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Oral malodor reduction by a combination of chemotherapeutical and mechanical treatments

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Abstract

Bacterial proliferation and plaque accumulation on the surface of the tongue are major factors contributing to oral malodor. In this research, we used subjective and objective methods to evaluate the breath benefit of a triclosan-containing dentifrice (Blend-a-Med Complete Night) with and without tongue brushing in a randomized, examiner-blinded, three-period crossover clinical trial. Twenty-nine adults (mean age 40.2 years) with morning malodor were randomly assigned to a treatment sequence: triclosan dentifrice, triclosan dentifrice plus tongue brushing, and a control dentifrice (Crest Cavity Protection). The subjects used each product four times in 27 h with a 2-day wash-out period between treatments. Halimeter measurements were taken at baseline and at 3, 24 and 27 h. Subject questionnaire data assessing the breath quality were collected at 24 and 27 h. Both triclosan regimens showed significant improvement in oral malodor (p<0.03) relative to the control. Significant (p=0.035) malodor benefit was observed when tooth brushing with triclosan dentifrice was supplemented with tongue brushing. The triclosan dentifrice was associated with significant improvement (p<0.05) in morning mouth feel and feeling of clean and fresh breath during the day relative to the control. There were no adverse events reported. The triclosan dentifrice was effective against overnight and daytime oral malodor. Supplementing routine brushing with tongue brushing resulted in additional breath improvement and breath benefits of the triclosan dentifrice were first-person noticeable.

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References

  1. Bradshaw DJ, Marsh PD, Watson GK, Cummins D (1993) The effects of triclosan and zinc citrate, alone and in combination, on a community of oral bacteria grown in vitro. J Dent Res 72:25–30

    PubMed  Google Scholar 

  2. Carvalho MD, Tabchoury CM, Cury JA, Toledo S, Nogueira-Filho GR (2004) Impact of mouthrinses on morning bad breath in healthy subjects. J Clin Periodontol 31(2):85–90

    Article  PubMed  Google Scholar 

  3. Christen AG, Swanson BZ Jr (1978) Oral hygiene: a history of tongue scraping and brushing. J Am Dent Assoc 96:215–219

    PubMed  Google Scholar 

  4. Cicek Y, Orbak R, Tezel A, Orbak Z, Erciyas K (2003) Effect of tongue brushing on oral malodor in adolescents. Pediatr Int 45(6):719–723

    Article  PubMed  Google Scholar 

  5. Delanghe G, Bollen C, van Steenberghe D, Feenstra L (1998) Halitosis, foetor ex ore. Ned Tijdschr Tandheelkd 105(9):314–317

    PubMed  Google Scholar 

  6. Greenman J, Duffield J, Spenser P,Rosenberg M, Corry D, Saad S, Lenton P, Majerus G, Nachnani S, El-Maaytah M (2004) Study on organoleptic intensity scale for measuring oral malodor. J Dent Res 83:81–85

    PubMed  Google Scholar 

  7. Gulati MS, Gupta L (1998) Clinical evaluation of supplementing tongue brushing to most advocated regime of tooth brushing. J Indian Soc Pedod Prev Dent 16(1):12–16

    PubMed  Google Scholar 

  8. Hartley G, el-Maaytah M, Greenman J (1995) Tongue microflora of subjects with low and high malodor levels. J Dent Res 75:195

    Google Scholar 

  9. Heath RJ, Rubin JR, Holland DR, Zhang E, Snow ME, Rock CO (1999) Mechanism of triclosan inhibition of bacterial fatty acid synthesis. J Biol Chem 274(16):11110–11114

    Article  PubMed  Google Scholar 

  10. Hyde RJ, Feller RP, Sharon IM (1981) Tongue brushing, dentifrice, and age effects on taste and smell. J Dent Res 60(10):1730–1734

    PubMed  Google Scholar 

  11. Jones CL, Ritchie JA, Marsh PD, van der Ouderaa F (1988) The effect of long-term use of a dentifrice containing zinc citrate and a non-ionic agent on the oral flora. J Dent Res 67(1):46–50

    PubMed  Google Scholar 

  12. Kleinberg I, Codipilly M (1995) The biological basis of oral malodor formation. In: Rosenberg M (ed) Bad breath: research perspectives. Ramat Publishing, Tel Aviv, pp 13–39

    Google Scholar 

  13. Kleinberg I, Westbay G (1990) Oral malodor. Crit Rev Oral Biol Med 1:247–259

    PubMed  Google Scholar 

  14. Kleinberg I, Codipilly DM (2002) Cystein challenge testing: a powerful tool for examining oral malodour process and treatments in vivo. Int Dent J 52(3):221–228

    PubMed  Google Scholar 

  15. Lang NP, Sander L, Barlow A, Brennan K, White DJ, Bacca L, Bartizek RD, McClanahan SF (2002) Experimental gingivitis studies: effects of triclosan and triclosan-containing dentifrices on dental plaque and gingivitis in three-week randomized controlled clinical trials. J Clin Dent 13(4):158–166

    PubMed  Google Scholar 

  16. Loesche WJ, Kazor C (2002) Microbiology and treatment of halitosis. Periodontol 2000 28:256–279

    Article  PubMed  Google Scholar 

  17. Marsh PD (1991) Dentifrices containing new agents for the control of plaque and gingivitis: microbiological aspects. J Clin Periodontol 18(6):462–467

    Article  PubMed  Google Scholar 

  18. McDowel JD, Kassebaum DK (1993) Diagnosis and treating halitosis. J Am Dent Assoc 124:55–64

    Google Scholar 

  19. McNamara TF, Alexander JF, Lee M (1972) The role of microorganisms in the production of oral malodor. Oral Surg Oral Med Oral Pathol 34(1):41–48

    Article  PubMed  Google Scholar 

  20. Meskin LH (1996) A breath of fresh air. J Am Dent Assoc 127:1282–1286

    PubMed  Google Scholar 

  21. Miyazaki H, Sakao S, Katoh Y, Takehara T (1995) Correlation between volatile sulphur compounds and certain oral health measurements in the general population. J Periodontol 66:679–684

    PubMed  Google Scholar 

  22. Niles HP, Gaffar A (1993) Relationship between sensory and instrumental evaluations of mouth odor. J Soc Cosmet Chem 44:101–107

    Google Scholar 

  23. Nogueira-Filho GR, Duarte PM, Toledo S, Tabchoury CP, Cury JA (2002) Effect of triclosan dentifrices on mouth volatile sulphur compounds and dental plaque trypsin-like activity during experimental gingivitis development. J Clin Periodontol 29(12):1059–1064

    Article  PubMed  Google Scholar 

  24. Quirynen M, Avontroodt P, Soers C, Zhao H, Pauwels M, van Steenberghe D (2004) Impact of tongue cleansers on microbial load and taste. J Clin Periodontol 31(7):506–510

    Article  PubMed  Google Scholar 

  25. Richter JL (1996) Diagnosis and treatment of halitosis. Compendium 17(4):370–386

    PubMed  Google Scholar 

  26. Roldan S, Herrera D, Sanz M (2003) Biofilms and the tongue: therapeutical approaches for the control of halitosis. Clin Oral Investig 7(4):189–197

    Article  PubMed  Google Scholar 

  27. Rosenberg M, Kulkarni GV, Bosy A, McCulloch CAG (1991) Reproducibility and sensitivity of oral malodor measurements with a portable sulfide monitor. J Dent Res 70:1436–1440

    PubMed  Google Scholar 

  28. Rosenberg M, Septon I, Eli I, Bar-Ness R, Gelernter I, Brenner S (1991) Halitosis measurement by an industrial sulfide monitor. J Periodontol 63:776–782

    Google Scholar 

  29. Rosenberg M, Kozlovsky A, Gelertner I, Cherniak O, Gabbay J, Baht R, Eli I (1995) Self-estimation of oral malodor. J Dent Res 74(9):1577–1582

    PubMed  Google Scholar 

  30. Rosenberg M (2002) The science of bad breath. Sci Am 286(4):72–79

    Article  PubMed  Google Scholar 

  31. Russell AD (2004) Whither triclosan? J Antimicrob Chemother 53(5):693–695

    Article  PubMed  Google Scholar 

  32. Sanz M, Roldan S, Herrera D (2001) Fundamentals of breath malodour. J Contemp Dent Pract 2(4):1–17

    PubMed  Google Scholar 

  33. Sarrazin JJ (1920) Tongue cleansing. Dent Pract Dent Rec 30:599

    Google Scholar 

  34. Schmidt NF, Missan SR, Tarbet WJ, Cooper AD (1978) The correlation between organoleptic mouth-odor ratings and levels of volatile sulfur compounds. Oral Surg Oral Med Oral Pathol 45:560–567

    Article  PubMed  Google Scholar 

  35. Scully C, el-Maaytah M, Porter SR, Greenman J (1997) Breath odor: etiopathogenesis, assessment and management. Eur J Oral Science 105(4):287–293

    Article  Google Scholar 

  36. Sreenivasan P, Gaffar A (2002) Antiplaque biocides and bacterial resistance: a review. J Clin Periodontol 29(11):965–974

    Article  PubMed  Google Scholar 

  37. Stephen KW, Saxton CA, Jones CL, Ritchie JA, Morrison T (1990) Control of gingivitis and calculus by a dentifrice containing a zinc salt and triclosan. J Periodontol 61(11):674–679

    PubMed  Google Scholar 

  38. Stewart MJ, Parikh S, Xiao G, Tonge PJ, Kisker C (1999) Structural basis and mechanism of enoyl reductase inhibition by triclosan. J Mol Biol 290(4):859–865

    Article  PubMed  Google Scholar 

  39. Suarez F, Furne J, Springfield J, Levitt MD (2000) Morning breath odor: influence of treatments on sulfur gases. J Dent Res 79:1773–1777

    PubMed  Google Scholar 

  40. Suller MTE, Russell AD (2000) Triclosan and antibiotic resistance in Staphylococcus aureus. J Antimicrob Chemother 46:11–18

    Article  PubMed  Google Scholar 

  41. Tanaka M, Anguri H, Nishida N, Ojima M, Nagata H, Shizukuishi S (2003) Reliability of clinical parameters for predicting the outcome of oral malodor treatment. J Dent Res 82(7):518–522

    Article  PubMed  Google Scholar 

  42. Tangerman A (2002) Halitosis in medicine: a review. Int Dent J 52:201–206

    PubMed  Google Scholar 

  43. Tonzetich J, Ng SK (1976) Reduction of malodor by oral cleansing procedures. Oral Surg Oral Med Oral Pathol 42(2):172–181

    Article  PubMed  Google Scholar 

  44. Tonzetich J (1977) Production and origin of oral malodor: a review of mechanisms and methods of analysis. J Periodontol 48:13–20

    PubMed  Google Scholar 

  45. Winston JL, Bartizek RD, McClanahan SF, Mau MS, Beiswanger BB (2002) A clinical methods study of the effects of triclosan dentifrices on gingivitis over six months. J Clin Dent 13(6):240–248

    PubMed  Google Scholar 

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Acknowledgements

The authors acknowledge Lynn Downey, Susan Fiedler, Pelin Gunenc, Rob Hinkle, Stephen McClanahan, Victoria Milyanenkova, and Lisa Saletta for their contributions to study preparation and execution.

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  1. Procter & Gamble, 8700 Mason-Montgomery Road, Mason, OH, 45040-9462, USA

    Svetlana Farrell, Robert A. Baker, Marta Somogyi-Mann, Jon J. Witt & Robert W. Gerlach

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  1. Svetlana Farrell
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  2. Robert A. Baker
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  3. Marta Somogyi-Mann
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Correspondence to Svetlana Farrell.

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Farrell, S., Baker, R.A., Somogyi-Mann, M. et al. Oral malodor reduction by a combination of chemotherapeutical and mechanical treatments. Clin Oral Invest 10, 157–163 (2006). https://doi.org/10.1007/s00784-006-0044-5

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  • DOI: https://doi.org/10.1007/s00784-006-0044-5

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