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15-10-2012 | Oral medicine | Article

Best oral malodor treatment differs according to source


Free abstract

medwireNews: Oral malodor in patients with periodontitis is better treated by periodontal treatment than tongue cleaning, but both treatments are necessary to effectively remove the disease, contend the authors of a study review.

Conversely, evidence shows that tongue cleaning alone can significantly reduce oral malodor in patients with gingival disease, they note, in the Journal of Evidence-Based Dental Practice.

The conclusions emerge from a study that is "informative from the point of view of clinicians and addresses an important oral health concern among patients," say reviewers Khady Ka and Belinda Nicolau from McGill University in Montreal, Canada.

Their report is based on a paper by Masayuki Ueno (Tokyo Medical and Dental University, Japan), published in the Journal of Periodontal Research.

"The results of this article may help oral health practitioners to take better care of patients who have periodontal disease and also oral malodor concerns," write Ka and Nicolau.

"Periodontal treatment and tongue cleaning are two common procedures that could easily be repeated in different settings and among various populations," they suggest.

For the study, 229 individuals aged 25-60 years with malodor caused by periodontitis (n=111) or gingivitis (n=118) were randomly assigned to receive either periodontal treatment (including tooth polishing and root planing) during week 1 of the study, and tongue cleaning in week 2, or those treatments in reverse order.

Oral malodor was reassessed via an organoleptic test (where 0=no odor and 5=severe odor) and OralChroma (Takasago Electric Industry Co, Ltd, Osaka, Japan, where a hydrogen sulfide [H2S] level >1.5 mg/10 mL and methanethiol [CH3SH] >0.5 ng/10 mL denotes malodor) in all patients 1 week after each treatment.

Malodor in patients with periodontitis decreased significantly after both treatments, but there was more benefit from periodontal treatment than from tongue cleaning, with a 1.41-point difference in organoleptic score from baseline versus a 0.49-point difference.

By contrast, patients with gingival disease benefitted more after treatment with tongue cleaning than they did after periodontal treatment, with an organoleptic score difference of 1.12 from baseline versus 0.41, respectively.

The study's reviewers note that while not life-threatening, oral malodor can be a source of discomfort and reduce individuals' quality of life. "[Those] who are suffering from it are usually aware of their condition and may avoid social situations, leading them to miss good opportunities in different aspects of life," the pair concludes.

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Sarah Guy, medwireNews Reporter