Breath Odor and Oral Cavity

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 24883

Special Issue Editor


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Guest Editor
Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
Interests: halitosis; saliva; periodontitis; peri-implantitis; microbiology

Special Issue Information

Dear Colleagues,

The purpose of this Special Issue is to bring the latest breath odor research results to the broad field of healthcare professionals and increase awareness of bad breath (halitosis, malodor, foetor), with a specific focus on the oral aspects.

Breath odor is a common complaint in society. It may reflect consumption of odorous foods and beverages, lifestyle habits such as smoking, use of certain medications or be a sign of systemic diseases (extra-oral halitosis), such as upper respiratory tract infections and uncontrolled diabetes. However, the most common form of breath odor has its origin in the oral cavity (intra-oral halitosis), where odorous compounds, mainly volatile sulfur compounds, are formed as a result of bacterial metabolism.

In addition to foul-smelling volatile sulfur compounds, other volatile and non-volatile compounds can be found in breath that cannot be detected by a human nose but with an electronic nose. These developments offer a promising tool, not only for bad breath diagnostics, but also for a broader use of breath odor as a diagnostic tool.

Prof. Dr. Marja L. Laine
Guest Editor

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Keywords

  • malodor
  • halitosis
  • fetor
  • mouth
  • intra-oral
  • extra-oral

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Published Papers (6 papers)

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Research

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14 pages, 1693 KiB  
Article
Clinical Trial Evaluating Quality of Life in Patients with Intra-Oral Halitosis
by Iwona Olszewska-Czyz, Sarkis Sozkes and Agata Dudzik
J. Clin. Med. 2022, 11(2), 326; https://doi.org/10.3390/jcm11020326 - 10 Jan 2022
Cited by 5 | Viewed by 1751
Abstract
Halitosis is considered to be extremely unattractive in the context of social interactions. The main research objective of this study was to evaluate whether intra-oral halitosis may impact patients’ quality of life (QOL). One hundred generally healthy adult participants complaining about oral malodor [...] Read more.
Halitosis is considered to be extremely unattractive in the context of social interactions. The main research objective of this study was to evaluate whether intra-oral halitosis may impact patients’ quality of life (QOL). One hundred generally healthy adult participants complaining about oral malodor and diagnosed with intra-oral halitosis were enrolled in this study. For halitosis diagnosis, a gas chromatography (GC) analysis by the Oral Chroma portable device was used. QOL assessment was based on the Short Form 36-item Health Survey (SF-36). The respondents had the highest scores in the physical functioning (PF), activity limitations caused by emotional problems (RE) and activity limitations caused by physical problems (RP) domains, and the weakest in the general health perception (GH), vitality (VT) and emotional wellbeing (MH) ones. The total volatile sulfur compounds (VSCs) level was negatively correlated with SF-36 domains. The SF-36 domains’ scores decreased the higher the level of VSC was. The respondents assessed their QOL to be at its best in physical functioning and activity limitations caused by emotional and physical problems and the worst in general health perception, vitality and emotional wellbeing. The strongest correlation between halitosis and decreased QOL was found in the social functioning (SF), vitality, emotional wellbeing and general health perception domains. Full article
(This article belongs to the Special Issue Breath Odor and Oral Cavity)
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10 pages, 546 KiB  
Article
Efficacy of a Zinc Lactate Mouthwash and Tongue Scraping in the Reduction of Intra-Oral Halitosis: A Single-blind, Controlled, Crossover Clinical Trial—A Pilot Study
by Agata Dudzik, Sarkis Sozkes, Ewa Michalak and Iwona Olszewska-Czyz
J. Clin. Med. 2021, 10(23), 5532; https://doi.org/10.3390/jcm10235532 - 26 Nov 2021
Cited by 4 | Viewed by 2958
Abstract
Intra-oral halitosis is defined as an unpleasant odor that comes out of the mouth. The aim of this study was to investigate the effect of zinc lactate mouthwash and tongue scraping on intra-oral halitosis. The study was conducted on 60 volunteers that were [...] Read more.
Intra-oral halitosis is defined as an unpleasant odor that comes out of the mouth. The aim of this study was to investigate the effect of zinc lactate mouthwash and tongue scraping on intra-oral halitosis. The study was conducted on 60 volunteers that were divided into two groups and fol-lowed two types of 14-day oral hygiene protocols on a cross-over basis after a 7-day wash-out period. One protocol was based on tooth brushing only, while the other was based on additional mouth rinsing with a zinc lactate product and tongue scraping. Morning mouth breath was as-sessed organoleptic and by volatile sulfur compound concentrations. The highest mean organo-leptic and volatile sulfur compound measurement values were found in the tooth brushing without mouth washing and tongue scraping oral hygiene protocol (p < 0.05). The zinc lactate mouthwash combined with tongue scraping appears to be an important hygienic procedure to reduce breath odor. Full article
(This article belongs to the Special Issue Breath Odor and Oral Cavity)
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15 pages, 1062 KiB  
Article
Evaluation of the Efficacy of Lacer HaliTM Treatment on the Management of Halitosis: A Randomized Double-Blind Clinical Trial
by Laiqi Xiang, Rosa Rojo and Juan Carlos Prados-Frutos
J. Clin. Med. 2021, 10(11), 2256; https://doi.org/10.3390/jcm10112256 - 23 May 2021
Cited by 3 | Viewed by 2139
Abstract
Background: Halitosis of oral origin is very common in the general population. Due to their antimicrobial properties, chlorhexidine-based products are widely used in the management of this condition, but these are associated with reversible side effects. In this study we evaluated the efficacy [...] Read more.
Background: Halitosis of oral origin is very common in the general population. Due to their antimicrobial properties, chlorhexidine-based products are widely used in the management of this condition, but these are associated with reversible side effects. In this study we evaluated the efficacy of Lacer HaliTM mouthrinse and toothpaste in subjects with intraoral halitosis after several applications under normal conditions of use. Methods: In this randomized clinical trial with mouth rinse and toothpaste, single-center, double-blinded, parallel participants were assigned to an experimental group (Lacer HaliTM,, n = 20), a positive control group (HalitaTM, n = 20), and a placebo group (n = 20). The active duration of the study was 18 days. The clinical follow-up evaluations were performed at five time points (T0, T1, T2, T3, and T4). The intensity of halitosis was evaluated by organoleptic measurement and the portable gas chromatograph OralChromaTM. The data were analyzed using generalized mixed linear models. Results: Sixty patients completed the study. Lacer HaliTM, in comparison with HalitaTM, did not show statistically significant differences at any time during the study except for the levels of hydrogen sulfide and total volatile sulfur compounds at 15 days, where HalitaTM was better. Compared to the placebo treatment, Lacer HaliTM, was significantly more efficient, in terms of both the organoleptic evaluations at 8 days and the levels of hydrogen sulfide. Conclusions: Lacer HaliTM is an alternative to chlorhexidine-based toothpaste and mouthwashes in the management of halitosis. Full article
(This article belongs to the Special Issue Breath Odor and Oral Cavity)
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13 pages, 273 KiB  
Article
Knowledge and Management of Halitosis in France and Lebanon: A Questionnaire-Based Study
by Laetitia Harmouche, Yves Reingewirtz, Nicolas Tuzin, François Lefebvre, Jean-Luc Davideau and Olivier Huck
J. Clin. Med. 2021, 10(3), 502; https://doi.org/10.3390/jcm10030502 - 1 Feb 2021
Cited by 3 | Viewed by 2974
Abstract
Halitosis is a growing issue and its management is highly challenging. The aim of this study was to evaluate the knowledge and treatment strategies used by French (FD) and Lebanese (LD) dentists. A self-administered structured questionnaire was sent to FD and LD comprising [...] Read more.
Halitosis is a growing issue and its management is highly challenging. The aim of this study was to evaluate the knowledge and treatment strategies used by French (FD) and Lebanese (LD) dentists. A self-administered structured questionnaire was sent to FD and LD comprising questions about professional characteristics, management, and treatment of halitosis, patients’ referral, and halitosis-related knowledge. A multivariate analysis was conducted to determine differences between FD and LD and to identify parameters that could influence dentists’ management of halitosis. The questionnaire was filled out by 156 FD and 257 LD. Among them, 78.8% of FD and 68.9% of LD were confronted with halitosis management, while only a few routinely asked their patients about halitosis (16% FD, 13.2% LD). Regarding anamnesis, oral hygiene habits were more investigated by FD than LD (p < 0.05). The overall treatment satisfaction was low with 39.7% of FD and 28.4% of LD considering their treatment effective. Regarding halitosis-related knowledge, extra-oral causes were overestimated in both populations. FD (83.4%) and LD (65.8%) considered their education regarding halitosis as insufficient. This study highlights the need of professional education in both countries, targeting proper diagnosis and treatment strategies of halitosis. Full article
(This article belongs to the Special Issue Breath Odor and Oral Cavity)

Review

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8 pages, 241 KiB  
Review
The Problem of Halitosis in Prosthetic Dentistry, and New Approaches to Its Treatment: A Literature Review
by Magdalena Wyszyńska, Monika Nitsze-Wierzba, Ewa Białożyt-Bujak, Jacek Kasperski and Małgorzata Skucha-Nowak
J. Clin. Med. 2021, 10(23), 5560; https://doi.org/10.3390/jcm10235560 - 26 Nov 2021
Cited by 2 | Viewed by 2010
Abstract
The aim of this work is a review of recent scientific literature about intra-oral halitosis among patients using dentures. Halitosis is a condition in which an unpleasant smell comes out of the oral cavity, which is caused mainly by volatile sulfur and non-sulfured [...] Read more.
The aim of this work is a review of recent scientific literature about intra-oral halitosis among patients using dentures. Halitosis is a condition in which an unpleasant smell comes out of the oral cavity, which is caused mainly by volatile sulfur and non-sulfured compounds. The etiology of halitosis may be intra- or extra-oral; in most patients, however, it is due to the activity of microorganisms in the oral cavity. The problem of the occurrence of intra-oral halitosis has accompanied patients for many years. In dental prosthetics, the problem of halitosis occurs in patients using removable or fixed dentures. In both cases, new niches for the development of microorganisms may be created, including those related to intra-oral halitosis. It should be noted that dentures—both fixed and removable—are a foreign body placed in the patient’s oral cavity which, in case of insufficient hygiene, may constitute a reservoir of microorganisms, causing this unpleasant condition. Conventional treatment of intraoral halitosis reduces microbial activity via chemical and/or mechanical action. Currently, the search for new strategies in the treatment of halitosis is in progress. One idea is to use photodynamic therapy, while another is to modify poly(methyl methacrylate) (PMMA) with silver and graphene nanoparticles. Additionally, attempts have been made to combine those two methods. Another unconventional method of treating halitosis is the use of probiotics. Full article
(This article belongs to the Special Issue Breath Odor and Oral Cavity)
17 pages, 5357 KiB  
Review
The Role of Oral Microbiota in Intra-Oral Halitosis
by Katarzyna Hampelska, Marcelina Maria Jaworska, Zuzanna Łucja Babalska and Tomasz M. Karpiński
J. Clin. Med. 2020, 9(8), 2484; https://doi.org/10.3390/jcm9082484 - 2 Aug 2020
Cited by 84 | Viewed by 11768
Abstract
Halitosis is a common ailment concerning 15% to 60% of the human population. Halitosis can be divided into extra-oral halitosis (EOH) and intra-oral halitosis (IOH). The IOH is formed by volatile compounds, which are produced mainly by anaerobic bacteria. To these odorous substances [...] Read more.
Halitosis is a common ailment concerning 15% to 60% of the human population. Halitosis can be divided into extra-oral halitosis (EOH) and intra-oral halitosis (IOH). The IOH is formed by volatile compounds, which are produced mainly by anaerobic bacteria. To these odorous substances belong volatile sulfur compounds (VSCs), aromatic compounds, amines, short-chain fatty or organic acids, alcohols, aliphatic compounds, aldehydes, and ketones. The most important VSCs are hydrogen sulfide, dimethyl sulfide, dimethyl disulfide, and methyl mercaptan. VSCs can be toxic for human cells even at low concentrations. The oral bacteria most related to halitosis are Actinomyces spp., Bacteroides spp., Dialister spp., Eubacterium spp., Fusobacterium spp., Leptotrichia spp., Peptostreptococcus spp., Porphyromonas spp., Prevotella spp., Selenomonas spp., Solobacterium spp., Tannerella forsythia, and Veillonella spp. Most bacteria that cause halitosis are responsible for periodontitis, but they can also affect the development of oral and digestive tract cancers. Malodorous agents responsible for carcinogenesis are hydrogen sulfide and acetaldehyde. Full article
(This article belongs to the Special Issue Breath Odor and Oral Cavity)
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