Journal Article

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

Winkel, Edwin, Ademovski, Seida Erovic, Persson, G. Rutger, Lingström, Peter, Renvert, Stefan, Tangerman, Albert

2013

Overview

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 10/21with 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.

• Publisher: Springer-Verlag,Springer Nature B.V
• Subject: Adult / Aged / Anti-Infective Agents, Local - therapeutic use / Bacteria / Bacteria - drug effects / Bacterial Load - drug effects / Bacteroides - drug effects / Bacteroides - isolation & purification / Bacteroides forsythus / Chlorhexidine - therapeutic use / Clinical Medicine / clinical trial / Cross-Over Studies / Dentistry / Drug Combinations / Female / Follow-Up Studies / Fusobacterium / Fusobacterium - drug effects / Fusobacterium - isolation & purification / Halitosis / Halitosis - drug therapy / Halitosis - microbiology / Humans / Hydrogen Sulfide - analysis / Klinisk medicin / Male / Medical and Health Sciences / Medicin och hälsovetenskap / Medicine / microflora / Middle Aged / Mouth rinse / Mouthwashes - therapeutic use / Odontologi / Odontology / Oral Hygiene - instrumentation / Original Article / Porphyromonas gingivalis / Porphyromonas gingivalis - drug effects / Porphyromonas gingivalis - isolation & purification / Prevotella melaninogenica / Prevotella melaninogenica - drug effects / Prevotella melaninogenica - isolation & purification / Pseudomonas aeruginosa / Pseudomonas aeruginosa - drug effects / Pseudomonas aeruginosa - isolation & purification / randomized / Single-Blind Method / Staphylococcus aureus / Staphylococcus aureus - drug effects / Staphylococcus aureus - isolation & purification / Sulfhydryl Compounds - analysis / Sulfides - analysis / tongue / Tongue - drug effects / Tongue - microbiology / Tongue scraping / Treponema denticola / Treponema denticola - drug effects / Treponema denticola - isolation & purification / Volatile Organic Compounds - analysis / VSC / Young Adult / Zinc Acetate - therapeutic use