The relationship between oral malodor and volatile sulfur compound–producing bacteria

Abstract

Halitosis can be a crippling social problem, and standard dental treatments and mouthwashes often provide only temporary relief. The mouth is home to hundreds of bacterial species that produce several fetid substances as a result of protein degradation. Volatile sulfur compound (VSC)-producing bacteria colonizing the lingual dorsum have recently been implicated in the generation of halitosis. Detection of VSCs, such as methylmercaptan and hydrogen sulfite, via organoleptic and objective methods, can aid in the identification of their source. Following comprehensive evaluation for possible causes, most halitosis in patients seen in an ENT practice can be localized to the tongue. We review methods of diagnosis and treatment of oral malodor from the overgrowth of proteolytic, anaerobic, gram-negative bacteria on the crevices of the lingual dorsum. Bacteriologic analysis of biofilm and scraped specimens obtained from the lingual dorsum and other oral sites, primarily gingival pockets and tonsillar crypts, can identify VSC-producing bacteria. Porphyromonas, Prevotella, Actinobacillus, and Fusobacterium species are the most common organisms identified. Halitosis is an oral phenomenon, with almost no cases originating distal to the tonsils. Halitosis arising from the lingual dorsum secondary to overpopulated VSC-producing bacteria can be successfully managed with a combination of mechanical cleansing using tongue brushes or scrapes and chemical solutions containing essential oils, zinc chloride, and cetylpyridinium chloride.

Halitosis: Un asunto del odontólogo

“…Un ambiente anaeróbico es una característica importante en la biogénesis de la halitosis, ya que permite producir altos niveles de CVS, por lo tanto a mayor cantidad de bacterias hay un mayor riesgo de presentar halitosis (12,35).…”

Halitosis: a review of associated factors and therapeutic approach

“…The morphology of the dorsum of the tongue provides additional irregularities such as fissures, grooves and depapillated areas that may serve as retention areas for harboring bacteria. 1,29,33,34 The development of a predominant anaerobic microbiota associated with tongue coating has been considered an ideal microenvironment to produce malodorous compounds, and therefore different authors have tried to assess the relationship between the morphology of the tongue and the severity of oral halitosis. 35,36 Numerous studies have found a relationship between the mechanical removal of tongue coating and the reduction of both organoleptic scores and VSC levels, including reduction in methyl mercaptan levels and the methyl mercaptan/hydrogen sulfide ratio, in both healthy and periodontitis patients, with or without halitosis.…”

“…20,21,31,37 Mechanical reduction of malodor and of the intraoral bacterial count may be achieved by disrupting the tongue biofilm, thus decreasing the production of VSCs and other volatile organic compounds. 32,34,38 Various available instruments can be applied to the tongue, and by gentle pressure the majority of the tongue coating can be scraped off. 38 Brushing the dorsum of the tongue with toothpaste was more effective than brushing the teeth.…”

Efficacy of Oral Refresher Strip Containing Five Types of Essential Oils on Oral Malodor

“…Physiological oral malodor is caused by a bacterial putrefactive process occurring within the oral cavity that converts protein into amino acid so that volatile sulfur compounds (VSCs) causing oral malodor are produced [4]. Anaerob Gram negative bacteria are most likely the main causes of oral malodor.…”