{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:56:43Z","timestamp":1787029003896,"version":"build-2736575974"},"reference-count":47,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T00:00:00Z","timestamp":1725321600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Kaneka Corporation and Kaneka Americas Holding Inc.","award":["UU05052020"],"award-info":[{"award-number":["UU05052020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Microorganisms"],"abstract":"<jats:p>Persistent malodor affects many people worldwide and is usually associated with poor dental hygiene. This pilot trial aimed to determine whether proper dental hygiene (DH) and a probiotic dietary supplement support oral health in volunteers with persistent malodor. Volunteers (n = 35) were randomly assigned to the probiotic or placebo cohort. The probiotic cohort (n = 20) brushed and flossed their teeth twice daily and used probiotics for 30 days; the placebo cohort (n = 15) followed the same hygiene practices and used the placebo. The intervention phase was followed by a 30-day follow-up period. Measured outcomes were malodor and tongue-coating scores, probiotic DNA levels, salivary cytokines, and salivary pH. DH and probiotics significantly decreased malodor (~50% during intervention) and tongue coating scores (~45% during intervention). These changes remained through the course of the trial. The probiotic DNA levels increased in the probiotic cohort and dropped in the placebo cohort after the intervention started. The malodor moderately correlated with the tongue coating P. acidilactici level. The addition of probiotics increased IL-10 levels during the intervention and decreased IL-8, TNF-\u03b1, and IL-6 by the end of the study. People with malodor may benefit from using DH and probiotics. Additional trials are needed to definitively establish the benefits of probiotic dietary supplements.<\/jats:p>","DOI":"10.3390\/microorganisms12091821","type":"journal-article","created":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T04:06:41Z","timestamp":1725336401000},"page":"1821","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Results of a Pilot Trial Assessing the Effects of Proper Oral Hygiene and a Probiotic Dietary Supplement on Oral Health in Volunteers with Oral Malodor"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3738-1460","authenticated-orcid":false,"given":"Elena Y.","family":"Enioutina","sequence":"first","affiliation":[{"name":"The Division of Clinical Pharmacology, Pediatrics, School of Medicine, University of Utah, Salt Lake City, UT 84108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. James","family":"Keddington","sequence":"additional","affiliation":[{"name":"School of Dentistry, University of Utah, Salt Lake City, UT 84108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurtis G.","family":"Hauck","sequence":"additional","affiliation":[{"name":"School of Dentistry, University of Utah, Salt Lake City, UT 84108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amarina","family":"Chavez","sequence":"additional","affiliation":[{"name":"School of Dentistry, University of Utah, Salt Lake City, UT 84108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey J.","family":"Clifford","sequence":"additional","affiliation":[{"name":"The Department of Pathology, School of Medicine, University of Utah, Salt Lake City, UT 84112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thy (April)","family":"Cao","sequence":"additional","affiliation":[{"name":"The Department of Pathology, School of Medicine, University of Utah, Salt Lake City, UT 84112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6653-0669","authenticated-orcid":false,"given":"Bryce","family":"Smith","sequence":"additional","affiliation":[{"name":"The Department of Pathology, School of Medicine, University of Utah, Salt Lake City, UT 84112, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0255-654X","authenticated-orcid":false,"given":"Kathleen M.","family":"Job","sequence":"additional","affiliation":[{"name":"The Division of Clinical Pharmacology, Pediatrics, School of Medicine, University of Utah, Salt Lake City, UT 84108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Balch","sequence":"additional","affiliation":[{"name":"Family and Preventive Medicine Department, School of Medicine, University of Utah, Salt Lake City, UT 84108, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1111\/odi.14172","article-title":"Aetiology and associations of halitosis: A systematic review","volume":"29","author":"Memon","year":"2023","journal-title":"Oral Dis."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"631","DOI":"10.3920\/BM2020.0090","article-title":"Probiotics diminish the post-operatory pain following mandibular third molar extraction: A randomised double-blind controlled trial (pilot study)","volume":"11","author":"Salavert","year":"2020","journal-title":"Benef. Microbes"},{"key":"ref_3","unstructured":"World Population Review (2024, July 17). Utah Population Review. Available online: https:\/\/worldpopulationreview.com\/states\/utah-population."},{"key":"ref_4","unstructured":"Tungare, S., Zafar, N., and Paranjpe, A.G. (2024, June 20). Halitosis In: StatPearls [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK534859\/."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1136\/bmj.38954.631968.AE","article-title":"Oral malodour (halitosis)","volume":"333","author":"Porter","year":"2006","journal-title":"BMJ"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Hampelska, K., Jaworska, M.M., Babalska, Z., and Karpi\u0144ski, T.M. (2020). The Role of Oral Microbiota in Intra-Oral Halitosis. J. Clin. Med., 9.","DOI":"10.3390\/jcm9082484"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1038\/ijos.2012.39","article-title":"Halitosis: The multidisciplinary approach","volume":"4","author":"Bollen","year":"2012","journal-title":"Int. J. Oral Sci."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Kim, J.Y., and Kim, H.N. (2020). Changes in Inflammatory Cytokines in Saliva after Non-Surgical Periodontal Therapy: A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18010194"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/1477-7525-8-34","article-title":"Self-reported halitosis and emotional state: Impact on oral conditions and treatments","volume":"8","author":"Settineri","year":"2010","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1111\/j.1600-0722.2009.00630.x","article-title":"Prevalence of halitosis in the population of the city of Bern, Switzerland: A study comparing self-reported and clinical data","volume":"117","author":"Bornstein","year":"2009","journal-title":"Eur. J. Oral Sci."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1111\/odi.12198","article-title":"Characteristics of patients complaining of halitosis and factors associated with halitosis","volume":"20","author":"Lu","year":"2014","journal-title":"Oral Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"03281-20","DOI":"10.1128\/mBio.03281-20","article-title":"Longitudinal Multi-omics and Microbiome Meta-analysis Identify an Asymptomatic Gingival State That Links Gingivitis, Periodontitis, and Aging","volume":"12","author":"Huang","year":"2021","journal-title":"MBio"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"185","DOI":"10.3177\/jnsv.64.185","article-title":"Effects of French Pine Bark Extract Chewing Gum on Oral Malodor and Salivary Bacteria","volume":"64","author":"Watanabe","year":"2018","journal-title":"J. Nutr. Sci. Vitaminol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1007\/s40496-017-0159-6","article-title":"Use of Probiotics and Oral Health","volume":"4","author":"Allaker","year":"2017","journal-title":"Curr. Oral Health Rep."},{"key":"ref_15","first-page":"Cd012213","article-title":"Interventions for managing halitosis","volume":"12","author":"Eachempati","year":"2019","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1007\/s12602-017-9351-1","article-title":"The Effect of Probiotics on Halitosis: A Systematic Review and Meta-analysis","volume":"11","author":"Yoo","year":"2019","journal-title":"Probiotics Antimicrob. Proteins"},{"key":"ref_17","first-page":"257","article-title":"Examination, classification, and treatment of halitosis; clinical perspectives","volume":"66","author":"Yaegaki","year":"2000","journal-title":"J. Can. Dent. Assoc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1034\/j.1600-051X.2003.00342.x","article-title":"Clinical effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc-lactate on oral halitosis. A dual-center, double-blind placebo-controlled study","volume":"30","author":"Winkel","year":"2003","journal-title":"J. Clin. Periodontol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"4605","DOI":"10.1128\/AEM.66.11.4605-4614.2000","article-title":"Quantitative analysis of small-subunit rRNA genes in mixed microbial populations via 5\u2032-nuclease assays","volume":"66","author":"Suzuki","year":"2000","journal-title":"Appl. Environ. Microbiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"461","DOI":"10.4103\/0972-124X.118317","article-title":"Salivary pH: A diagnostic biomarker","volume":"17","author":"Baliga","year":"2013","journal-title":"J. Indian Soc. Periodontol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s13027-016-0093-6","article-title":"Salivary and serum IL-10, TNF-\u03b1, TGF-\u03b2, VEGF levels in oropharyngeal squamous cell carcinoma and correlation with HPV and EBV infections","volume":"11","author":"Stec","year":"2016","journal-title":"Infect. Agents Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Yu, X., Devine, D.A., and Vernon, J.J. (2024). Manipulating the diseased oral microbiome: The power of probiotics and prebiotics. J. Oral Microbiol., 16.","DOI":"10.1080\/20002297.2024.2307416"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.archoralbio.2011.10.006","article-title":"Isolation and characterization of probiotic strains for improving oral health","volume":"57","author":"Bosch","year":"2012","journal-title":"Arch. Oral Biol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Beattie, R.E. (2024). Probiotics for oral health: A critical evaluation of bacterial strains. Front. Microbiol., 15.","DOI":"10.3389\/fmicb.2024.1430810"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1089\/jmf.2019.4603","article-title":"Reduction of Halitosis by a Tablet Containing Weissella cibaria CMU: A Randomized, Double-Blind, Placebo-Controlled Study","volume":"23","author":"Lee","year":"2020","journal-title":"J. Med. Food"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"4567","DOI":"10.1007\/s00784-023-05081-4","article-title":"Effects of water flossing on gingival inflammation and supragingival plaque microbiota: A 12-week randomized controlled trial","volume":"27","author":"Xu","year":"2023","journal-title":"Clin. Oral Investig."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e433","DOI":"10.4317\/jced.57771","article-title":"Oral colonization by Levilactobacillus brevis KABPTM-052 and Lactiplantibacillus plantarum KABPTM-051: A Randomized, Double-Blinded, Placebo-Controlled Trial (Pilot Study)","volume":"13","author":"Nart","year":"2021","journal-title":"J. Clin. Exp. Dent."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1111\/j.1365-2672.2006.02837.x","article-title":"A preliminary study of the effect of probiotic Streptococcus salivarius K12 on oral malodour parameters","volume":"100","author":"Burton","year":"2006","journal-title":"J. Appl. Microbiol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Och\u00f4a, C., Castro, F., Bulhosa, J.F., Manso, C., Fernandes, J.C.H., and Fernandes, G.V.O. (2023). Influence of the Probiotic L. reuteri on Periodontal Clinical Parameters after Nonsurgical Treatment: A Systematic Review. Microorganisms, 11.","DOI":"10.3390\/microorganisms11061449"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1007\/s12602-019-9521-4","article-title":"Probiotics as an Adjunct Therapy for the Treatment of Halitosis, Dental Caries and Periodontitis","volume":"12","author":"Bustamante","year":"2020","journal-title":"Probiotics Antimicrob. Proteins"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s00784-014-1221-6","article-title":"Impact of orally administered lozenges with Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp. lactis BB-12 on the number of salivary mutans streptococci, amount of plaque, gingival inflammation and the oral microbiome in healthy adults","volume":"19","author":"Toiviainen","year":"2015","journal-title":"Clin. Oral Investig."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"246","DOI":"10.3109\/00016357.2011.640281","article-title":"Effect of chewing gums containing the probiotic bacterium Lactobacillus reuteri on oral malodour","volume":"70","author":"Keller","year":"2012","journal-title":"Acta Odontol. Scand."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"19583","DOI":"10.3390\/s150819583","article-title":"Multi-Sensor Approach for the Monitoring of Halitosis Treatment via Lactobacillus brevis (CD2)\u2014Containing Lozenges\u2014A Randomized, Double-Blind Placebo-Controlled Clinical Trial","volume":"15","author":"Marchetti","year":"2015","journal-title":"Sensors"},{"key":"ref_34","first-page":"127","article-title":"Oral Biofilm and Its Impact on Oral Health, Psychological and Social Interaction","volume":"7","author":"Abebe","year":"2021","journal-title":"Int. J. Oral Dent. Health"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"659","DOI":"10.2147\/IDR.S232982","article-title":"The Battle of Probiotics and Their Derivatives Against Biofilms","volume":"13","author":"Barzegari","year":"2020","journal-title":"Infect. Drug Resist."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1111\/jcpe.12752","article-title":"Clinical and microbiological effects of the adjunctive use of probiotics in the treatment of gingivitis: A randomized controlled clinical trial","volume":"44","author":"Montero","year":"2017","journal-title":"J. Clin. Periodontol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1517\/14712598.2012.693474","article-title":"Probiotics as oral health biotherapeutics","volume":"12","author":"Saha","year":"2012","journal-title":"Expert Opin. Biol. Ther."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Robin, V., Wim, T., Maria, C.L., and Isabelle, L. (2024). Probiotics for maintaining oral health during fixed orthodontic treatment: A systematic review and meta-analysis. Int. J. Dent. Hyg., 1\u201314.","DOI":"10.1111\/idh.12821"},{"key":"ref_39","unstructured":"Fuquay, J.W. (2011). Lactic Acid Bacteria: Pediococcus spp.. Encyclopedia of Dairy Sciences, Academic Press. [2nd ed.]."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"155506","DOI":"10.1016\/j.cyto.2021.155506","article-title":"Cytokines in saliva as biomarkers of oral and systemic oncological or infectious diseases: A systematic review","volume":"143","author":"Diesch","year":"2021","journal-title":"Cytokine"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.1017\/erm.2013.8","article-title":"Inflammatory mediators in the pathogenesis of periodontitis","volume":"15","year":"2013","journal-title":"Expert Rev. Mol. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e24924","DOI":"10.1097\/MD.0000000000024924","article-title":"Associations between salivary cytokines and periodontal and microbiological parameters in orthodontic patients","volume":"100","author":"Chen","year":"2021","journal-title":"Medicine"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Huang, Y.K., Tseng, K.F., Tsai, P.H., Wang, J.S., Lee, C.Y., and Shen, M.Y. (2021). IL-8 as a Potential Therapeutic Target for Periodontitis and Its Inhibition by Caffeic Acid Phenethyl Ester In Vitro. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22073641"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e6932","DOI":"10.1097\/MD.0000000000006932","article-title":"Association between interleukin-8 levels and chronic periodontal disease: A PRISMA-compliant systematic review and meta-analysis","volume":"96","author":"Finoti","year":"2017","journal-title":"Medicine"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e20170232","DOI":"10.1590\/1678-7757-2017-0232","article-title":"The effects of IL-10 gene polymorphism on serum, and gingival crevicular fluid levels of IL-6 and IL-10 in chronic periodontitis","volume":"26","author":"Toker","year":"2018","journal-title":"J. Appl. Oral Sci."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Sumbayak, I.A., Masulili, S.L.C., Tadjoedin, F.M., Sulijaya, B., Mutiara, A., Khoirowati, D., Soeroso, Y., and Bachtiar, B.M. (2023). Changes in Interleukin-1\u03b2, Tumor Necrosis Factor-\u03b1, and Interleukin-10 Cytokines in Older People with Periodontitis. Geriatrics, 8.","DOI":"10.3390\/geriatrics8040079"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Ngo, D.H., and Vo, T.S. (2019). An Updated Review on Pharmaceutical Properties of Gamma-Aminobutyric Acid. Molecules, 24.","DOI":"10.3390\/molecules24152678"}],"container-title":["Microorganisms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-2607\/12\/9\/1821\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:47:43Z","timestamp":1760111263000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-2607\/12\/9\/1821"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,3]]},"references-count":47,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2024,9]]}},"alternative-id":["microorganisms12091821"],"URL":"https:\/\/doi.org\/10.3390\/microorganisms12091821","relation":{},"ISSN":["2076-2607"],"issn-type":[{"value":"2076-2607","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,3]]}}}