The Effects of Dentifrice Containing Sodium Bicarbonate and Triclosan on Oral Malodor

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1 International Journal of Clinical Preventive Dentistry Volume 7, Number 1, March 2011 The Effects of Dentifrice Containing Sodium Bicarbonate and Triclosan on Oral Malodor JiHye Kim 1, YeonSoo Jang 1, SeungChul Shin 2, ByungJun Kim 3, JaeHyun Ahn 3 1 Department of Oral Health, Graduate School of Public Health & Social Welfare, Dankook University, 2 Department of Preventive Dentistry, College of Dentistry, Dankook University, Cheonan, 3 LG Household & Health Care Research Park, Daejeon, Korea Objective: The object of this study is to evaluate the effect of dentifrice containing sodium bicarbonate and triclosan on the removal of kimchi and garlic odor and its 12 hours lasting efficacy. Methods: To confirm the efficacy of dentifrice on oral malodor invitro and clinical trials were conducted. Antibacterial activity on P. intermedia and removal efficacy of kimchi and garlic odor were measured by GC and a Halimeter, invitro. Clinical trials were designed by a double blind, crossover study design for subjects aged between The removal effect of kimchi odor and its 12 hour longlasting inhibitory effect of oral malodor were conducted by organoleptic evaluations and/or through a Halimeter. Results: Antibacterial activity on P. intermedia, experiment group 2 (sodium bicarbonate/triclosan), was under 100 CFU/ml. Experiment group 2 showed effective reduction in oral malodor using cultivated saliva with garlic. The result of measuring the effects removing acetic acid among the kimchi odor ingredients using GC showed that compared to the control group, the peak area of experiment group 2 decreased 52.28%. The result of sensory evaluation after brushing under the kimchi intake showed the statistically meaningful effect of oral malodor control for 2 hours after brushing than the control group (p<). In clinical tests through sensory evaluation and Halimeter measuring oral malodor the controlling effect in 12 hours after brushing, the experiment group inhibited oral malodor control more than the control group (p<). Conclusion: It is proven that dentifrice containing sodium bicarbonate and triclosan is more effective on oral malodor control than dentifrice without triclosan and sodium bicarbonate. Keywords: sodium bicarbonate, triclosan, oral malodor, dentifrice Introduction Corresponding author JiHye Kim olive1210@naver.com Received February, 16, 2011, Revised March, 4, 2011, Accepted March, 7, 2011 Oral malodor can be defined as an odor causing an unpleasant feeling to someone (1). The American Dental Association reported that more than 50% of the American adult population had complaints of oral malodor and 25% of them suffered from severe chronic oral malodor (2). Oral malodor is one of the important factors of social and mental obstacles in relationships. Oral malodor can be classified as genuine halitosis, pseudohalitosis, and halitophobia (3). Genuine halitosis can be measured by a sensory evaluation and use of an objective test machine. It can be categorized into pathological and physiological halitosis. Physiological halitosis occurs during an empty stomach, menstruation, pregnancy, smoking, drinking and after taking drugs or food. Pathological halitosis is divided into intra oral and extra oral factors. Among these, intra oral factors are tongue plaque, periodontal diseases, dental caries, stomatitis, and poor restoration (46). It has been reported that approximately 8590% of oral malodor occurrence is caused by internal oral factors and oral malodor within the oral cavity, are expressed 41

2 International Journal of Clinical Preventive Dentistry by volatile sulfur compounds (VSC) focused mainly on hydrogen sulfide and methyl mercaptan (5). VSCs are produced mainly by the action of oral bacteria sulfur containing compounds created by peptides and proteins in gingival crevicular fluid, blood, desquamated epithelial cells, saliva and foods (7). In terms of related micro organisms such as Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleateum, Treponema denticola and Tannerella forsythensis these are known as Gram negative anaerobic organisms (810). To treat and reduce oral malodor, it is effective to use physical methods to clean the tongue and dental plaque and it is more effective to use physical methods combined with chemical controls to inhibit oral microorganisms (5,7). To do this, there are many methods which include antibacterial agents to reduce oral malodor with dentifrice or mouth wash (11). Synthetic compounds such as zinc chloride, chlorohexidine, triclosan and cetylpyridinium chloride (CPC) have been mostly used (9,12,13). These antibacterial agents need not cause adverse effects on the body and oral tissues when used for a long period. Recently, there have been many attempts to study oral care products with fewer side effects in long term use, containing natural plant extract. Kim et al (11,13) reported that dentifrice and spray containing curcuma xanthorrhiza extract had an effect on controlling oral malodor and antibacterial activity. Lee et al (14) and Kim et al (15) demonstrated that dentifrice and mouth wash containing mastic are effective in reducing oral malodor. In our study, we focus on sodium bicarbonate known as baking soda. Sodium bicarbonate has generally been used both inside and outside the country. Because sodium bicarbonate is soft and has a low abrasivity, it is thought to be less potentially damaging to enamel and dentin (16,17). In a clinical study it was demonstrated that the plaque controlling effect of dentifrice containing sodium bicarbonate was higher than the control dentifrice without sodium bicarbonate (18). Also, since sodium bicarbonate is a natural buffer, it helps maintain the mouth s natural ph level as it neutralizes food acids, even after brushing (19). Triclosan has a wide range of anti microbial activity and several clinical studies have proven it to be safe (20) and it has been commonly used in cosmetics, dentifrice and has the ability to inhibit acne, and work as an antiseptic (21). The object of this study is to confirm that dentifrice containing triclosan and sodium bicarbonate will show the oral malodor controlling effect for a long period and the reducing effect instantly. In addition, the effectiveness of dentifrice containing triclosan and sodium bicarbonate is expected if they are used properly. This will happen because triclosan has a wide anti micro bacterial activity about a gram negative and positive bacteria and the sodium bicarbonate shows low abrasivity, high detergency and neutralization. Material and Methods Kimchi (Jonggatjip matkimchi, Deasang Co., LTD, Jeonbuk, Korea) and garlic powder (Bongdong NH, Jeonbuk, Korea) were purchased from the local market in Daejeon, Korea. Detailed information about materials is shown in Table 1. Kimchi was purchased the next day after manufacture and used within 5 days. While the experiments were performed, the kimchi was stored in a refrigerator at 0 o C. 1. Invitro study Table 1. Materials information Kimchi Garlic Contents Salted cabbage (72.3%), radish, red pepper, garlic, ginger, green onion, onion, leek, aekjeot (anchovy and shrimp), purified salt, etc. Dried powdered garlic 1) Composition ingredient of experimental dentifrice In this study, dentifrice compositions are listed in Table 2. Experiment groups were divided in to three groups. To measure the efficacy of our dentifrice, we divided into three groups; control, experiment group 1 containing sodium bicarbonate, and experiment group 2 containing sodium bicarbonate and triclosan. Table 2. Dentifrice components invitro study (Unit: %) Ingredients Experiment 1 Experiment 2 Experimental ingredients Otheringredients Baking soda Triclosan Dental type silica Sodium fluoride Tocopherol acetate Sodium pyrophosphate Vol. 7, No. 1, March 2011

3 JiHye Kim, et al:the Effects of Dentifrice on Oral Malodor 2) Antimicrobial activity against bacteria causing oral malodor (1) Strain Prevotella intermedia (ATCC 15032) was used as a strain in this experiment. The broth was prepared by the addition of menadion (50 ng/ml) and hemin (5 μg/ml) to Brain Heart Infusion (BHI). The strain was cultivated by a successive culture in the Brain Heart Infusion (BHI: Difco, USA) broth, inoculated with the same broth and subsequently cultured another 72 hours in an anaerobic chamber at 37 o C. (2) Experiment method 5% experimental dentifrice solutions were prepared with a dilution of BHI liquid medium, containing CFU/ml strain and cultured an additional 3 minutes. Cultured experimental solutions were diluted sequentially up to 1/1,000. Diluted solutions were inoculated to the solid medium and cultivated for 48 hours. Afterwards the colony forming unit (CFU) was recorded. All experiments were conducted three times. 3) Invitro evaluation of inhibitory effect of VSC by a substance causing oral malodor 10 volunteer subjects brushed with the control dentifrice. After 1 hour, 10 ml of saliva was collected from each subject in a polyethylene tube. Collected saliva was moved to an anaerobic chamber, poured into a 250 ml beaker and homogenously mixed for 10 minutes using a magnetic stirrer at 500 rpm. The experimental solution for Halimeter (RH17K, Interscan Co. USA) was prepared by mixing 2 ml of saliva, 200 μl of 5% garlic solution and 50 μl of 33% dentifrice and distilled water slurry using sealed 20 ml gas chromatography vials. All samples were aged for 1 hour and 30 minutes in a 37 o C anaerobic chamber. Volatile sulfur compounds (VSC) were measured by a Halimeter equipped with a needle to insert it into the vial for 30 seconds. Herein above processes were repeated 10 times for each experimental dentifrice. Table 3. Dentifrice components in clinical study (Unit: %) Experimental ingredients Other ingredients Ingredients Experiment Baking soda Triclosan Dental type silica Sodium fluoride Tocopherol acetate Sodium pyrophosphate ) Invitro evaluation of volatile organic acid removal effects in kimchi odor Sample slurry for gas chromatography was prepared by mixing 2 ml of kimchi liquid and 2 g dentifrice in a sealed 20 ml GC vial. Prepared samples were separated by a gas chromatography (GC: Agilent GC 6890N) equipped with a Headspace sampler (Agilent G1888) and identified acetic acid using a Mass spectrometric detector (Agilent 5875 MSD). Separation conditions of the GC were preheated for 10 minutes at 30 o C, injected for 1 minute at 100 o C in the loop, and separated using a 30 m length, 0.32 mm inner diameter FFAP capillary column on the condition that 50 o C start temperature is ramped to 230 o C at the rate of 5 o C/minute. After separation MSD detected m/z 60, 45 to identify the organic acid. 2. Clinical trial 1) Composition ingredient of experimental dentifrice In the clinical trials the experiment group and control group were designed to compare breath control efficacy of the former and the later dentifrice. Detailed information on experiment groups are shown in Table 3. 2) Subjects and experiment method Subjects participating in this study were healthy men and women aged between For those with the onset of dental caries and periodontal disease, the presence of orthodontic appliances, which can cause oral malodor, systemic disease or who are taking certain medications were excluded from this study as subjects. (1) Organoleptic evaluation of oral malodor Sensory evaluation of oral malodor was conducted using a 1m length Teflon tube with a 3/8 inch and 1/2 inch inner and outer diameter, respectively. For subjects privacy a partition with the dimensions of 90 cm in height and 120 cm in width was set between the subjects and examiners. On one side of the partition two examiners were seated and on the other side the subjects. Once the subjects came to the test room, they kept their mouth closed for one minute and thereafter blew out the air held in their mouth. The raters calibrated for a few days to match the rating between raters. When the calibration process was completed, the Pearson correlation coefficient showed 0.81 representing a very high reliability between examiners (22,23). Determination Table 4. Organoleptic scale of oral malodor Score Oral malodor Score Oral malodor None Most pleasant Mild, very pleasant Moderately pleasant Slightly pleasant Neither pleasant or unpleasant Slightly unpleasant Moderately unpleasant Very unpleasant Most unpleasant IJCPD 43

4 International Journal of Clinical Preventive Dentistry guidelines of oral malodor are shown in Table 4. (2) Halimeter measurement First, we turned on the main switch 30 minutes before the unit application for preactivation and adjusted it to zero point of the unit to check the gas. The subjects closed their mouth for 12 minutes breathing through their nose. Next, the tip of the inhalation tube of the apparatus was inserted into the subject s mouth and they continued to breathe through their nose. Gas from the subject s oral cavity was sucked into the Halimeter and the digital readings were read on the display. The highest numbers were recorded during the test. 3) Clinical evaluation of kimchi originated odor For subjects aged between 2735, 23 subjects (males 12, females 11) chewed 25 g of kimchi for one minute and thereafter ingested it. Their oral malodor was measured in intervals right after brushing, 30 minutes, 1 hour and 2 hours, respectively, using the organoleptic evaluation. 4) Clinical evaluation of longlasting efficacy For subjects aged between 2738, 16 subjects (males 6, females 10), a crossover study design for an evaluation was conducted. Subjects brushed for 1 minute 12 hours before organoleptic and Halimeter oral malodor tests. Subjects refrained from oral hygiene for 12 hours, and did not eat, drink, or smoke the morning of their examination visit. Subjects visited the examiners 12 hours after brushing and then tested the organoleptic evaluation and Halimeter. Table 5. Antimicrobial activity on P. intermedia (Unit: CFU/ml) Experiment 1 Experiment 2 P. intermedia Less than 100 Table 6. Inhibitory effect of VSC caused by garlic in Halimeter Experiment 1 Experiment 2 Halimeter VSC (ppb) ±95.84 a ±44.63 a,b ±43.37 b All values are the mean±standard deviation. *pvalues are determined by oneway ANOVA analysis among groups. a,b,c Value with same superscript letter were not statistically significant by Duncan multiple comparison at α=. 5) Statistical analysis For statistical analysis of all data collected Window SPSS 12.0 statistical package program (SPSS Inc., USA) was used with the significance level being. One way ANOVA was used for comparing the oral malodor control effect on dentifrice containing active ingredients and thereafter the Duncan multiple comparisons test was used for significant differences between groups in vitro. A paired ttest was performed for evaluation of oral malodor control according to time progress in this clinical study. Results 1. Results of invitro study 1) Antibacterial activity in P. intermedia As a result of antibacteial activity on P. intermedia, control and experiment group 1, experiment group 2 are CFU/ml, CFU/ml, under 100 CFU/ml, respectively. Experiment group 2 had a strong antibacterial activity on P. intermedia (Table 5). 2) Invitro evaluation of inhibitory effect of VSC by a substance causing oral malodor After applying a garlic solution, experiment and control dentifrice to collected saliva, amounts of VSC measured by Halimeter are shown in Table 6. In the experiment group 2 containing triclosan and sodium bicarbonate compared to control, oral malodor decreased by 38% more (p<). Experiment group 1 showed no significant difference compared to control statistically. 3) Invitro evaluation of volatile organic acid removal effects in kimchi odor According to the results which measured the peak area of acetic acid, the control, experiment group 1 and 2 in GC/Mass were 351,858, 418,822, and 877,654 respectively. Compared with the control group, experiment group 1 and 2 decreased 59.90%, 52.28%, respectively, in the peak area. Experiment group 1 and 2 were more effective than the control Table 7. Effectiveness of elimination of acetic acid in kimchi odor by gas chromatography Experiment 1 Experiment 2 Peak area of acetic acid 877, , ,822 Difference 525, ,823 Reduction compared with control group (%) Vol. 7, No. 1, March 2011

5 JiHye Kim, et al:the Effects of Dentifrice on Oral Malodor Figure 1. Peak area of acetic acid using dentifrice by GC/MS analysis. (A): group, (B): Experiment group 1, (C): Experiment group 2. Table 8. Result of organoleptic evaluation of oral malodorafter eating kimch Dentifrice group N Prebrushing (After kimchi) After brushing After 30 minutes After 1 hour After 2 hours Experiment p* ± ± ± ± ± ± ± ± ± ± All values are the mean±standard deviation. *pvalues are determined by paired ttest analysis among groups. group in the elimination of violate acetic acid of kimchi odor. Experiment 1 and 2 showed no significant differences (Table 7, Figure 1). 2. Results of clinical study 1) Clinical evaluation of kimchi originated odor (1) Organoleptic evaluation The short term results of effectiveness of using the cross over experiment are shown in Table 8. The oral malodor sensory evaluation index shortly after brushing were 0.23 (control group) and 0.59 (experiment group) and after 2 hours was 3.90 (control group) and 4.46 (experiment group), respectively. From shortly after brushing to 2 hours the experiment groups compared to the control group showed a significant decrease of oral malodor statistically (p<). 2) Clinical evaluation of longlasting efficacy (1) Organoleptic evaluation Table 9 shows the results of the sensory evaluation of the cross over on 16 subjects. 12 hours after brushing the organoleptic evaluation index values were 6.19 (experiment group) and 6.50 (control group) (p<), respectively. The oral malodor index IJCPD 45

6 International Journal of Clinical Preventive Dentistry Table 9. Result of 12 hours later brushing by Halimeter and organoleptic evaluation Dentifrice group Experiment p* N Organoleptic scores 6.19± ± Halimeter scores (ppb) ± ± All values are the mean±standard deviation. *pvalues are determined by paired ttest analysis of among groups. was significantly lower than the control group. (2) Halimeter measurement 12 hours after brushing, VSC value was recorded by the Halimeter (Table 9). The mean of the Halimeter measure recorded was ppb (experiment group), ppb (control group), respectively. The oral malodor index of the experiment group was lower than the control group in a significant level (p<). Discussion Oral malodor has become a common symptom that people are concerned about with the increase of social activities. Interest on preventing and eliminating oral malodor has gradually increased because bad breath is taken as the cause of social and psychological disorders. Koreans tend to prefer pungent food such as kimchi and garlic. Many studies have focused on prevention and elimination of oral malodor in various ways. Recently, there have been many studies which expect reduction in oral malodor by adding active ingredients, such as Cetylpyridinium chloride (CPC), Chlorohexidine, Xanthorrizol, and Mastic to dentifrice or mouth wash (9,1214). Among a variety of dentifrice compositions, there have also been many studies on sodium bicarbonate and triclosan. Zambon et al (1996) reported that sodium bicarbonate, which is used in this study, had an effect on dental plaque and gingivitis, decrease in tooth staining and the safety of dentifrice formulation (24). It is also reported that dentifrice containing sodium bicarbonate had an effect on decreasing of oral malodor (25). Sodium bicarbonate showed outstanding results in reducing oral malodor. Because of the wellknown effects of sodium bicarbonate, dentifrice containing sodium bicarbonate is recommended by dentists to control oral malodor (26). Triclosan is known as safe material through many studies with a variety of antibacterial activity (20). In previous reports, dentifrice containing triclosan showed antibacterial activity, inhibition of dental plaque and the effects of oral malodor control (21,23). The purpose of this study is to evaluate effects of dentifrice containing sodium bicarbonate and triclosan in eliminating odor caused by kimchi and garlic and the general control of oral malodor over a long period. Among the factors of oral malodor within oral factors, oral malodor after eating foods such as garlic and kimchi is classified as physiological breath. They can be solved by brushing and using mouth wash. However, Korean food, i.e., kimchi and garlic with sulfide, remains mucosa and, thus, the oral malodor is not easily removed even after brushing. Therefore, in this study, tests were conducted on experiment dentifrice and the effects on elimination of the odor of kimchi and garlic were shown. Sensory evaluation, Gas chromatography analysis and Halimeter are used for measurement of oral malodor. GC measured all of the material causing odor, but it took a long time to measure, and required a relative high cost and skilled personnel. Despite the disadvantage of sensory evaluation by sense of odor which requires an evaluator trained for objectivity, it is widely used due to the similarities with real life (22). The Halimeter measures the total amount of sulfur in the breath. It is portable and easy to use. This study was carried out both in vitro and clinically to control oral malodor. First, on antibacterial activity of P. intermedia of causative strain of halitosis control group, experiment group 1 and 2 were CFU/ml, CFU/ml and under 100 CFU/ml, respectively. The control group and experiment group 1 had some antibacterial activity on P. intermedia, but experiment group 2 had the most effective activity among them. In the control group, antibacterial activity appeared due to the basic antibacterial activity of dentifrice formulation by surfactant, flavor and etc. In experiment group 1, antibacterial activity was more effective than the control group due to containing sodium bicarbonate. In experiment group 2, antibacterial activity was the most effective through the cooperation of triclosan and sodium bicarbonate. It is already reported that sodium bicarbonate has effects on microorganisms causing periodontal disease when it is used with high density in vitro (27). P. intermedia, used to evaluate antibacterial activity in this study, is known as representative strains causing oral malodor and periodontal disease (810,28,29). Dentifrices which were containing triclosan showed the outstanding antibacterial efficacy to causative bacteria of oral malodor such as Porphyromonas gingivalis, Fusobacterium nucleatum and Prevotella intermedia in the previous works (21,30). Experimental dentifrice also contained the same amount of triclosan and would show the antibacterial efficacy to the above mentioned strains. In this study, it is reassured that not only triclosan but also sodium bicarbonate have effects on strains causing oral malodor when combined with dentifrice. 46 Vol. 7, No. 1, March 2011

7 JiHye Kim, et al:the Effects of Dentifrice on Oral Malodor Shin et al (31) reported that diallyl disulfide is an important volatile component of garlic by analyzing the odor ingredients of Korean garlic. Breath components after eating garlic were mainly methyl mercaptan, allyl methyl sulfide and allyl mercaptan (32). Experiments using saliva were carried out to study the effects of dentifrice toward garlic causing oral malodor in vitro. Methods were designed, considering the results that Richter et al (33) found in the air of cultivated saliva and that of human breath are similar. When garlic is taken through the mouth, garlic with a number of sulfide create VSC, causing oral malodor by cooperating with salivary protein, peptide and oral microorganisms. Experiment group 2 containing triclosan and sodium bicarbonate showed more effect on controlling oral malodor than the control group by approximately 38%. Experiment group 1 didn t show any significance statistically. When used with sodium bicarbonate and tricloasn, oral malodor is inhibited by odor of neutralization of sodium bicarbonate and antibacterial activity of triclosan. The results showed that volatile organic acid in kimchi components were the peak of acetic acid after applying the experiment group 1, 2 and control group dentifrice to a kimchi solution through a GC/MS analysis. The result of the measuring peak area showed that both experiment group 1 and 2 decreased over 50% than the control without any active ingredient. This is effective in the elimination of acetic acid. Effects on elimination of acetic acid seem to happen through neutralization of sodium bicarbonate. Since the mechanisms of oral malodor control of triclosan was caused by antibacterial activity against strains causing oral malodor, triclosan didn t have an effect on eliminating odor compounds without microorganisms. This showed dentifrice containing sodium bicarbonate is effective in eliminating volatile odor compounds through neutralization. In the crossover clinical study on the effect of oral malodor control after eating kimchi, the experiment group showed more of an effect on oral malodor control than the control group for 2 hours after brushing with dentifrice in a sensory evaluation and from 1 hour to 2 hours after brushing in a Halimeter measurement. Kimchi odor is caused by the effects of its ingredients, i.e., red pepper, garlic, ginger, leek and etc., on the cultivation of microorganisms involving fermentation, and is mainly composed of sulfide compounds, organic acid and alcohols (34). Sulfide compounds were dimethyl disulfide, methyl allyl sulfide, dially disulfide and etc. (35,36), and volatile organic acids were acetic acid and formic acid (37). The unique odor of kimchi which some would like to avoid can be described as a sour odor and a stale or moldy odor, and is caused by volatile acid such as acetic acid (38). In this study, the effect of sodium bicarbonate was proven by measuring the amount of reduction of acetic acid in kimchi components. In clinical and sensory evaluations, the experiment group was more effective in reducing oral malodor than the control group for 2 hours after brushing, because of the cooperation of antibacterial activities against strain causing oral malodor caused by the acid transforming of sodium bicarbonate and tricolosan which transform odorous acid volatile, the cause of oral malodor made by volatile sulfide and organic acid, into a nonodorous form (25,39). The limit of this study is that since we measured only for 2 hours after using dentifrices, we cannot predict the changes of the effect afterwards. In the clinical crossover experiment on oral malodor 12 hours after brushing, it was shown that the experiment group containing sodium bicarbonate and triclosan was more effective in oral malodor control than controls statistically in the Halimeter and sensory evaluations. This proves cooperation of the antibacterial activity of triclosan and neutralization of sodium bicarbonate affects on the control of biofilm and antibacterial activity on P. intermedia. There were many products for removing oral malodor with a masking flavor which temporally hide odor, rather than for elimination of it or antibacterial activity. In this study, it is expected that combining tricolosan extended the duration of the effect in the mouth by inhibition of the strain causing oral malodor and biofilm, and that strong odor elements like kimchi odor were removed immediately by transformation of sodium bicarbonate into acid. Since this study is limited in that it only measured the effects of oral malodor control, it is necessary to have further clinical evaluations on a longterm basis (for a few months) on the effects of oral malodor control in various ways. Conclusion The purpose of this study was to evaluate effects of dentifrices containing triclosan and sodium bicarbonate on oral malodor control through measuring elimination of the odor of garlic and kimchi. The results are as follows: 1. The result of testing antibacterial activity of the experiment group against P. intermedia, the control group and experiment group 1 (sodium bicarbonate) had antibacterial activity. However, experiment group 2 (sodium bicarbonate/ triclosan) showed the highest antibacterial activity. 2. The result of measuring oral malodor through the Halimeter after cultivating salvia with a garlic solution and dentifrices to evaluate the VSC controlling effect under the garlic intake in IJCPD 47

8 International Journal of Clinical Preventive Dentistry vitro, experiment group 2 (sodium bicarbonate/ triclosan) had more effects on oral malodor control than the control group. 3. The result of measuring the effects removing acetic acid among the Kimchi odor ingredients using GC showed that compared to controls, the peak area of experiment group 1 (sodium bicarbonate), group 2 (sodium bicarbonate/triclosan) decreased 59.90%, 52.28%, respectively. 4. The result of the sensory evaluation measuring the effects of oral malodor control after brushing with dentifrice containing sodium bicarbonate and triclosan under the kimchi intake showed the statistically meaningful effect of oral malodor for 2 hours after brushing than the control group (p<). 5. In clinical tests through the sensory evaluation and Halimeter measuring oral malodor controlling effect in 12 hours after brushing, the experiment group containing sodium bicarbonate and triclosan inhibited oral malodor more than the control group (p<). Consequently, it is proven that dentifrice containing sodium bicarbonate and triclosan is more effective on oral malodor control than the control group. References 1. Heo HY, Shin SC, Cho JW, Park KS. A study about the relationship between worker s mouthodor survey and factor analysis. J Korean Acad Dent Health 2005;29(3): American Dental Association. Oral malodor. J Am Dent Assoc 2003;134(2): Kawaguchi Y. Fresh breath clinic in Japan. Diagnosis, treatment and prevention of oral malodor. Int Dent J 2006;2(1): Mandel ID. Dental plaque: nature, formation and effects. J Periodontol 1966;37: Tonzetich J. Production and origin of oral malodor: a review of mechanisms and methods of analysis. J Periodontol 1977; 48(1): Kim YS, Mun YH, Kim SH, Cho JW. Correlation coefficient between dental plaque and halitosis. Int Dent J 2009;5(4): Diana V, Fariba S. Halitosis. Dermatol Clin 2003;21: McNamara T, Alexander J, Lee M. The role of microorganisms in the production of oral malodor. Oral Surg Oral Med Oral Pathol 1972;34: Quirynen M, Mongardini C, Van Steenberghe D. The effect of a 1stage full mouth disinfection on oral malodor and microbial colonization of tongue in periodontitis patients. A pilot study. J Periodontol 1998;69: Roldan S, Winkel E, Herrera D, Sanz M, Van Winkelhoff AJ. The effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc lactate on the microflora of oral halitosis patients. J Clin Periodontol 2003;30(5): Kim BI, Jeong SH, Kim MY, Kim HS, Yoo JH, Kwon HK. Clinical antihalitosis effects of oral spray containing Curcuma xanthorrhiza oil. J Korean Acad Dent Health 2006;30(1): Choi JM, Choi JY, Hwang KS, Park YD. Improvement effect of oral environment after using mouthwash containing cetylpyridinium chloride or triclosan. J Korean Acad Dent Health 2007; 31(3): Kim BI, Kim SN, Chang SY, et al. A highly selective antibacterial effect of Curcuma xanthorrhiza extract against oral pathogens and clinical effectiveness of a dentifrice containing Curcuma xanthorrhiza extract for controlling bad breath. J Korean Acad Dent Health 2005;29(2): Lee CH, Park KS. A clinical experiment on the effects of masticcontaining dentifrice in reducing dental plaque and oral malodor. Int Dent J 2009;5(4): Kim TH, Lee SM, Lee MG, Cho JW. Clinical study on the Halitosis control by use of Mastic Mouth rinse. Int Dent J 2009; 5(4): Lehne RK, Winston AE. Abrasivity of sodium bicarbonate. Clin Prev Dent 1983;5: Winston AE, Lehne RK. The effect of concentration on the abrasivity of baking soda. Clin Prev Dent 1983;5: Putt MS, Milleman KR, Ghassemi A, et al. Enhancement of plaque removal efficacy by tooth brushing with baking soda dentifrices: result of five clinical studies. J Clin Dent 2008;19(4): Kashket S, Yaskell T. Effects of a highbicarbonate dentifrice on intraoral demineralization. Compend Contin Educ Dent Suppl 1996;17(19):S Desalva S, King B, Lin Y. Triclosan: a safety profile. Am J Dent 1989;16: Kim JB, Moon HS, Paik DI, et al. Effect of a triclosan containing dentifrice on gingivitis, plaque formation and antimicrobial activity against the pathogens of oral diseases. J Korean Acad Dent Health 1998;22(2): Rosenberg M, McCulloch C A. Measurement of oral malodor: current methods and future prospects. J Periodontol 1992;63: Hu D, Zhang YP, DeVizio W, Proskin HM. A clinical investigation of the efficacy of two dentifrices for controlling oral malodor and plaque microflora overnight. J Clin Dent 2008;19: Zambon JJ, Mather ml, Gonzales Y. A microbiological and clinical study of the safety and efficacy of bakingsoda dentifrices. Compend Contin Educ Dent Suppl 1996;17(19):S Brunette DM, Proskin HM, Nelson BJ. The effects of dentifrice systems on oral malodor. J Clin Dent 1998;9: Honda S. Advance course for malodor control at dental clinics. Int Dent J 2007;3(3): Newburn E, Hoover CI, Ryder MI. Bactericidal action of bicarbonate ion on selected periodontal pathogenic microorganisms. J Periodontol 1984;55(1): Jee YJ, Shin SC, Song HJ, Cho JW. Correlation coefficiency be 48 Vol. 7, No. 1, March 2011

9 JiHye Kim, et al:the Effects of Dentifrice on Oral Malodor tween the oral malodor and the critical periodontal index. Int Dent J 2006;2(1): Tanaka M, Yamamoto Y, Kuboniwa M, et al. Contribution of periodontal pathogens on tongue dorsa analyzed with realtime PCR to oral malodor. Microbes and Infect 2004;6(12): Cullinan MP, Hamlet SM, Westerman B, Palmer JE, Faddy MJ, Seymour GJ. Acquisition and loss of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans and Prevotella intermedia over a 5year period: effect of a triclosan/copolymer dentifrice. J Clin Periodontol 2003;30(6): Shin DB, Seog HM, Kim JH, Lee YC. Flavor composition of garlic from different area. Korean J Food Sci Technol 1999;31(2): Tamaki T, Sonoki S. Volatile sulfur compounds in human expiration after eating raw or heattreated garlic. J Nutr Sci Vitaminol (Tokyo) 1999;45(2): Richter VJ, Tonzetich J. The application of instrumental technique for the evaluation of odoriferous volatiles from saliva and breath. Arh Oral Biol 1964;9: Choi AR, Park DI, Yoo GJ, Kim SY, Jang JB, Chae HJ. Effect of soaking of subingredients on odor and fermentation characteristics of Kimchi. J Korean Soc Food Sci Nutr 2009; 38(11): Hawer WD, Ha JH, Seog HM, Nam YJ, Shin DW. Changes in the taste and flavor compounds of Kimchi during fermentation. Korean J Food Sci Technol 1988;20: Ko YT, Lee JY. Quality characteristics of Kimchi prepared with Chinese radish and its quality change by freezedrying. Korean J Food Sci Technol 2003;35: Chyun JH, Rhee HS. Studies on the volatile fatty acids and carbon dioxide producted in different Kimchi. Korean J Food Sci Technol 1976;8(2): Hawer WD. Study of change in flavor components in Korean cabbage Kimchi during fermentation. Proceeding of symposium `Science of Kimchi` of Korean Society of Food Science and Technology, Seoul. 1994: Rosenberg M. Bad Breath: Research Perspectives. 2nd ed. Seoul: Shinhung International; 1998:58. IJCPD 49