Asian bad breath

Added: Lisa Fetters - Date: 04.04.2022 05:12 - Views: 42819 - Clicks: 8186

Halitosis has great adverse impact on personal and social life. Materials and Methods. Study selection and data collection were conducted. Risks of bias were assessed by the Cochrane tool. Synthesis of was done by RevMan 5. Subgroup analysis by classification of halitosis and sensitivity analysis were also conducted. Seventeen studies were included. The follow-up length ranged from five days to eight weeks. Subgroup analysis and sensitivity analysis showed inificant. Halitosis is defined as offensive odor exhaling from oral cavity, the main component of which is volatile sulphur compounds VSCs including hydrogen sulfide, dimethyl sulfide, and methyl mercaptan [ 1 ].

Halitosis is classified as genuine halitosis, pseudo-halitosis, and halitophobia [ 9 ]. Eighty to ninety percent of genuine halitosis has intraoral sources, including gingivitis, periodontitis, and tongue coating in favor of microorganism [ 8 ]. Halitosis with extraoral sources comes from systematic diseases such as nasal inflammation, diabetes mellitus, respiratory, and digestive diseases or medication [ 9 ]. Current western medicine WM for halitosis mainly includes mechanical methods periodontal initial treatment, oral prophylaxis, tooth brushing, flossing, and tongue cleaning and chemical methods chlorhexidine, essential oil, menthol, chlorine dioxide, and two-phase oil-water rinse [ 10 ].

However, WM mainly diminish the level of VSCs or related anaerobic bacteria thus having drug resistance and side effect on the existing oral microbial ecology [ 11 ]. In cases of extraoral health, WM discussed above has little effect on the systematic sources, resulting in relatively high recurrence rate and low patient satisfaction [ 2 ].

Asian bad breath

Besides, there is no way to treat halitosis with unknown sources [ 9 ]. Research in halitosis in traditional Chinese medicine CM dates back to thousands of years ago. According to ancient books in China, halitosis is defined as rotting smell from mouth and has been treated with acupuncture, moxibustion, and decoction of Chinese herbs. Recently, a of randomized controlled clinical trials in China reported that orally administrated CM and combined Chinese and western medicine CWM have superior effects on halitosis than WM alone. But no synthesis of those has been made.

Only randomized controlled clinical trials were included in this systematic review. The intervention should be Chinese herbs for mouth rinse or taken orally, combined with western therapy or not. The control should be western therapy. Subjects have either intraoral halitosis or extraoral halitosis. To be diagnosed as intraoral halitosis, subjects should not have systematic disease that could induce oral malodor.

Outcome measurements should include effective rate. Studies were excluded if halitosis was a syndrome of disease and not specially estimated. RCTs in which control group is blank or placebo were also excluded. Two individual researchers XY Wu and J. Zhang conducted literature search independently and in duplicate.

Asian bad breath

A third researcher M Nie was consulted if disagreements occurred. Study selection and data collection were conducted by two researchers XY Wu and J. Zhangindependently and in duplicate. Any disagreement was solved by discussion with a third researcher M. Study selection procedure was conducted according to the inclusion and exclusion criteria. Firstly, all the in the databases above were gathered together and duplications were discarded.

Secondly, Titles and abstracts were scanned. Full-texts were accessed if they might meet our criteria or they were needed for further confirmation. Thirdly, we assessed full-texts and determined the included studies. In this step, reasons for excluding studies were recorded. We also conducted a manual search in the references and citation database of included studies.

After study selection, data for all included studies were extracted. Key information included first author, country, publication year, the of subjects, criteria for halitosis diagnosis and treatment effect assessment, treatment methods, follow-up length, and outcome measurements. Authors were contacted for missing data if necessary.

The Cochrane tool [ 30 ] was used to evaluate risks of bias. According to the tool, selection bias, performance bias, detection bias, attrition bias, and reporting bias were evaluated according to the sequence generation, allocation concealment, blinding, incomplete outcome data, and other potential risks.

Review Manager 5. The fixed effect model was used when less than four studies were included in a meta-analysis while the random-effects model was used when four studies or more were included. Statistical heterogeneity among the studies was evaluated with the Cochrane Q test and I 2 statistic. Subgroup analysis by classification of halitosis was conducted. Sensitivity analysis was conducted by excluding studies in which no criteria for halitosis diagnosis were mentioned. When studies in one group had ten studies or more, we evaluated the possibility of publication bias by a funnel plot of the mean differences for asymmetry.

After discarding duplications, remained. Titles and abstracts were scanned and articles were excluded. For the remaining 74 articles, we assessed full-texts and excluded 56 articles. Reasons for exclusion are listed in Figure 1. Besides, one study [ 31 ] was excluded from meta-analysis for longer follow-up length one year than others. Seventeen studies were included in the final quantitative synthesis.

Asian bad breath

Details are listed in Figure 1. All the 17 articles were randomized controlled clinical trials in Chinese. For the effect of CM on halitosis, six studies were included [ 12 — 17 ] with a follow-up length ranging from five days to eight weeks.

For the effect of CWM on halitosis, 11 studies were included [ 18 — 28 ], with a follow-up length ranging from one week to one month.

Asian bad breath

Intraoral halitosis mainly originated from gingivitis, periodontitis, and poor oral care. Extraoral halitosis mainly originated from systematic diseases such as gastritis, constipation, and children amygdalitis. Criteria for halitosis diagnosis and treatment effect assessment were different among studies. Details are listed in Table 1. For randomization, three studies described the method and were considered appropriate. Thirteen studies were described as randomized without describing the methods.

And three studies did not mention method of randomization. Only one study described methods of allocation concealment and double blinding appropriately. All studies fully reported outcomes described in methods. No withdrawal or dropout was reported. Other risks of bias were assessed regarding different halitosis diagnosis criteria.

Four studies did not mention any method for halitosis diagnosis, considered as high risks of bias. Two studies mentioned an organoleptic test without describing evaluation scale, considered as unclear risks of bias. All included studies showed high risks of bias in at least one domain. Figures 2 and 3. For sensitivity analysis, four studies were excluded in which no criteria for halitosis diagnosis were mentioned. Sensitivity analysis presented robust.

To the best of our knowledge, this is the first study to synthesize the of the effect of CM and CWM on halitosis. An in vivo study [ 32 ] reported that chlorhexidine mouth rinse, containing pericarp extract of Garcinia mangostana L. Li MY et al. A four-week-period RCT [ 34 ] reported that Chinese herb Hyangsa-Pyeongwi san could alleviate halitosis and increase quality of life in functional dyspepsia patients and the effect only lasted for four weeks.

In CM theory, halitosis originates from retention of damp, heat or fire in mouth, stomach, liver, or spleen, all of which are interconnective as an entirety. So, CM treatment concentrates on a balance of the whole body rather than a certain organ. Modern pharmacology explained the mechanisms of these herbs. Coptis chinensis has properties including antibacterial, antitoxin, antiulcer, and reducing gastric acid [ 36 ]. It decreased level of inflammatory cytokines such as VEGF and TNF in arthritis mouse serum and regulated the cell proliferation, differentiation, and apoptosis related genes to alleviate inflammation [ 3738 ].

The extraction of Coptis chinensis could also inhibit urease to anti- H. Lonicera japonica had strong effects on VSCs and bacteriostasis functions on halitosis related anaerobic bacteria [ 4546 ]. In this study, CM shows better effect on extraoral halitosis while CWM shows better effect on intraoral halitosis, although the difference was not ificant. On the contrary, periodontal treatment in WM could reduce oral VSCs and related anaerobic bacteria immediately. So, the effect by CM was limited by a short follow-up length in this study. CM and WM benefit from each other and combining them together lead to even superior.

Different criteria for halitosis diagnosis and treatment effect assessment were used among included studies. However, sensitivity analysis showed no ificant result. The gold standard for diagnosis of halitosis is organoleptic measurement [ 47 ], which is subjective and inconsistent. Furthermore, it is hard to grade the severity of halitosis with clear boundaries. This partly explains the low inheterogeneity among included studies despite different evaluation scales being used.

Future studies should use quantifiable outcome measures, such as component in breath or saliva, to make their reproducible and objective. We have done comprehensive literature search and covered nearly all available studies. Subgroup and sensitivity analysis was made to ensure the reliability of. However, all studies included were in Chinese and scored high risks of bias in at least one domain. In one study [ 13 ] CM mouth rinse was used in treating intraoral halitosis while in others CM was taken orally.

Only studies with short follow-up length no longer than 8 weeks were included. Combining Chinese medicine and western medicine has quicker and stronger effect on halitosis in short term. Min Nie and Xinyu Wu contributed to conception and de and manuscript revision. Xinyu Wu, Jie Zhang, and Min Nie contributed to database search, study selection, and data collection. Xinyu Wu and Yikun Zhou contributed to risks of bias assessment.

Ze He was involved in statistical analysis. Qiaoyi Cai was involved in writing of the paper. This is an open access article distributed under the Creative Commons Attributionwhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Article of the Year Award: Outstanding research contributions ofas selected by our Chief Editors.

Read the winning articles. Journal overview. Special Issues. Academic Editor: Chang G. Received 03 Sep Revised 16 Oct Accepted 31 Oct Published 26 Nov Abstract Object. Introduction Halitosis is defined as offensive odor exhaling from oral cavity, the main component of which is volatile sulphur compounds VSCs including hydrogen sulfide, dimethyl sulfide, and methyl mercaptan [ 1 ].

Asian bad breath

email: [email protected] - phone:(571) 752-9894 x 7132

Whether Chinese Medicine Have Effect on Halitosis: A Systematic Review and Meta-Analysis