Halitosis affects a large part of the population. Many of those that are affected suffer from this problem for a long time before they visit a professional halitosis clinic. Further, halitosis creates social and psychological disadvantages. Although halitosis has multifactorial origins, in nine out of ten cases the source can be found within the oral cavity. The most frequent intra-oral causes are tongue coating, gingivitis, and periodontitis, or a combination of these. A general dental practitioner is often faced with patients suffering from halitosis in her/his dental practice and therefore should be able to manage it. Using standardized strategies, a high level of treatment success can be achieved. In the literature, several methods to determine halitosis and various possibilities for treatment are described. The present review summarizes diagnostics, prevalence, and current treatments of oral halitosis.

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. AbstractBackground: Oral malodor is a very discomforting condition deriving from the presence of volatile sulfur compounds in the expired air. In halitosis of intraoral etiology, the volatile sulfur compounds are metabolic products of the oral microorganisms within the biofilm coating the tongue dorsum as well as other tissues in the oral cavity. The aim of this study was to characterize and compare the microbial composition of tongue biofilm in volunteers suffering from halitosis and healthy volunteers by means of both the culture method and culture-independent cloning technique.Results: A high bacterial variety (more than 80 different species) was detected using the combination of both methods. A distinct bacterial composition was revealed in the halitosis-associated biofilms compared with the health-associated biofilms.Actinomyces graevenitzii was shown to be significantly associated with the halitosis condition. The culture method identified 47 species, included Veillonella rogosae, never isolated from the tongue biofilm of halitosis patients so far. In the healthy condition, the culture-dependent method showed that the most frequent species were Streptococcus parasanguinis among the aerobes and Veillonella spp. among the anaerobes. The culture-independent cloning method detected more than 50 species.Streptococci, in particular S. mitis/oralis, S. pseudopneumoniae, and S. infantis as well as Prevotella spp., were found most frequently in halitosis patients. Streptococcus salivarius and Rothia mucilaginosa were found more frequently in the healthy condition. Conclusions:The combination of the culture-dependent and culture-independent cloning techniques allowed for a widespread analysis of the tongue biofilm in halitosis patients. The results can support further pharmacological research for new antimicrobial agents and halitosis therapy strategies. K E Y W O R D Sculture-independent cloning technique, halitosis, microbial culture, tongue biofilm | 11 of 12

During the coronavirus disease 2019 (COVID-19) pandemic, vocational counselors in Switzerland more frequently worked from home (WFH) and less frequently worked on-site. The aim of this study was to assess how WFH corresponds with indicators of job performance and occupational wellbeing. More specifically, the current questionnaire study analyzed the increase in WFH, self-reported productivity, distractibility in WFH, current job satisfaction, work-life balance in WFH, and feeling of loneliness. Findings showed that the increase in WFH in vocational counseling psychologists during the COVID-19 pandemic was associated with an increase in productivity and job satisfaction and with lower distractibility in WFH compared to work on-site. However, more frequent WFH was not significantly associated with improved work-life balance during the COVID-19 pandemic. Vocational counselors who shared the office on-site with many colleagues experienced higher feeling of loneliness during WFH. Vocational counselors regarded the condition of WFH as productive and satisfying while work-life balance did not improve. The discussion sheds light on the potential WFH-related increase of boundary management demands.

A case of a 56-year-old woman with a mole pregnancy and a human chorionic gonadotropin (HCG)-induced thyreotoxicosis is presented. A proper diagnosis was only made after a period of patient and doctor's delay. After performing a hysterectomy, the HCG quickly normalized. Thyroid function normalized with thiamazol treatment. It is well known that older women have a higher risk to develop gestational trophoblastic disease (GTD). Furthermore, the chance of persistent trophoblastic disease is increased in this population. The literature on risk factors for developing persistent GTD and the possibilities for treatment in older patients is reviewed.

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