口臭と歯周病との関係-舌苔に含まれる口腔内細菌の関連性

Relationship between halitosis and periodontal disease - associated oral bacteria in tongue coatings.

抄録

目的:

本研究の目的は、口臭患者の舌苔（TC）および唾液検体中の口臭と口腔内細菌との関係を検討し、舌清掃が口臭に及ぼす影響を評価することである。

AIM: The objective of our study was to investigate the relationship between halitosis and oral bacteria in tongue coating (TC) and saliva samples from patients with halitosis, and to evaluate the effect of tongue cleaning on halitosis.

方法:

口腔内の悪臭を訴える94名を対象とした。オルガノレプティック（OR）値、ガスクロマトグラフィーによる揮発性硫黄化合物（VSC）濃度、およびTCスコアを口臭の臨床的パラメータとして用いた。歯周病関連口腔内細菌数の測定には定量的リアルタイムポリメラーゼ連鎖反応を用いた。

METHODS: Ninety-four participants complaining of oral malodour were included in the study. Organoleptic (OR) values, volatile sulphur compound (VSC) concentrations determined by gas chromatography and TC scores were used as clinical parameters of halitosis. Quantitative real-time polymerase chain reactions were used to determine the numbers of periodontal disease-associated oral bacteria.

結果:

TCスコアとOR値、メチルメルカプタン（CH3 SH）濃度およびVSC濃度には有意な相関が認められた（スピアマンの順位相関係数検定、P<0.01）。また、口臭の臨床的パラメータとTC検体中の総細菌数およびPrevotella intermedia、Fusobacterium nucleatum、Campylobacter rectus濃度との間には正の相関が認められた。しかし、唾液サンプルに関しては同様の相関は認められなかった。参加者を舌清掃の習慣の有無で2つのグループに分けた。舌清掃の習慣がある参加者は、他の参加者に比べ、ORスコア、VSC濃度、P.intermedia、F.nucleatum、C.rectus濃度が有意に低かった（Mann-Whitney U-検定、P<0.05）。

RESULTS: There was a significant correlation between TC scores and OR values, methylmercaptan (CH3 SH) concentrations and VSC concentrations (Spearman's rank-correlation coefficient test, P < 0.01). There was also a positive correlation between the clinical parameters of halitosis and total bacterial numbers and Prevotella intermedia, Fusobacterium nucleatum and Campylobacter rectus concentrations in the TC samples. However, there was no similar correlation with respect to the saliva samples. The participants were sub-divided into two groups based on whether they had the habit of tongue cleaning or not. The participants with the habit of tongue cleaning had significantly lower OR scores, VSC concentrations and P. intermedia, F. nucleatum and C. rectus levels than the other participants (Mann-Whitney U-test, P < 0.05).

結論:

以上の結果から、TCの歯周病関連口腔内細菌は口臭と密接に関連しており、舌清掃は口臭改善に有効な方法である可能性が示唆された。

CONCLUSION: These results suggested that periodontal disease-associated oral bacteria in TCs are closely related to halitosis and that tongue cleaning may be an effective method for improving halitosis.