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Biofilms and the tongue: therapeutical approaches for the control of halitosis

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Abstract

Due to its location and functions, the tongue is one of the most important anatomic structures in the oral cavity. However, knowledge in regards to its role and implications in oral health and disease is scarce. Moreover, although the dorsum of the tongue seems to harbour one of the most complex microbiological niches in human ecology, the knowledge of the role of tongue flora in health and disease is also very limited. Similarly, the nature of the tongue coating and the factors that influence its development and composition are almost unknown. The interest in the study of the tongue niche has increased in recent years due to its association with oral halitosis and to its role as a suitable reservoir for periodontal pathogens. The structure of the tongue favours a unique and complex bacterial biofilm, in which periodontal pathogens are frequently found. However, little is known about how to control this bacterial niche, and factors affecting tongue coating composition and aspect are not fully understood. Studies available on the influence of mechanical or antimicrobial approaches against tongue biofilm are very limited. Mechanical treatments showed a transient reduction in halitosis-related variables but were limited in time. Different antimicrobials agents have been evaluated: chlorhexidine, chlorine dioxide, metal ions, triclosan, formulations containing essential oils , and hydrogen peroxide. However, most studies were designed as short-term models. Some of these studies demonstrated that the reduction in halitosis-related variables was associated with significant changes in the tongue microflora.

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References

  1. Asikainen S, Alaluusua S, Saxen L (1991) Recovery of A. actinomycetemcomitans from teeth, tongue, and saliva. J Periodontol 62:203–206

    CAS  PubMed  Google Scholar 

  2. Bosy A, Kulkarni GV, Rosenberg M, McCulloch G (1994) Relationship of oral malodor to periodontitis: evidence of independence in discrete subpopulations. J Periodontol 65:37–46

    CAS  PubMed  Google Scholar 

  3. Brunette DM, Proskin HM, Nelson BJ (1998) The effects of dentifrice systems on oral malodor. J Clin Dent 9:76–82

    CAS  PubMed  Google Scholar 

  4. Chen ZL (1987) Brief history of tongue inspection. Chin Med J 100:38–44

    CAS  PubMed  Google Scholar 

  5. Danser, M. (1996) The prevalence of periodontal bacteria colonizing the oral mucous membranes. Thesis, ACTA, Amsterdam

  6. Danser MM, Timmerman MF, van Winkelhoff AJ, van der Velden U (1996) The effect of periodontal treatment on periodontal bacteria on the oral mucous membranes. J Periodontol 67:478–485

    CAS  PubMed  Google Scholar 

  7. Danser MM, van Winkelhoff AJ, De Graaff J, Loos BG, van der Velden U (1994) Short-term effect of full-mouth extraction on periodontal pathogens colonizing the oral mucous membranes. J Clin Periodontol 21:484–489

    Google Scholar 

  8. Danser MM, van Winkelhoff AJ, De Graaff J, van der Velden U (1995) Putative periodontal pathogens colonizing oral mucous membranes in denture-wearing subjects with a past history of periodontitis. J Clin Periodontol 22:854–859

    CAS  PubMed  Google Scholar 

  9. De Boever, EH, De Uzeda, M, Loesche, WJ (1995) Role of tongue surface characteristics and tongue flora in halitosis. J Dent Res 74:127.

    Google Scholar 

  10. De Boever EH, Loesche WJ (1995) Assessing the contribution of anaerobic microflora of the tongue to oral malodor. JADA 126:1384–1392

    PubMed  Google Scholar 

  11. Frascella J, Gilbert R, Fernandez P (1998) Odor reduction potential of a chlorine dioxide mouthrinse. J Clin Dent 9:39–42

    CAS  PubMed  Google Scholar 

  12. Frascella J, Gilbert RD, Fernandez P, Hendler J (2000) Efficacy of a chlorine dioxide-containing mouthrinse in oral malodor. Compend Contin Educ Dent 21:241–248

    CAS  PubMed  Google Scholar 

  13. Gerlach RW, Hyde JD, Poore CL, Stevens DP, Witt JJ (1998) Breath effects of three marketed dentifrices: a comparative study evaluating single and cumulative use. J Clin Dent 9:83–88

    CAS  PubMed  Google Scholar 

  14. Giani PL, Abbate M, Kanapka J, Codipilly M, and Kleinberg I (1996) VSC inhibiting activity of experimental mouthwashes. J Dent Res 75:195.

    Google Scholar 

  15. Goldberg S, Cardash H, Browning H, Sahly H, Rosenberg M (1997) Isolation of Enterobacteriaceae from the Mouth and Potential Association with Malodor. J Dent Res 76:1770–1775

    CAS  PubMed  Google Scholar 

  16. Greenstein G (2002) Full-mouth therapy versus individual quadrant root planning: a critical commentary. J Periodontol 73:797–812

    PubMed  Google Scholar 

  17. Hoshi K, van Steenberghe D (1996) The effect of tongue brushing or toothpaste application on oral malodor reduction. In: van Steenberghe D, Rosenberg M (eds) Bad breath. A multidisciplinary approach. Leuven University Press, Leuven, pp 255–264

  18. Kaizu T, Tsunoda M, Aoki H, Kimura K (1978) Analysis of volatile sulphur compounds in mouth air by gas chromatography. Bull Tokyo Dent Coll 19:43–52

    CAS  PubMed  Google Scholar 

  19. Kozlovsky A, Goldberg S, Natour I, Rogatky-Gat A, Gelernter I, Rosenberg M (1996) Efficacy of a 2-phase oil:water mouthrinse in controlling oral malodor, gingivitis, and plaque. J Periodontol 67:577–582

    CAS  PubMed  Google Scholar 

  20. Lee KH, Tanner ACR, Maiden MFJ, Weber HP (1999) Pre- and Post-implantation microbiota of the tongue, teeth, and newly-placed implants. J Clin Periodontol 26:822–832

    CAS  PubMed  Google Scholar 

  21. Lindquist B, Emilson CG, Wennerholm K (1989) Relationship between mutans streptococci in saliva and their colonization of the tooth surfaces. Oral Microbiol Immunol 4:71–76

    CAS  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  23. Mantilla-Gómez S, Danser MM, Sipos PM, Rowshani B, Van der Velden U, van der Weijden GA (2001) Tongue coating and salivary bacterial counts in healthy/gingivitis subjects and periodontitis patients. J Clin Periodontol 28:978

    Google Scholar 

  24. Marsh PD (1992) Microbiological aspects of the chemical control of plaque and gingivitis. J Dent Res 71:1431–1438

    CAS  PubMed  Google Scholar 

  25. Massler M (1980) Geriatric nutrition: the role of taste and smell in appetite. J Prosthet Dent 43:247–250

    CAS  PubMed  Google Scholar 

  26. 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

    CAS  PubMed  Google Scholar 

  27. Niles HP, Vazquez J, Rustogi KN, Williams M, Gaffar A, Proskin HM (1999) The clinical effectiveness of a dentifrice containing triclosan and a copolymer for providing long-term control of breath odor measured chromatographically. J Clin Dent 10:135–138

    CAS  PubMed  Google Scholar 

  28. Niles, HP (1995) Long-lasting breath protection with a triclosan/copolymer/NaF dentifrice. J Dent Res 74:209.

    Google Scholar 

  29. Olshan AM, Kohut BE, Vincent JW, Borden LC, Delgado N, Qaquish J, Sharma NC, McGuire JA (2000) Clinical effectiveness of essential oil-containing dentifrices in controlling oral malodor. Am J Dent 13:18C-22C

    CAS  PubMed  Google Scholar 

  30. Pitts G, Brogdon C, Hu L, Masurat T, Pianotti R, Schumann P (1983) Mechanism of action of an antiseptic, anti-odor mouthwash. J Dent Res 62:738–742

    CAS  PubMed  Google Scholar 

  31. Pitts G, Pianotti R, Feary TW, McGuiness J, Masurat T (1981) The in vivo effects of an antiseptic mouthwash on odor-producing microorganisms. J Dent Res 60:1891–1896

    Google Scholar 

  32. Quirynen M, De Soete M, Dierickx K, van Steenberghe D (2001) The intraoral translocation of periodontopathogens jeopardises the outcome of periodontal therapy. A review of the literature. J Clin Periodontol 28:499–507

    Google Scholar 

  33. Quirynen M, Mongardini C, van Steenberghe D (1998) The effect of a 1-stage full-mouth disinfection on oral malodor and microbial colonization of the tongue in periodontitis patients. A pilot study. J Periodontol 69:374–382

    CAS  PubMed  Google Scholar 

  34. Ralph WJ (1987) Hygiene of the tongue. Gerodontics 3:169–170

    CAS  PubMed  Google Scholar 

  35. Roldán S, Winkel EG, Herrera D, Sanz M, van Winkelhoff AJ (2003) The effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc lactate on the microflora of oral halitosis patients. A dual-centre, double-blind placebo-controlled study. J Clin Periodontol 30:427–434.

    PubMed  Google Scholar 

  36. Rosenberg M (1997) Bad breath: research perspectives. Ramot Publishing- Tel Aviv University, Ramat Aviv

    Google Scholar 

  37. Rosenberg M, Gelernter I, Barki M, Bar-Ness R (1992) Day-long reduction of oral malodor by a two-phase oil:water mouthrinse as compared to chlorhexidine and placebo rinses. J Periodontol 63:39–43

    CAS  PubMed  Google Scholar 

  38. Schmidt NF, Tarbet WJ (1978) The effect of oral rinses on organoleptic mouth odor ratings and levels of volatile sulfur compounds. Oral Surg Oral Med Oral Pathol 45:876–883

    CAS  PubMed  Google Scholar 

  39. Seemann R, Kison A, Bizhang M, Zimmer S (2001) Effectiveness of mechanical tongue cleaning on oral levels of volatile sulfur compounds. JADA 132:1263–1267

    CAS  PubMed  Google Scholar 

  40. Sharma NC, Galustians HJ, Qaquish J, Galustians A, Rustogi KN, Petrone ME, Chaknis P, Garcia L, Volpe AR, Proskin HM (1999) The clinical effectiveness of a dentifrice containing triclosan and a copolymer for controlling breath odor measured organoleptically twelve hours after toothbrushing. J Clin Dent 10:131–134

    CAS  PubMed  Google Scholar 

  41. Silwood CJL, Grootveld MC, Maiden MFJ (2001) A multifactorial investigation of the ability of oral health care products (OHCPs) to alleviate oral malodour. J Clin Periodontol 28:634–641

    Article  CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  43. Timmerman MF, van der Weijden GA, Armand S, Abbas F, Winkel EG, van Winkelhoff AJ, van d, V (1998) Untreated periodontal disease in Indonesian adolescents. Clinical and microbiological baseline data. J Clin Periodontol 25:215–224

    CAS  PubMed  Google Scholar 

  44. Togelius J, Kristoffersson K, Anderson H, Bratthall D (1984) Streptococcus mutans in saliva: intraindividual variations and relation to the number of colonized sites. Acta Odontol Scand 42:157–163

    CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  46. van Steenberghe D, Avontroodt P, Peeters W, Pauwels M, Coucke W, Lijnen A, Quirynen M (2001) Effect of different mouthrinses on morning breath. J Periodontol 72:1183–1191

    PubMed  Google Scholar 

  47. van Steenberghe D, Rosenberg M (1996) Bad Breath: A multidisciplinary approach. Leuven University Press, Leuven

    Google Scholar 

  48. van Winkelhoff AJ, Van der Velden U, Winkel EG, De Graaf J (1986) Black-pigmenting bacteroides and motile organisms on oral mucosal surfaces in individuals with and without periodontal breakdown. J Periodont Res 21:434–439

    PubMed  Google Scholar 

  49. Waler SM (1997) The effect of some metal ions on volatile sulfur-containing compounds originating from the oral cavity. Acta Odontol Scand 55:261–264

    CAS  PubMed  Google Scholar 

  50. Winkel EG, Roldán S, van Winkelhoff AJ, Herrera D, Sanz M (2003) The clinical effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc lactate on oral halitosis. A dual-center, double-blind placebo-controlled study. J Clin Periodontol 30:300–306

    CAS  PubMed  Google Scholar 

  51. Yaegaki K, Coil JM (2000) Examination, classification and treatment of halitosis; clinical perspectives. J Can Dent Assoc 66:257–261

    CAS  PubMed  Google Scholar 

  52. Yaegaki K, Sanada K (1992) Biochemical and clinical factors influencing oral malodor in periodontal patients. J Periodontol 63:783–789

    CAS  PubMed  Google Scholar 

  53. Yaegaki K, Sanada K (1992) Volatile sulfur compounds in mouth air from clinically healthy subjects and patients with periodontal disease. J Periodont Res 27:233–238

    CAS  PubMed  Google Scholar 

  54. Young A, Jonski G, Rolla G, Waler SM (2001) Effects of metal salts on the oral production of volatile sulfur-containing compounds (VSC). J Clin Periodontol 28:776–77

    Article  CAS  PubMed  Google Scholar 

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Roldán, S., Herrera, D. & Sanz, M. Biofilms and the tongue: therapeutical approaches for the control of halitosis. Clin Oral Invest 7, 189–197 (2003). https://doi.org/10.1007/s00784-003-0214-7

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