Subjective strengths of oral malodor – Peculiar circadian variation and
reduction through treatment -
Higuchi K.†, †††, Honda S. ††, †††
(†Higuchi Dental Clinic Co. Med. ††Honda Dental Co. Med. †††Excellent Breath Alliance Clinics)
Most patients of self-recognizing halitosis sense that they have certain
oral malodor due tobehaviors of others and abnormal intraoral conditions.
Their smell is usually physiological and relatively lighter than pathological
halitosis. Many patients say that the malodor changes periodically and
it is especially worse just after awaking. These changes are not well-known
and there are a few reports about them. We studied about these changes
with a visualized analogue scale (VAS) every time of treatment. We also
observed the effect of our comprehensive malodor treatment on the troubles
of the patients.
50 patients who came to Higuchi Dental Clinic from September 2007 to September
2010 because of oral malodor were studied. They consisted of 12 males and
1.Controlling of oral anaerobes
Tooth brushing and tongue cleaning instruction
Chloride dioxide agent (ProFresh, TheraBreath)
2.Harmonizing the systemic function related ordinary habit and recovery
of oro-physiological function.
Improvement of ordinary habit Instruction of the way of talking.
Training of pronunciation and muscle Water taking and diet.Excellent Breath
Gum and Excellent Breath Dental Paste.
3.Management of anxiety against the oral malodor Personality of the patient
Meaning of the behavior of others
Arising mechanism of the malodor when the patient is tensed.
[Results and conclusions]
We might make clean the actual conditions of morning breathas patients
often complained. Halitosis is thought that it is mainly related to anaerobic
activities and to VSCs. Besides lowering of oro-physiological function
and anxiety about the suspicious behaviors of others, it makes the condition
more complicated and serious. Our treatment method was useful for improvement
of both subjective and objective oral malodor.
In this study subjective strength about oral malodor was of same level
each day, whereas it
changed periodically in a day. The oral malodor seemed to be worst after
awaking and least before sleeping. We considered that oral and pharyngeal
cavities became dry during sleep, because a salivary flow was reduced.
Following production of volatile sulfur compounds
(VSCs) by anaerobes, VAS scores showed highest level consequently. Since
before sleeping was the most relaxing time for most patients and a salivary
flow was increased, VAS scores were minimized. Comparing the VAS scores
between before and after treatment, subjective oral malodor was lightened
at all of four times in a day. Objective one was lightened too. These results
showed effectiveness of our treatment methods.