Halitosis Clinical Trial
Official title:
Effect of Probiotic Lactobacillus Reuteri-containing Lozenges (Prodentis) on Halitosis in Patients With Chronic Periodontitis
The purpose of this study is to determine whether Lactobacillus reuteri-containing lozenges (Prodentis) are effective in treatment of halitosis in patients with chronic periodontitis.
Bad breath (oral malodor, lat. halitosis) is amongst most common patients' complaints in the
dental office. Ironically, available literature and research done on this topic thus far are
relatively scarce. Oral malodor is most commonly caused by oral bacteria (87%), yet it can
also be sourced from ear, nose and throat region and in a small percentage from distant
parts of the body or is of unknown origin. Periodontal pathogens and other Gram(-) anaerobic
microorganisms such as Porphyromonas gingivalis, Treponema denticola, Prevotella intermedia,
Fusobacterium nucleatum, Enterobacter cloacae, Prevotella loescheii and Porphyromonas
endodontalis are regarded as producers of malodorous gases. Namely, these bacterial species
and periodontal pathogens particularly produce so called volatile sulfur compounds (VSC)
which give mouth air its malodorness. Methylmercaptan, hydrogen sulfide and dimethyl sulfide
are waste products of bacterial metabolism, specifically degradation of sulfur-, methionine-
and cysteine-containing aminoacids. Offensive smells also stem from other compounds which do
not contain sulfur, diamines and polyamines such as cadaverine, putrescine and skatole.
Probiotics are defined as living microorganisms which are considered to have beneficial
health effect on their host when consumed in adequate amount. Regarding their advantageous
role in periodontal disease, inhibition of specific periodontal pathogens and alteration of
host immune response through multifactorial causes are thought to be their main working
mechanisms. Reuterin and reutericyclin are two bacteriocins produced by Lactobacillus
reuteri that inhibit growth of pathogenic bacteria, while bacterium also exhibits strong
capacity of host tissue adherence and subsequent competition with pathogens.
Based on this data, research on efficacy of probiotic lozenges on halitosis in patients with
chronic periodontitis.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator)
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