Halitosis - oral malodour

Published on February 28, 2017   42 min

Other Talks in the Series: Oral & Maxillofacial Medicine

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Halitosis Oral Malodor by Professor John Greenman.
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Direction of talk. I'm going to cover the background and early work, and the measurement of oral malodor. The role of microbes and tongue biofilm in malodor, whether or not there's a periodontal contribution to oral malodor, and the various interventions that people can do to try and reduce or ameliorate the problems of malodor. So we start with the background and early work.
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Early work on breath malodor was work done by Tonzetich in the 1970s, where he used gas chromatography to analyze the sulphur compounds in the mouth air of humans. He also looked specifically at the production and origin of oral malodor and reviewed the mechanisms and methods of analysis, he found that hydrogen sulfide, methyl sulfide, and dimethyl sulfide were the most important gases, and also showed that the tongue surface might be the most important site of generation within the mouth.
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Early work also consisted of something called a salivary putrefactions model. This is where work is mixed, organisms that they had isolated or indeed mixed cultures of organisms from a mouth and put them into media contenting certain types of amino acids. And Tonzetich, and McNamara, and Kleinberg, and Codipilly, these were the workers who showed that anaerobes, particularly gram-negative anaerobes, produced a higher degree of malodor in culture than other groups. They're also able to show that some of the substrates were very effective in inducing odor such as cystine or cysteine, which the microbes change to hydrogen sulfide. Methionine, which microbes change to methylmercaptan. Ormithine, arginine or lysine, which were changed to either putrescine or cadaverine, and tryptophan that was changed to indole. And, of course, all these gases are highly aromatic, highly smelly.