Nir Sterer

Tel Aviv University | TAU · Prosthodontics

Previous study suggested that fixed dental prostheses (crowns) increase oral malodor production. There might be a role to temporary acrylic crowns contributing to oral malodor. In the current study, we analyzed the microbiome associated with malodorous temporary dental crowns. The study population comprised nineteen patients (mean age 45.8 ± 10.9,...

A full-mouth radical dental treatment under general anesthesia is a common approach for treating severe early childhood caries (S-ECC). However, previous study showed recurrence of the disease in 80% of cases within 12 months. The aim of the present study was to examine the changes in microbial composition of the dental biofilm of these children fo...

Previous studies have shown that sub-lethal exposure of blue light caused increased bacterial cell membrane permeability. We hypothesized that combining blue light exposure with other antibacterial agents may increase their efficacy. The aim of the present study was to test the combined effect of blue light and sodium fluoride against dental caries...

Streptococcus mutans is considered a major cariogenic bacterium. Most anti-cariogenic dentifrices are limited by a short exposure time. The aim of the present study was to test the hypothesis that adding a mucoadhesive agent to the formulation may increase its bioavailability and efficacy. We tested the effect of adding hydroxyethyl cellulose (HEC)...

Temporary dental crowns and bridges are commonly made of poly-methylmethacrylate (PMMA), a porous material attracting the microbial biofilm associated with malodor production. The purpose of the present study was to test pre-disinfection of PMMA on malodor-related parameters in an experimental oral biofilm. PMMA discs were pre-soaked in anti-malodo...

A previous study showed that sub-lethal exposure of blue light caused cell membrane damage in Fusobacterium nucleatum (Fn). The aim of the present study was to test the combined effect of blue light and silver nanoparticles against Fn. Bacterial suspensions were exposed to blue light (400–500 nm) with or without silver nanoparticles (10 nm). Expose...

Denture stomatitis is a common manifestation of oral candidiasis affecting some 65% of denture wearers. This condition is initiated by the adherence of Candida albicans to denture base acrylic resin. The present study aimed to test the in vitro effect of traditional and novel fabrication methods on Candida albicans adhesion to denture base samples....

Previously, we have shown that sub-lethal exposure of blue light caused increased cell membrane permeability in Fusobacterium nucleatum. The aim of the present study was to test the effect of this exposure on the activity of Lavender, Sage, Echinacea and Mastic gum extracts against volatile sulfide compounds (VSC) production by Fusobacterium nuclea...

Unlike other complaints such as pain, discomfort, or impaired esthetics, breath odors are not sensed by the patients themselves but rather by their close environment (e.g., friends, family members, coworkers). As a result, patients are unable to give a reliable report on their condition (e.g., onset, frequency, duration, intensity). Therefore, it i...

According to reports from various multidisciplinary breath odor clinics around the world, some 4–8% of breath odor cases are ear–nose–throat (ENT)-related conditions (Quirynen et al. 2009; Seemann et al. 2006). These include nasal and pharyngeal infections and conditions such as chronic sinusitis, chronic (caseous) tonsillitis, foreign bodies, and...

Breath odors or halitosis denotes any type of disagreeable scent felt on a person’s breath during exhalation and speech. These odors have many different causes and may originate from various locations such as the oral cavity, tonsils, nasal cavity, upper respiratory tract, and the lungs.

The key to successful resolution of a breath odor complaint is its objective diagnosis (for more details, see Chap. 9). First, the physical nature of the complaint has to be verified. Subsequently, the source of the malodor should be determined. Based on these, an appropriate treatment may be suggested and implemented.

Breath odors, much like other odor nuisances (e.g., sewage, garbage, livestock waste), are perceived in everyday life by our sense of smell. The human nose can pick up the scent of a large variety of different odorants at very low concentrations that are sometimes below instrumental detection thresholds. That is why organoleptic measurements employ...

Although relatively rare, especially among the ambulatory population, breath odors may be a sign of a systemic condition or a metabolic disorder (Table 7.1). Usually, this symptom will appear in a later stage of the disease when the patient is already diagnosed. However, sometimes the breath odor may be an early sign or even the only sign for the u...

A growing body of knowledge has accumulated over the last 60 years in the field of breath odor research. This has enabled researchers and clinicians to continually build on the scientific findings, devising better means for understanding, diagnosing, and managing this common human condition. However, some important questions regarding this issue ar...

The sense of smell is the least understood of all human senses. The olfaction process is a complex one involving both physiological peripheral sensing and cognitive and emotional central processing. The olfactory receptor neurons are situated in the olfactory epithelium located in the upper portion of the nasal cavity. These cells project cilia int...

The inability of a person to sense his own breath results in a situation called the “bad breath paradox” (Scott Harper, personal communication). According to this paradox many people suffering from breath odors are unaware of their condition, whereas many others that do not have any breath odor worry excessively that they do. For example, in a stud...

Breath odors are an age-old worldwide problem, and over the centuries different cultures have developed different folk remedies. In Thailand, sufferers chew the peels of oversize guavas. Iraqis keep cloves between their teeth. Italians chew parsley. Indians chew fennel seeds. Brazilians cite cinnamon as a folk remedy. Indeed, many plant extracts co...

In some 15–30% of patients complaining of a serious breath odor problem, little or no malodor can be detected by the examiner either organolepticaly by smelling the patient’s breath or using laboratory techniques (Quirynen et al. 2009; Seemann et al. 2006). These patients vary in their level of conviction regarding their perceived odor problem. Som...

There is ample evidence that in the large majority of cases, oral malodor derives from bacterial activity within the oral cavity. It is also likely that most cases of odor deriving from the nasal passages and tonsils are also bacterial in origin. One indication for this is the transient reduction of oral malodor observed following local antiseptic...

In the absence of well-informed science, people intuitively associate breath odors with the digestive system. Perhaps, the stomach odors that arise transiently during eructation (burping) lead many to assume that breath odor may originate in the stomach. Old medical texts on this topic (Howe 1898; Shifman et al. 2002) cite indigestion, constipation...

Breath odors are a common condition. Various studies conducted around the world in different populations, using odor judge and instrumental measuring techniques and with varying threshold criteria have found prevalence of bad breath to range from as low as 2% of the population to over 60% (Table 11.1). It is clear that the lack of standardization i...

This comprehensive, evidence-based textbook presents the latest knowledge on bad breath, describing insights from basic research and offering expert guidance on current approaches to diagnosis and treatment. The new edition has been thoroughly updated to take account of recent advances in understanding. The opening chapters examine in detail the or...

Oral malodour is considered to be caused mainly by the production of volatile sulfide compounds (VSC) by anaerobic Gram-negative oral bacteria. Previous studies showed that these bacteria were susceptible to blue light phototoxicity mediated by the production of reactive oxygen species (ROS). In the present study, we tested the effect of blue light...

Background A common reason for failure of root canal treatment is residual bacterial biofilm or reinfection due to coronal seal inadequacy. Recently, the idea of using macromolecules with antibacterial features has evolved. The addition of nanoparticle macromolecules to sealers gained antibiofilm properties as shown in several in vitro studies. Nev...

Mucoadhesive tablets containing herbal formulation have been previously shown to reduce oral malodour. The aim of the present in vitro study was to test the effect of the mucoadhesive agent hydroxyethylcellulose (HEC) added to a liquid phase herbal extract formulation on the mucoadhesive retention of the active ingredients and their effect against...

The worldwide number of dental implants and orthopedic prostheses is steadily increasing. Orthopedic implant loosening, in the absence of infection, is mostly attributable to the generation of wear debris. Dental peri-implantitis is characterized by a multifactorial etiology and is the main cause of implant failure. It consists of a peri-implant in...

In the past, our inability to cultivate most of the oral microorganisms has limited our view of this complex ecosystem. In the present study, we utilized next generation deep sequencing techniques to revisit the microbiome associated with dentures malodour a growing problem with the rise in life expectancy. Study population comprised of twenty six...

With millions of new dental and orthopedic implants inserted annually, periprosthetic osteolysis becomes a major concern. In dentistry, peri-implantitis management includes cleaning using ultrasonic scaling. We examined whether ultrasonic scaling releases titanium particles and induces inflammation and osteolysis. Titanium discs with machined, sand...

Oral malodour is considered to be caused mainly by the production of volatile sulfide compounds (VSC) by anaerobic Gram-negative oral bacteria. Previous study showed that these bacteria were susceptible to blue light (wavelengths of 400–500 nm). In the present study, we tested the effect of blue light in the presence of red dyes on malodour product...

Gingivitis is the most common form of gum disease caused by oral bacteria. Previous research has shown the antibacterial activity of Sage, Echinacea, Lavender and Mastic gum against these bacteria. The aim of the study was to test their effect delivered using a mucoadhesive tablet on gingivitis as compared with a chemical mouthwash. Thirty healthy...

PurposeThe aim of this study was to evaluate the efficacy of autologous intraoral onlay bone grafting (OBG) in correlation with long-term survival rates of dental implants placed in the augmented bone.Materials and MethodsA retrospective study was conducted on 214 patients who received a total of 633 dental implants placed in 224 autologous intraor...

Oral malodour is considered to be caused mainly by the production of volatile sulfide compounds (VSC) by anaerobic Gram-negative oral bacteria. Previous study showed that these bacteria were susceptible to blue light (wavelengths of 400- 500 nm). In the present study, we tested the effect of blue light in the presence of zinc and erythrosin on malo...

Clinical investigations on patients suffering from halitosis clearly reveal that in the vast majority of cases the source for an offensive breath odor can be found within the oral cavity (90%). Based on these studies, the main sources for intra-oral halitosis where tongue coating, gingivitis/periodontitis or a combination of the two. Thus, it is pe...

Clinical investigations on patients suffering from halitosis clearly reveal that in the vast majority of cases the source for an offensive breath odor can be found within the oral cavity (90%). Based on these studies, the main sources for intra-oral halitosis where tongue coating, gingivitis/periodontitis and a combination of the two. Thus, it is p...

Canine oral malodor is a common complaint among dog owners. The aim of this study was to test the effect of an antimicrobial herbal palatal mucoadhesive tablet on oral malodor in dogs. Twelve dogs suffering from oral malodor participated in the study. Palatal mucoadhesive tablets were prepared with or without the herbal medicinals: Echinacea (Echin...

Two phase oil-water mouthwash has been previously shown to efficiently bind oral microorganisms, relying on their cell surface hydrophobicity. The aim of the present in vitro study was to test the cetylpyridinium chloride (CPC) retention and volatile sulfide compounds (VSCs) adsorption abilities of the oil droplets created by mixing of a two phase...

Objective: Onlay bone grafting (OBG) using autologous bone blocks is an accepted method for the reconstruction of atrophic alveolar ridges. Method: A retrospective study was conducted on 250 patients' files (mean age at OBG surgery 50.3±15.5, 179 females) who received a total of 727 dental implants placed in 262 augmentations using OBG from 1999...

Previous research has shown the oral malodor reducing abilities of an herbal formulation delivered using a palatal mucoadhesive tablet. The aim of the present study was to test the day-long effect of this preventive treatment on oral malodor reduction as compared with placebo and commercial mouthwash. Forty young healthy subjects (mean age, 25.8 ±...

Oral malodor (halitosis) is a common and disturbing condition. In most cases it derives from bacterial activity within the oral cavity. These bacteria breakdown and utilize proteins and produce foul smelling by-products such as volatile sulfide compounds (VSC). Objectives: The aim of the present study was to test the in vitro effect of a mouthrinse...

According to reports from various multidisciplinary breath odor clinics around the world, some 4–8% of breath odor cases are ENT-related conditions (Quirynen et al. 2009; Seemann et al. 2006). These include nasal and pharyngeal infections and conditions such as: chronic sinusitis, chronic (caseous) tonsillitis, foreign bodies, and craniofacial anom...

Breath odor or halitosis denotes any type of disagreeable scent felt on a person’s breath ­during exhalation and speech. These odors have many different causes and may originate from ­various locations such as the oral cavity, nasal cavity, upper respiratory tract, and lungs.

Breath odors, much like other odor nuisances (e.g., sewage, garbage, livestock waste), are perceived in everyday life by our sense of smell. The human nose can pick up the scent of a large variety of different odorants at very low concentrations that are sometimes below instrumental detection thresholds. That is why organoleptic measurements employ...

The key to a successful resolution of a breath odor complaint is a correct diagnosis of its source (for more details see Chap. 9). Once the objectivity of the complaint has been substantiated and the source of the malodor located, an appropriate treatment may be implemented.

Breath odors are an age-old, worldwide problem, and over the centuries different cultures have developed different folk remedies. In Thailand, sufferers chew the peels of oversize guavas. Iraqis keep cloves between their teeth. Italians chew parsley. Indians chew fennel seeds. Brazilians cite cinnamon as a folk remedy. Indeed, many plant extracts c...

The inability of a person to sense his own breath results in a situation called the “bad breath paradox” (Scott Harper, personal communication). According to this paradox, most of the people suffering from breath odors are unaware of their condition, whereas many others that do not have any breath odor worry excessively that they do. For example, i...

Although relatively rare, especially among the ambulatory population, breath odors may be a sign of a systemic condition or a metabolic disorder (Table 7.1). Usually, this symptom will appear in a later stage of the disease when the patient is already diagnosed. However, sometimes the breath odor may be an early sign or even the only sign for the u...

A growing body of knowledge has accumulated over the last 60 years in the field of breath odor research. This knowledge enabled researchers and clinicians to devise means for better understanding, diagnosing, and managing this condition. However, some questions regarding this issue are still left open and require further investigation.

In some 15–30% of patients complaining of a serious breath odor problem, little or no ­malodor can be detected by the examiner either organoleptically by smelling the patient’s breath or using laboratory techniques (Quirynen et al. 2009; Seemann et al. 2006). These patients vary in their level of conviction regarding their perceived odor problem. S...

In the absence of well-informed science, people intuitively associate breath odors with the digestive system. Perhaps, the stomach odors that arise transiently during eructation (burping) lead many to assume that breath odor may originate in the stomach. Looking into old medical texts on this topic (Howe 1898; Shifman et al. 2002), in which indiges...

There is ample evidence that in the large majority of cases, oral malodor derives from bacterial activity within the oral cavity. It is also likely that most cases of odor deriving from the nasal passages and tonsils are also bacterial in origin. One indication for this is the transient reduction of oral malodor observed following local antiseptic...

Unlike other complaints such as pain, discomfort, or impaired esthetics, breath odors are not sensed by the patients themselves but rather by people around them (e.g., friends, family members, coworkers). As a result, patients are unable to give a reliable report on their condition (e.g., onset, frequency, duration, intensity). Therefore, it is imp...

The sense of smell is the least understood of all human senses. The olfaction process is a complex one involving both physiological peripheral sensing and cognitive and emotional central processing. The olfactory receptor neurons are situated in the olfactory epithelium located in the upper portion of the nasal cavity. These cells project cilia int...

Breath odors are a common condition. Various studies conducted around the world in ­different populations, using different measuring techniques and varying threshold criteria have reported different prevalence of this condition, ranging from as low as 2% of the population to over 60% (Table 11.1).

Frequently provisional restorations require long-term permanence in the oral cavity, thus an antibacterial effect is desirable. We hypothesized that this effect may be achieved by incorporating polyethyleneimine (PEI) nanoparticles into provisional cements. The nanoparticles antibacterial effect incorporated at 0.5%, 1%, and 2% w/w into provisional...

In the present investigation we examined the effect of three brands of coffee on microbial volatile sulfur compound (VSC) production using a decarboxylase incubation assay. Stimulated whole saliva was added to decarboxylase medium supplemented with 0.005% hemin. Incubation was carried out anaerobically for 72 h in the presence of powdered coffee at...

We recently suggested that oral malodor production involves two steps: (i) deglycosylation of glycoproteins and (ii) proteolysis and amino acid utilization of the protein core to yield volatiles such as volatile sulfide compounds (VSCs). Our aim was to test the hypothesis that β-galactosidase activity and VSC production occur in distinct areas of t...

To evaluate the effect of temperature on external tooth bleaching. Human molars and premolars were internally stained and assessed using a standardized tea solution. The mesial aspects of the teeth were assigned to the treatment group (bleaching at 45 degrees C), and the distal aspects of the teeth were assigned to the control group (bleaching at 3...

The aim of the present study was to test the effect of a palatal mucoadhesive tablet containing an herbal formulation on oral malodor production and volatile sulfide compound (VSC) levels, and to evaluate its antimicrobial activity. A total of 56 healthy young volunteers participated in experiments 1 and 2. The palatal adhesive tablets were prepare...

Previous research has shown that the production of volatile sulfide compounds (VSC) by oral bacteria is associated with oral malodor. In the present study, we report a novel technique (microscopic sulfide assay (MSA)) for the quantification of VSC-producing oral microorganisms. The MSA was performed by overnight incubation of saliva samples in the...

The aim of the present study was to test the association between transmucosal depth of 2-stage dental implants and malodor production. Fifty-nine 2-stage implants were tested in 14 patients. Measurements were conducted 3 to 4 weeks following second-stage surgery. Measurements included healing abutment malodor scored using a subjective scale, volati...

In part 1 of this study, the authors showed that coating polymethyl methacrylate (PMMA) provisional restorations with bonding resin (BR) or liquid polish (LP) significantly reduced early in vivo biofilm formation on these restorations. The aim of the present study was to determine the mechanism through which these materials inhibit biofilm formatio...

Biofilm accumulation on provisional restorations may affect the surrounding tissues' integrity. The purpose of this study was to test in vivo biofilm formation on polymethyl methacrylate (PMMA) self-cured acrylic resin provisional crowns. Three types of PMMA surfaces were tested: (1) polished, (2) polished and coated with bonding agent, and (3) pol...

The chemomechanical excavation approach fits the "adhesive cavity" design criteria by producing a rounded internal outline of cavity walls. However, such a relatively new and conservative approach should be at least as effective as conventional bur excavation in the removal of residual caries. Objectives: The aim of the present study was to test th...

Although the contribution of the oral microbiota to oral malodor is well-documented, the potential role of Gram-positive micro-organisms is unclear. In the current study, we tested the hypothesis that Gram-positive micro-organisms contribute to malodor production by deglycosylating oral glycoproteins, rendering them susceptible to subsequent proteo...

Salivary incubation assays are commonly used in oral malodor studies. Using an in vitro model system, the effect of various natural medicinals (i.e., echinacea, propolis, elder, mastic gum, marigold, sage, lavender, thyme, and chamomile) on salivary protein putrefaction and malodor production was examined. Malodor production levels were scored by a...

The problem: Biofilm is an organized colony of bacteria interwoven with an extracellular polysaccharide matrix criss-crossed with water tunnels and mushroom- like structures. It is in the researcher’s interest to quantify the biofilm in a conservative manner, enabling the biofilm to continue its development uninterruptedly. The purpose of this stud...

The antimicrobial effect of mastic gum, an ancient remedy for oral malodor, against Porphyromonas gingivalis, a known odorogenic periopathogenic oral bacterium, was tested using the agar diffusion test. Paper discs impregnated with mastic gum methanolic extract (MME) [0.5-4% (wt/vol)] produced inhibition zones of 10.5-13.7 mm, respectively, without...

Oral malodour is considered to be caused by the proteolytic activity of anaerobic Gram-negative oral bacteria. In a previous study, it was shown that these bacteria were susceptible to blue light (wavelengths of 400-500 nm). In this study, the effect of blue light on malodour production by mixed oral microflora was tested in a salivary incubation a...

Putrefaction of saliva is commonly used as an in-vitro assay in oral malodour investigations. To exam the hypothesis that deglycosylation of salivary glycoproteins promotes oral malodour production. Porphyromonas gingivalis-mediated putrefaction of salivary glycoproteins was tested following preincubation of saliva in the presence of beta-galactosi...

Deglycosylation of oral mucins may be a critical initial step leading to their subsequent proteolysis and putrefaction. The present study was undertaken to determine whether activity in saliva of a major glycosidic enzyme (beta-galactosidase) is associated with oral malodor in a group of 64 subjects. Enzyme activity was detected by the use of a chr...

Deglycosylation of oral mucins may be a critical initial step leading to their subsequent proteolysis and putrefaction. The present study was undertaken to determine whether activity in saliva of a major glycosidic enzyme (β–galactosidase) is associated with oral malodor in a group of 64 subjects. Enzyme activity was detected by the use of a chromo...

The main purpose of the study was to examine the anti-malodor properties of oxidizing lozenges, as compared to breath mints and chewing gum. Healthy, young adult volunteers (N = 123; mean age 24.5 years) were measured for oral malodor-related parameters (whole mouth odor measured by 2 judges; tongue dorsum posterior odor using the spoon test; volat...