsal part of tongue biofilm, and how their quantitative amounts differ in halitosis patients. The clinical bacterial material from halitosis patients (altogether 98 persons, volatile sulphur compounds (VSC) on average 380 ppb) was taken from periodontal pockets and the dorsal part of the tongue for microbiological diagnostics of anaerobic bacteria, using polymerase chain reaction (PCR) tests for the comparison of bacterial quantity. The study showed the primary aetiology factors of halitosis in Latvia, and offers possible versions of microbiological diagnostics of halitosis. Even though the examination of halitosis patients and determination of VSC using a halimeter is technically simpler and cheaper, the determination of aetiological factors and their combinations using microbiological examination of clinical material with PCR tests are more precise. A characteristic ecological niche of anaerobic bacteria is not only the anaerobic environment of periodontal pockets, but also the microbiota of the dorsal part of the tongue. Additionally, some anaerobic bacteria species (Porohyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia) in larger amounts are found on the microbiome of the tongue. Therefore, it is advisable to begin microbiological diagnostics in halitosis patients with quantitative diagnostics of Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Treponema denticola on the biofilm of the tongue coating. [ABSTRACT FROM AUTHOR]

The purpose of this study was to characterize and compare subgingival microbiome before and after periodontal treatment to learn if any changes of the subgingival microbiome were reflected in intra-oral halitosis. We tested the hypothesis that intra-oral halitosis (Volatile sulfur compounds levels) correlates with corresponding subgingival bacterial levels before and after periodontal treatment. Twenty patients with generalized periodontitis completed the study. Subgingival plaque samples were collected at baseline and 6–8 weeks after nonsurgical periodontal therapy. Full-mouth periodontal status assessed probing depth (PD), clinical attachment loss (CAL), gingival recession (REC), bleeding on probing (BoP), PISA and PESA. Halitosis assessment was made using a volatile sulfur compounds (VSC) detector device. Periodontal measures were regressed across VSC values using adjusted multivariate linear analysis. The subgingival microbiome was characterized by sequencing on an Illumina platform. From a sample of 20 patients referred to periodontal treatment, 70% were females (n = 14), with a mean age of 56.6 (±10.3) years; full-mouth records of PD, CAL, BOP (%) allowed to classify the stage and grade of periodontitis, with 45% (n = 9) of the sample having Periodontitis Stage IV grade C and 95% (n = 19) had generalized periodontitis. The correlation of bacterial variation with VSCs measured in the periodontal diagnosis and in the reassessment after treatment were evaluated. Fusobacterium nucleatum, Capnocytophaga gingivalis and Campylobacter showaei showed correlation with the reduction of VSC after periodontal treatment (p-value = 0.044; 0.047 and 0.004, respectively). Capnocytophaga sputigena had a significant reverse correlation between VSCs variation from diagnosis (baseline) and after treatment. Microbial diversity was high in the subgingival plaque on periodontitis and intra-oral halitosis participants of the study. Furthermore, there were correlations between subgingival plaque composition and VSC counting after periodontal treatment. The subgingival microbiome can offer important clues in the investigation of the pathogenesis and treatment of halitosis. [ABSTRACT FROM AUTHOR]

Several in vitro and in vivo studies have evaluated the effect of probiotics on oral health; however, human clinical studies are still limited. Therefore, this study aimed to examine the effects of Weissella cibaria Chonnam Medical University (CMU)-containing tablets on halitosis. This randomized, double-blinded, placebocontrolled study included 100 adults with halitosis (age, 20-70 years). The participants were randomly assigned to the test group (n = 50) and control group (n = 50). One tablet [1 × 108 colony forming units (CFU)/tablet] was to be taken each day over 8 weeks. The concentrations of volatile sulfur compounds (VSCs), bad breath improvement scores, and oral colonization of W. cibaria were measured. Psychosocial indicators including depression, self-esteem, oral health-related quality of life, and subjective oral health status were evaluated. Most variables were assessed at baseline, 4, and 8 weeks, and W. cibaria number and safety variables were assessed at baseline and 8 weeks. Intergroup comparisons were carried out using Student's t-test, Chi-square test, or Fisher's exact test on per-protocol analysis. Intragroup differences before and after intake were analyzed using the linear mixed-effect model (LMM). Per-protocol analysis was carried out in the test group (n = 45) and control group (n = 46). Total VSC was significantly lower in the probiotics group than in the placebo group at baseline (week 0, p = 0.046) and at 8 weeks (p = 0.017). The sum of hydrogen sulfide and methyl mercaptan did not differ significantly between the groups at baseline; however, it was significantly lower in the probiotics group than in the placebo group at week 8 (p = 0.012). Bad breath improvement (BBI) scores were significantly reduced at week 8 (p = 0.006) in the probiotics group. Statistically significant intergroup differences were observed for changes in the level of W. cibaria at week 8 (p < 0.001). Psychological indicators significantly improved from baseline to week 8 in the probiotics group. No safety issues were observed in either group. The levels of W. cibaria was higher in patients with halitosis using W. cibaria CMU-containing tablets. The subjective degree of bad breath and psychological indicators were improved in patients with halitosis using W. cibaria CMU-containing tablets. [ABSTRACT FROM AUTHOR]

The aim of this study is to examine the relationship between the use of masks, that have become almost part of our lives during coronavirus disease-2019 (COVID-19) pandemic, and bad breath (halitosis). Material and Methods: This study is based on a questionnaire conducted from April 1 to May 1, 2021, among physicians, healthcare workers and their relatives in a tertiary center hospital. Results: A total of 778 individuals, comprised of 401 (51.5%) male and 377 (48.5%) female, were included in the study. Halitosis was present in 394 (50.6%) of all participants. Halitosis was present statistically higher in males than females (225 vs 169, p=0.002). The duration of the halitosis was statistically associated with not only the number of the diseases but also change in complaint of halitosis after started using mask (p=0.006 and p<0.001, respectively). The type of used mask had a strong association with the frequency of mask change (p=0.009). There was a strong relationship between the frequency of tooth brushing and frequency of mask change or starting/increasing complaint of halitosis after using mask (p=0.002 for both). Conclusion: Our study suggests that COVID-19 pandemic has a great impact on the awareness of halitosis. It also caused lifestyle changes of the individuals. More studies are needed to detect the effect of the halitosis on quality of life after started using mask. [ABSTRACT FROM AUTHOR]

BACKGROUND: Oral malodor, also known as halitosis or bad breath can be defined as an offensive odor that emerges from the oral cavity and can be easily detected by others. The etiology of halitosis is multifactorial and can include several intra- and extraoral factors such as gingivitis, periodontitis, chronic sinusitis, nasal inflammation, diabetes mellitus, lung carcinoma, liver insufficiency, cirrhosis, uremia, trimethylaminuria, and postnasal drip. Chlorine dioxide associated with chlorite anion results in the oxidative consumption of amino acids such as cysteine and methionine, which are precursors of volatile sulfur compounds (VSC). Thus, it can reduce the concentrations of VSCs which help in the reduction of oral malodor. Due to the lesser availability of literature to prove the effectiveness of this chlorine dioxide formula, this study is conducted to evaluate the inhibiting effect of commercially available chlorine dioxide-containing mouthwash - FRESHCLOR to combat oral malodor in patients. MATERIALS AND METHODS: The study was conducted among the patients reporting at the outpatient department of periodontics who visited with the chief complaint of bad breath and bleeding gums at KAHER'S VK Institute of Dental Sciences, Belagavi. Patients were selected according to inclusion criteria and divided into test and control groups. Post scaling Freshclor mouthwash was distributed to all test group participants. The organoleptic ratings for halitosis, gingival index (given by Loe H and Silness J, 1963), and plaque index (given by Loe H and Silness J, 1964) were recorded at baseline and 2 weeks for the group. RESULTS: There was a statistically significant reduction in halitosis with a reduction of gingival and plaque indices at 2 weeks from baseline in the test group. CONCLUSION: With the results, it can be concluded that chlorine dioxide-containing mouthwash - freshclor is effective in reducing halitosis. [ABSTRACT FROM AUTHOR]

Background: Face masking is associated with self‐perceived dry mouth and halitosis. Aim of the study was to measure the effect of different face masks on salivary parameters and halitosis. Methods: The randomized controlled crossover clinical trial with four periods included 40 oral healthy participants using different face masks (cloth mask, surgical mask, filtering facepiece 2 [FFP2] mask) or no mask (control) for 4 h in random order. Unstimulated salivary flow rate (primary outcome) and stimulated salivary flow rate, salivary pH and buffer capacity of stimulated and unstimulated saliva (secondary outcomes, blinded), and volatile sulfur compounds (secondary outcome) were measured before and after the 4‐h periods. Statistical analysis was performed by repeated measures ANOVA (p < 0.05). Results: Of 40 randomized participants, 39 completed the study. Unstimulated salivary flow rate prior to face masking amounted to 0.6 ± 0.3 ml/min. Face masking had no significant effect on unstimulated salivary flow (p = 0.550). Face masking had also no significant effect on the other salivary parameters (p ≥ 0.518). The concentration of volatile sulfur compounds (VSC) prior to face masking amounted to 157.3 ± 59.7 ppb. After face masking, the concentration of VSC increased slightly, but not significantly (p = 0.055): 168.1 ± 76.3 ppb (control), 199.3 ± 132.7 ppb (cloth masks), 188.5 ± 101.1 ppb (surgical masks), and 189.7 ± 90.1 ppb (FFP2 masks). Conclusion: Four hours of face masking did not change the salivary flow rate, pH, and buffer capacity, and had no significant effect on VSC's levels. Wearing face masks does not seem to result in measurable side‐effects on salivary parameters such as a reduced salivary flow rate or VSC's levels. Clinical trial registration: The protocol was prospectively registered at ClinicalTrials.gov (NCT04914208) on June 4, 2021. [ABSTRACT FROM AUTHOR]

Background: Halitosis associated with periodontitis shelters specific periodontal pathogens, especially at sites such as periodontal pockets and the dorsal surface of the tongue; antimicrobial photodynamic therapy (aPDT) has shown an antimicrobial effect against them. Materials and Methods: A total of 24 participants with a clinical diagnosis of halitosis and stage II grade B periodontitis were divided into two groups. Scaling and root planing (SRP) plus aPDT was given to one group of 12 patients (group I), while SRP alone was performed in another. aPDT was performed using a 660 nm diode laser, in continuous contact mode. Clinical parameters such as halitosis score, plaque index, and probing depth were measured. Subgingival plaque samples were collected on 0, 3rd, 7th, and 14th day after treatment for microbiological analysis of Porphyromonas gingivalis, Fusobacterium nucleatum, and Treponema denticola using real-time polymerase chain reaction. Results: Both groups have shown improvements in all clinical parameters, and statistically significant results were observed in group I compared with group II with a P < 0.05 from 0 day to 14 days. Conclusion: Within the scope of this study, the results have shown improvement in halitosis from a single sitting of aPDT, for a shorter duration and it can be recommended as adjunctive management for halitosis in patients with periodontal pockets. [ABSTRACT FROM AUTHOR]

This study aimed to verify and to validate the correlation between, and validate the assessment of, bacterial activity and the distribution of tongue coating, by analyzing quantitative light-induced fluorescence (QLF) images for the diagnosis of oral malodor. Oral malodor was measured using the Twin Breasor II, and bacterial activity and the distribution of tongue coating were investigated using QLF images. Bacterial activity and the distribution of tongue coating were quantitatively analyzed by dividing the tongue into six areas using the TB01 1.05 software. ROC curves were generated using MedCalc® software to validate the diagnosis of oral malodor, the testing of bacterial activity, and the distribution of tongue coating. Bacterial activity and the distribution of tongue coating showed a very strong association with each other (r = 0.937, p < 0.01), and were significantly higher in the oral malodor group (p < 0.05). The distribution of tongue coating was highly correlated with H2S (r = 0.223, p < 0.01) but not associated with CH3SH. Sensitivity, specificity, and the area under the curve confirmed the high accuracy of this method in assessing bacterial activity and the distribution of tongue coating in the diagnosis of oral malodor. Since QLF images provide significant accuracy during quantitative analysis in the identification of bacterial activity and the distribution of tongue coating, systematic management of tongue coating and reduced oral malodor can be achieved by actively using QLF images and oral malodor measurement. [ABSTRACT FROM AUTHOR]

In recent years, there has been increasing interest in research showing positive results in antimicrobial photodynamic therapy (aPDT) and laser therapy (LT) in dentistry. The authors of this review tried to answer the question: "Is the effectiveness of lasers and aPDT in the elimination of intraoral halitosis possible?" For this purpose, the electronic database of PubMed and Cochrane Library were searched until September 2021 using a combination of different keywords: (bad breath OR fetor ex ore OR halitosis OR oral malodor) AND (laser OR PDT OR PACT OR photodynamic inactivation OR photodynamic therapy OR photodynamic antimicrobial chemotherapy). Initially, 83 studies were identified. A total of 9 articles were qualified after the application of the eligibility criteria. Eight works concerned aPDT treatment, and only one dedicated to the Er,Cr:YSGG laser. A significant reduction in halitosis occurred immediately after both LT and aPDT. The review found the confirmation of the effectiveness of laser therapy in reducing the number of volatile sulfur compounds (VSC) and the amount of anaerobic bacteria responsible for VSC formation. In most studies, a positive effect was observed for a 1-week follow-up. Laser therapy (aPDT, Er,Cr:YSGG) effectively eliminates microorganisms that produce volatile compounds and can effectively eliminate bad breath for the longer period of time than traditional methods of combatting this ailment. [ABSTRACT FROM AUTHOR]

Objectives: To assess the self‐perception of breath odour (SPBO) and oral hygiene habits (OHHs) while the wearing of face masks during the COVID‐19 pandemic. Subjects and Methods: This cross‐sectional study included 4647 individuals who answered a structured questionnaire containing demographic, medical and dental variables and self‐perceived breath odour. Variables associated with changes in self‐perceived breath odour, self‐perceived halitosis and changes in OHHs were assessed through multivariate logistic regression. Results: Changes in self‐perceived breath odour were reported by 1572 individuals and were associated with smoking, systemic conditions, dry mouth, tongue coating, the period of face mask use and its interaction with prior thinking of having bad breath. Likewise, 645 individuals started to consider having bad breath. This was associated with the interaction between prior family/friends saying they have bad breath and period of face mask use. Changes in OHHs were strongly associated with changes in SPBO and starting to consider having bad breath. Conclusion: Changes in one's SPBO was associated with the wearing of face masks and was significant for changes in OHHs. Findings may be important to guide comprehensive preventive and therapeutic strategies in relation to oral health care. [ABSTRACT FROM AUTHOR]