Innovative Probiotic Lactic Yeast for the pharmaceutical, nutritional and agricultural industries

Halitosis treatment with Kluyveromyces B0399

Trial#168: Halitosis treatment through the administration of antibiotic-resistant lactic yeasts Kluyveromyces marxianus fragilis B0399 and the evaluation of the VSC levels with a digital halimeter.

Dr. Piero Nobili, Dr. Alberto R. Zanvit – Biological Dentistry Department, Italian Dental Institute – Milan

Halitosis is a common problem which creates severe social and relational difficulties. The most popular approach is to mask the smell, without considering the bacterial ethiology of the problem. The aim of this study is to measure the amount of VSC (Volatile Sulphur Compounds) and demonstrate the efficacy of probiotic therapy with follow-up at 7 and 14 days. About 91% of patients did not present halitosis. The protocol didn’t consider any oral hygiene treatment. Moreover, the drug is in capsule form with a shell which is resistant to gastric passage, to avoid disruption by gastric juices. Therefore results were achieved with a direct action on the intestine, not at an oral level. In conclusion, this study proves that, besides the rebalancing effect of probiotics in dysbiosis, there are many immunological implications on GALT (Gut Associated Lymphoid Tissue).
Halitosis is an organic disturbance that manifests itself with an unpleasant odour that comes out of the mouth be breathing or simply speaking.
By an epidemiologic point of view, there are not many variations based on race, sex, and age. Everyone in their life has suffered from halitosis, so much so that it has been discussed since Greek and Roman times. More detailed studies have only been done since the beginning of the last century.
Halitosis is classified in three categories: physiological or transient halitosis, true halitosis and halitophobia or imaginary halitosis.
Physiological halitosis is a situation normally present in specific situations and that goes away by itself, thus without a pathological significance. The so-called “morning breath” is a condition that is frequently presented in almost everyone. This is because during the night, the salivary flow is greatly reduced which leaves the mouth dry and smelly. The same condition is found with people who speak a lot for work; teachers, informants, those who are involved in public relations.
It can arise in a transient halitosis state in women during their menstrual cycle and in those who fast for long periods of time.
True halitosis is instead a pathological condition that presents itself as intraoral halitosis in 80-90% of the cases, 6-8% of the cases of upper respiratory tract pathologies as tonsillitis, sinusitis and rhinitis, while in only 1% of the cases of gastrointestinal problems. They can also affect some pharmacological therapies or bad habits like alcohol abuse and cigarette smoking, but also spicy food or onions, garlic and leek.
Another predisposed category is who has metabolic diseases like diabetes, hepatitis, kidney failure,...
Halitophobia is, lastly, a condition where the patient believes he or she has bad breath while not objectively experiencing that state. These types of patients need psychological support.
The origin of the offensive smell derives from the degradation of peptides containing sulphur by Gram-negative anaerobes which produces the so-called VSC (Volatile Sulphur
Compounds). The most represented are hydrogen sulphate, methyl mercaptan, dimethyl sulphide, fatty and short-chain acids (butyric acid, valeric, isovaleric and propionic) compounds diamminic, poliamminic, indole (skatole, methylamine, putrescine, cadaverine).
Hydrogen sulphate and methyl mercaptan constitute about 90% of the VSC present in breath.
Hydrogen sulphate is mainly produced on the third posterior of the tongue. The methyl mercaptan and dimethyl sulphide are generated by the periodontal tissues.
The condition necessary so that these compounds are produced is a basic environment.
In fact, halitosis vanishes in the presence of sugar which activates the saccharolytic fermentation that, in turn, lowers the intraoral pH, inhibiting the metabolic activity of the proteolytic microorganisms responsible for halitosis.
A population of patients of both sexes affected by halitosis, from ages 18 to 65, were considered.
At the first visit, patients were excluded who admitted to having cardiac problems, diabetic problems, immunosuppression, cancer, those who were already in conventional therapy to treat halitosis, and women who were pregnant. The selection of the group of patients was done at the end of rendering the sample as homogeneous as possible and excluding all the factors that could have falsified the result of the research.
After the medical history interview, the patients were subjected to an instrumental survey of the breath to objectify the presence or lack of presence of halitosis and to which degree.
The instrument used was a digital halimeter connected to a computer that, through a specific software (halisoft), monitored the levels of VSC present in the patient’s breath.
This cycle was repeated two other times.
At the end of the data recording, the quantity of VSC on the graphic survey was evaluated. The threshold value was fixed at 100 ppb, if it is superior, the presence of halitosis is considered.
The treatment for patients whose results were positive were done with a product with a base of lactic yeasts Kluyveromyces Fragilis B0399 and a serum made from goat milk in film-coated gastro-resistant capsules. The dosage was said to be the consumption of one capsule three times a day before main meals for about a month. A package containing 50 pills of the product were given free of charge to the patient suffering from halitosis.
The test performed with the digital halimeter was repeated at a distance of 7 to 14 days from the first survey and from the first therapy treatment. In this period, no dental operations were performed of any type.
115 patients were analyzed. Of these 115, 35 were allowed to get the therapy because they show VSC levels higher than 100 ppb.
No results were seen in only 3 cases.
We can then state that 91% of the cases recovered.
No collateral effect was reported from the patients during and after the use of the product.

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