The short-term treatment effects on the microbiota at the dorsum of the tongue in intra-oral halitosis patients--a randomized clinical trial.

Abstract

OBJECTIVES:

This study aims to assess the effects of rinsing with zinc- and chlorhexidine-containing mouth rinse with or without adjunct tongue scraping on volatile sulfur compounds (VSCs) in breath air, and the microbiota at the dorsum of the tongue.

MATERIAL AND METHODS:

A randomized single-masked controlled clinical trial with a cross-over study design over 14 days including 21 subjects was performed. Bacterial samples from the dorsum of the tongue were assayed by checkerboard DNA-DNA hybridization.

RESULTS:

No halitosis (identified by VSC assessments) at day 14 was identified in 12/21 subjects with active rinse alone, in 10/21 with adjunct use of tongue scraper, in 1/21 for negative control rinse alone, and in 3/21 in the control and tongue scraping sequence. At day 14, significantly lower counts were identified only in the active rinse sequence (p < 0.001) for 15/78 species including, Fusobacterium sp., Porphyromonas gingivalis, Pseudomonas aeruginosa, Staphylococcus aureus, and Tannerella forsythia. A decrease in bacteria from baseline to day 14 was found in successfully treated subjects for 9/74 species including: P. gingivalis, Prevotella melaninogenica, S. aureus, and Treponema denticola. Baseline VSC scores were correlated with several bacterial species. The use of a tongue scraper combined with active rinse did not change the levels of VSC compared to rinsing alone.

CONCLUSIONS:

VSC scores were not associated with bacterial counts in samples taken from the dorsum of the tongue. The active rinse alone containing zinc and chlorhexidine had effects on intra-oral halitosis and reduced bacterial counts of species associated with malodor. Tongue scraping provided no beneficial effects on the microbiota studied.

CLINICAL RELEVANCE:

Periodontally healthy subjects with intra-oral halitosis benefit from daily rinsing with zinc- and chlorhexidine-containing mouth rinse.

• Authors: Seida Erovic Ademovski, G Rutger Persson, Edwin Winkel, Albert Tangerman, Peter Lingström, Stefan Renvert
• Journal: Clinical oral investigations (Clin Oral Investig) Vol. 17 Issue 2 Pg. 463-73 (Mar 2013) ISSN: 1436-3771 [Electronic] Germany
• PMID: 22573244 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Infective Agents, Local
• Drug Combinations
• Mouthwashes
• Sulfhydryl Compounds
• Sulfides
• Volatile Organic Compounds
• chlorhexidine, zinc acetate drug combination
• methylmercaptan
• Zinc Acetate
• dimethyl sulfide
• Chlorhexidine
• Hydrogen Sulfide

Topics

• Adult
• Aged
• Anti-Infective Agents, Local (therapeutic use)
• Bacteria (drug effects)
• Bacterial Load (drug effects)
• Bacteroides (drug effects, isolation & purification)
• Chlorhexidine (therapeutic use)
• Cross-Over Studies
• Drug Combinations
• Female
• Follow-Up Studies
• Fusobacterium (drug effects, isolation & purification)
• Halitosis (drug therapy, microbiology)
• Humans
• Hydrogen Sulfide (analysis)
• Male
• Middle Aged
• Mouthwashes (therapeutic use)
• Oral Hygiene (instrumentation)
• Porphyromonas gingivalis (drug effects, isolation & purification)
• Prevotella melaninogenica (drug effects, isolation & purification)
• Pseudomonas aeruginosa (drug effects, isolation & purification)
• Single-Blind Method
• Staphylococcus aureus (drug effects, isolation & purification)
• Sulfhydryl Compounds (analysis)
• Sulfides (analysis)
• Tongue (drug effects, microbiology)
• Treponema denticola (drug effects, isolation & purification)
• Volatile Organic Compounds (analysis)
• Young Adult
• Zinc Acetate (therapeutic use)