THE EFFECT OF A 1-STAGE FULL-MOUTH DISINFECTION ON ORAL MALODOR AND MICROBIAL COLONIZATION OF THE TONGUE IN PERIODONTITIS PATIENTS - A PILOT-STUDY

ORAL MALODOR AFFECTS A LARGE proportion of the population and may be t he cause of a significant social and psychological handicap. This pilo t study aimed to examine whether a 1-stage full-mouth disinfection in periodontitis patients (scaling and root planing of all pockets within 24 hours together with the application of chlorhexidine to all intra- oral niches followed by chlorhexidine mouth rinsing for 2 months) resu lted in a significant improvement in malodor when compared to a fracti onated periodontal therapy (consecutive root planings per quadrant, at a 1 to 2 week interval). The baseline and outcome data concerning ora l malodor were linked to the presence of tongue coating and to its rou ghness (fissures). Twenty-four patients with severe periodontitis were randomly allocated to test and control groups. At baseline and after 1 and 2 months, the concentration of volatile sulfur compounds (VSC) i n the mouth was measured and organoleptic ratings (expired air and tot al mouth air) were given. Plaque samples were collected from the dorsu m of the tongue to calculate the number of colony forming units (CFU) per ml (anaerobic culturing) as well as the number of pigmented CFU/ml . Both the baseline organoleptic ratings and the VSC scores correlated well with the presence of tongue coating but not with the tongue roug hness. Because a correlation between tongue coating and its microbial load could not be detected, it was hypothesized that the tongue coatin g per se, and not the bacteria, might be responsible for the malodor. The 1-stage full-mouth disinfection resulted in a faster and additiona l reduction in the organoleptic ratings of the oral malodor, even afte r 3, months. This might be explained by the improved periodontal outco me and/or the more significant reduction in the CFU/ml of pigmented sp ecies. In contrast to the organoleptic ratings, which were significant ly reduced in both treatment groups (when compared to baseline), the V SC levels remained unchanged. This pilot study indicates that a 1-stag e full-mouth disinfection has, in comparison to a standard periodontal therapy, additional beneficial effects in the treatment of oral malod or.