Microorganisms rule in halitosis

Halitosis (bad breath) is estimated to influence more than half of the world's
population with varying degree of intensity. More than 85% of halitosis
originates from oral bacterial infections. Foul-smelling breath mainly results
from bacterial production of volatile sulfur compounds (VSCs) such as
hydrogen sulfide and methyl mercaptan. To date, major treatments for
elimination of oral malodor include periodontal therapy combined with
antibiotics or antimicrobial agents, and mechanical approaches including tooth
and tongue cleaning. These treatments may transiently reduce VSCs but carry
risks of generating toxicity, increasing resistant strains and misbalancing the
resident human flora. Therefore, there is a need to develop alternative
therapeutic modalities for halitosis. Plaque biofilms are the principal source for
generating VSCs which are originally metabolized from amino acids during co-
aggregation of oral bacteria. Blocking the bacterial coaggregation, therefore,
may prevent various biofilm-associated oral diseases such as periodontitis
and halitosis. Fusobacterium nucleatum (F. nucleatum), a Gram-negative
anaerobe oral bacterium, is a main bacterial strain related to halitosis.
Aggregation of F. nucleatum with other bacteria to form plaque biofilms in oral
cavity causes bad breath. FomA, the major outer membrane protein of F.
nucleatum, recruits other oral pathogenic bacteria such as Porphyromonas
gingivalis (P. gingivalis) in the periodontal pockets. A halitosis vaccine
targeting F. bacterium FomA significantly abrogates the enhancement of
bacterial co-aggregation, biofilms, production of VSCs, and gum inflammation
mediated by an inter-species interaction of F. nucleatum with P. gingivalis,
which suggests FomA of F. nucleatum to be a potential target for development
of vaccines or drugs against bacterial biofilm formation and its associated
pathogenicities.
In china they used a cross-sectional and longitudinal study design and
the pyrosequencing approach to track and compare the tongue
microbiota associated with oral malodor in 29 Chinese adults who
underwent a consecutive three-day evaluation for the amount of H2S
excreted orally. Three levels of the oral malodor state (healthy, oral
malodor, and severe oral malodor) were defined based on the H2S level.
Community structure of the tongue plaques was more sensitive to
changes of malodor state than to interpersonal variations or differences
in sampling times. Within each individual, the structure of microbiota
was relatively stable, while their variations were correlated with the
change in the H2S level. Severe oral malodor microbiota were the most
conserved in community structure, whereas the healthy ones were
relatively varied. Oral-malodor-associated bacteria were identified. The
relative abundance of Leptotrichia and Prevotella was positively
correlated with oral malodor severity, whereas Hemophilus and Gemella
exhibited a negative relationship with oral malodor severity. Our study
provides one of the first landscapes of oral microbiota changes
associated with oral malodor development and reveals microbes
potentially useful to the evaluation and control of oral malodor.
Its not only the bacteria can cause halitosis , there are other
microorganism like candida which can cause this problem in asevere
way .
Halitosis depend on the tongue sterility , because the tongue is a habitat for
oral microorganisms and tongue cleaning is so important as part of daily oral
hygiene. In addition tongue coating is described. Many microorganisms have
been found colonizing the dorsum of the tongue. Some studies find a positive
effect to tongue brushing on bacterial counts on the tongue. On the other hand
there are also studies that do not find any differences in bacterial counts
before or after tongue brushing. Bacteria colonizing the tongue and
periodontal pockets play an important role in the production of volatile sulphur
compounds in periodontal health and disease. These compounds can be the
cause of oral malodour. The amount of tongue coating in patients complaining
of halitosis was significantly greater than in patients without halitosis. Tongue
brushing on a regular basis, particular aiming at removing the coating on the
dorsum of the tongue, has been found to be fruitful in reducing oral malodour.
Studies investigating the role of tongue brushing and plaque accumulation or
gingival inflammation show conflicting results. It is clear that the tongue forms
the largest niche for microorganims in the oral cavity. However, on the basis of
literature, there appears to be no data to justify the necessity to clean the
tongue on a regular basis. One exception would be oral malodour.

Done by
Yahya al Omary