title: The short-term treatment effects on the microbiota at the dorsum of the tongue in intra-oral halitosis patients--a randomized clinical trial.
abstract: OBJECTIVE
  This study aims to assess the effects of rinsing with zinc- and chlorhexidine-containing mouth rinse with or without adjunct tongue scraping on volatile sulfur compounds (VSCs) in breath air, and the microbiota at the dorsum of the tongue.
  
  
  METHODS
  A randomized single-masked controlled clinical trial with a cross-over study design over 14 days including 21 subjects was performed. Bacterial samples from the dorsum of the tongue were assayed by checkerboard DNA-DNA hybridization.
  
  
  RESULTS
  No halitosis (identified by VSC assessments) at day 14 was identified in 12/21 subjects with active rinse alone, in 10/21 with adjunct use of tongue scraper, in 1/21 for negative control rinse alone, and in 3/21 in the control and tongue scraping sequence. At day 14, significantly lower counts were identified only in the active rinse sequence (p < 0.001) for 15/78 species including, Fusobacterium sp., Porphyromonas gingivalis, Pseudomonas aeruginosa, Staphylococcus aureus, and Tannerella forsythia. A decrease in bacteria from baseline to day 14 was found in successfully treated subjects for 9/74 species including: P. gingivalis, Prevotella melaninogenica, S. aureus, and Treponema denticola. Baseline VSC scores were correlated with several bacterial species. The use of a tongue scraper combined with active rinse did not change the levels of VSC compared to rinsing alone.
  
  
  CONCLUSIONS
  VSC scores were not associated with bacterial counts in samples taken from the dorsum of the tongue. The active rinse alone containing zinc and chlorhexidine had effects on intra-oral halitosis and reduced bacterial counts of species associated with malodor. Tongue scraping provided no beneficial effects on the microbiota studied.
  
  
  CONCLUSIONS
  Periodontally healthy subjects with intra-oral halitosis benefit from daily rinsing with zinc- and chlorhexidine-containing mouth rinse.
authors.affiliation: Department of Oral Health Science, Section for Health and Society, Kristianstad University, Kristianstad, Sweden.
authors.forename: Seida Erovic
authors.initials: SE
authors.lastname: Ademovski
authors.forename: G Rutger
authors.initials: GR
authors.lastname: Persson
authors.forename: Edwin
authors.initials: E
authors.lastname: Winkel
authors.forename: Albert
authors.initials: A
authors.lastname: Tangerman
authors.forename: Peter
authors.initials: P
authors.lastname: Lingström
authors.forename: Stefan
authors.initials: S
authors.lastname: Renvert
mesh_terms: D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D001419:Bacteria / Q000187:drug effects*; D058491:Bacterial Load / Q000187:drug effects; D001439:Bacteroides / Q000187:drug effects / Q000302:isolation & purification; D002710:Chlorhexidine / Q000627:therapeutic use; D018592:Cross-Over Studies; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005673:Fusobacterium / Q000187:drug effects / Q000302:isolation & purification; D006209:Halitosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D006862:Hydrogen Sulfide / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use; D009910:Oral Hygiene / Q000295:instrumentation; D016966:Porphyromonas gingivalis / Q000187:drug effects / Q000302:isolation & purification; D001443:Prevotella melaninogenica / Q000187:drug effects / Q000302:isolation & purification; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000302:isolation & purification; D016037:Single-Blind Method; D013211:Staphylococcus aureus / Q000187:drug effects / Q000302:isolation & purification; D013438:Sulfhydryl Compounds / Q000032:analysis; D013440:Sulfides / Q000032:analysis; D014059:Tongue / Q000187:drug effects / Q000382:microbiology*; D048373:Treponema denticola / Q000187:drug effects / Q000302:isolation & purification; D055549:Volatile Organic Compounds / Q000032:analysis; D055815:Young Adult; D019345:Zinc Acetate / Q000627:therapeutic use
chemical_list: D000891:Anti-Infective Agents, Local; D004338:Drug Combinations; D009067:Mouthwashes; D013438:Sulfhydryl Compounds; D013440:Sulfides; D055549:Volatile Organic Compounds; C072338:chlorhexidine, zinc acetate drug combination; C005231:methylmercaptan; D019345:Zinc Acetate; C004784:dimethyl sulfide; D002710:Chlorhexidine; D006862:Hydrogen Sulfide