The Effect of Mechanical Tongue Cleaning on Oral Malodor and Tongue Coating

Background: Mechanical tongue cleaning is an important oral hygiene procedure; it is known that a significant cause of volatile sulfur compounds (VSCs), a major component of bad breath, is due to the bacteria coating the tongue. This study was conducted to identify the effect of mechanical tongue cleaning on reducing bad breath and tongue coating. Methods: Various mechanical tongue-cleaning methods were studied, including removing tongue coating using a toothbrush, removing tongue coating using a tongue scraper, and removing tongue coating using a toothbrush and a tongue scraper together. The results were as follows. Results: First, the organic bad breath measurement value after cleaning the tongue significantly decreased in the group using only the toothbrush, the group using only the tongue scraper, and the group using both the toothbrush and the tongue scraper. However, there was no difference between the groups. Second, after cleaning the tongue, the measured values of the tongue coating in the values of WTCI (Winkel’s tongue coating index) and Qray view were significantly reduced in all three groups, and there was no difference between the groups. Third, the gas measurement value in the oral cavity using a machine significantly decreased only the H2S value of the group using the tongue scraper immediately after the mechanical tongue cleaning. Conclusions: From these results, it can be confirmed that mechanical tongue cleaning is effective at reducing bad breath and tongue coating. However, in this study, there was no difference in the reduction effect according to the tools (groups) used for mechanical tongue cleaning. It can therefore be seen that wiping accurately from the rear of the tongue to the front is more effective at reducing bad breath and tongue coating.

Descriptive Statistical Analysis Report on the Results of Questionnaire and Observations on Patients With Physiological Halitosis Who Visited the KUMC Halitosis Clinic- A Retrospective Study

Background: We initiated to prepare the basic data that could help us to understand the characteristics of patients with physiological halitosis symptoms in Korea and aid in explaining the causes of these symptoms. Methods: We collected questionnaire and dietary analysis results from the data of 246 adult patients diagnosed with physiological halitosis symptoms, collected the data from the patients’ salivary measurements and the analysis data of patients’ tongue and throat management status. Using the SPSS (IBM SPSS™, Ver. 22.0) program, we performed a frequency analysis, calculating the correlation coefficient Phi with an independence test.Results: The mean age and one standard deviation of 246 patients with physiological halitosis was 41.85±11.63 years. The proportion of women, the proportion of patients who replaced breakfast with fast food or skipped breakfast, with beverage drinking habits such as coffee, tea, or carbonated drink, with irregular or insufficient consumption of water, who recognized their own oral malodor, suffering anxiety or stress over oral malodor, with an introverted personality, with insufficient unstimulated salivation volume, with incorrect tongue management, and with PND (Postnasal drip) or PTC (Posterior Tongue Coating) were all statistically analyzed to be significant (p < 0.05). As a result of the correlation analysis, the Phi values of the seven pairs of the bivariate variables were from 0.137 to 0.196, and the Phi values of the five pairs of the bivariate variables - the Phi value between the breakfast pattern variable and the regular diet variable, the Phi value between the stimulating menu variable and the drinking variable, the Phi value between the unstimulated saliva variable and the stimulated saliva variable, the Phi value between the unstimulated saliva variable and the sedimentation ratio of saliva variable, and the Phi value between the stimulated saliva variable and the sedimentation ratio of saliva variable - were from 0.203 to 0.394 (p < 0.05). Conclusion: We could suggest the 10 potential common risk factors related to physiological halitosis symptom, and the five pairs of variables with Phi values ranging from 0.20 to 0.40 could be judged to have a moderate correlation.

Correlation Between Salivary Microbiology and H2S Concentration of Oral Cavity

Background: Halitosis is caused by metabolites produced by oral microorganisms. Hydrogen sulfide is the most important compound that leads to the oral malodor, and is thought to be closely correlated with the activity of oral microorganism. Therefore, it is important to clarify the correlation between oral microbes and metabolites. Methods: Based on the 16S rRNA gene amplicon and shotgun metagenomic sequencing of oral microorganism, and oral malodor test, this study attempted to explain the contribution of oral microorganisms to the hydrogen sulfide of oral malodor. Results: The data shows that microbial taxa consisted in the H2S low and high groups are different, and most of the enriched taxa in the H2S high group are genus that correlated with H2S concentration. The two species Fusobaeterium periodonticum and Prevotella nanceiensis are significant different in both coverage breadth and depth and LPS biosynthesis contributions in two groups. According to KEGG metabolism pathways detected by HUMAnN2, subjects of the H2S high group may have a high risk to bacterial infection, since the LPS biosynthesis is enrichment. The contribution of F. periodonticum to sulfur metabolism between two groups is significantly different, and the relative abundance of F. periodonticum is higher in the H2S high group as well. Conclusions: The H2S content, is significantly associated with the composition and abundance of microorganisms in the oral cavity. The increase of microbial abundance and metabolism of some sulfide products are the main causes of halitosis. The most of the enriched microorganisms enriched in people with high H2S are associated with oral diseases such as caries and periodontal diseases, indicating that the diseases associated with oral microbes are not independent of each other and have some associations between some oral diseases.

Halitosis Self-Perception and Awareness among Periodontal Patients—An Exploratory Study

Halitosis is an unpleasant breath odor that interferes with self-confidence and with people’s professional and social lives. The aim of this exploratory study was to evaluate the self-perception and awareness of oral malodor among patients with periodontitis.

Oral malodor: Epidemiology, Etiology, Physiology, Diagnosis, Counseling aspects and clinical management- An overview

Breath malodor is a social problem, and most patients complained about breath malodor in most countries. The etiological chain of breath malodor originated from the volatile sulfur compounds (VSC), gingival and periodontal diseases. When the threshold concentration, odor power, and volatility of the molecules increase in the expired air, it results in unpleasant breath odor. There are many tests to diagnose oral malodor, and the clinical management includes mechanical reduction of nutrients, clinical reduction of oral microorganisms, conversion, and masking of volatile sulfur compounds. When the dentist's treatment of oral malodor is not successful, then referral to the physician is warranted.

Comparison of the Effect of Er,Cr:YSGG Laser and Halita Mouthwash on Oral Malodor in Patients With Chronic Periodontitis: A Randomized Clinical Trial

Introduction: Periodontal disease and tongue coatings are among the major factors associated with oral malodor. The present study, comparatively evaluated the effects of the Er,Cr:YSGG laser and Halita mouthwash as adjunctive treatments to nonsurgical periodontal debridement on oral malodor reduction in chronic periodontitis patients. Methods: Sixty patients with stage II and III chronic periodontitis and bad breath. The patients were randomly divided into two groups (n=30). After conventional scaling and root planing, patients in group 1 underwent Er,Cr:YSGG laser (Waterlase; Biolase, San Clemente, CA, USA) irradiation of the internal surface of the pockets ( 1.5 W, 30 Hz, 20% A, 40% W) and the dorsum of the tongue (1 W, 30 Hz, 20% A, 40% W) immediately after SRP and on the third and seventh days. Group 2 patients were asked to use Halita mouthwash twice daily for one week. Baseline, 1 and 3-month post-treatment measurements of plaque index (PI), probing pocket depth (PPD), clinical attachment level (CAL), gingival index (GI), bleeding on probing (BOP) and organoleptic assessment of Halitosis severity were performed. Results: Significant improvement in all parameters was noted in both groups after 1 and 3 months, compared with baseline (P<0.05). The two groups had significant reductions which occurred in PPD, CAL and BOP levels and the organoleptic score in 1 and 3 months after the intervention (P<0.05). Conclusion: Er,Cr:YSGG laser irradiation and Halita mouthwash as adjuncts to non-surgical periodontal therapy are both effective in the treatment of oral malodor and improvement of periodontal parameters.