Halitosis - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References

HALITOSIS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES J AMES N. ...

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HALITOSIS A M EDICAL D ICTIONARY , B IBLIOGRAPHY , AND A NNOTATED R ESEARCH G UIDE TO I NTERNET R E FERENCES

J AMES N. P ARKER , M.D. AND P HILIP M. P ARKER , P H .D., E DITORS

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ICON Health Publications ICON Group International, Inc. 4370 La Jolla Village Drive, 4th Floor San Diego, CA 92122 USA Copyright ©2004 by ICON Group International, Inc. Copyright ©2004 by ICON Group International, Inc. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America. Last digit indicates print number: 10 9 8 7 6 4 5 3 2 1

Publisher, Health Care: Philip Parker, Ph.D. Editor(s): James Parker, M.D., Philip Parker, Ph.D. Publisher's note: The ideas, procedures, and suggestions contained in this book are not intended for the diagnosis or treatment of a health problem. As new medical or scientific information becomes available from academic and clinical research, recommended treatments and drug therapies may undergo changes. The authors, editors, and publisher have attempted to make the information in this book up to date and accurate in accord with accepted standards at the time of publication. The authors, editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of this book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised to always check product information (package inserts) for changes and new information regarding dosage and contraindications before prescribing any drug or pharmacological product. Caution is especially urged when using new or infrequently ordered drugs, herbal remedies, vitamins and supplements, alternative therapies, complementary therapies and medicines, and integrative medical treatments. Cataloging-in-Publication Data Parker, James N., 1961Parker, Philip M., 1960Halitosis: A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References / James N. Parker and Philip M. Parker, editors p. cm. Includes bibliographical references, glossary, and index. ISBN: 0-597-83969-7 1. Halitosis-Popular works. I. Title.

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Disclaimer This publication is not intended to be used for the diagnosis or treatment of a health problem. It is sold with the understanding that the publisher, editors, and authors are not engaging in the rendering of medical, psychological, financial, legal, or other professional services. References to any entity, product, service, or source of information that may be contained in this publication should not be considered an endorsement, either direct or implied, by the publisher, editors, or authors. ICON Group International, Inc., the editors, and the authors are not responsible for the content of any Web pages or publications referenced in this publication.

Copyright Notice If a physician wishes to copy limited passages from this book for patient use, this right is automatically granted without written permission from ICON Group International, Inc. (ICON Group). However, all of ICON Group publications have copyrights. With exception to the above, copying our publications in whole or in part, for whatever reason, is a violation of copyright laws and can lead to penalties and fines. Should you want to copy tables, graphs, or other materials, please contact us to request permission (E-mail: [email protected]). ICON Group often grants permission for very limited reproduction of our publications for internal use, press releases, and academic research. Such reproduction requires confirmed permission from ICON Group International Inc. The disclaimer above must accompany all reproductions, in whole or in part, of this book.

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Acknowledgements The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on halitosis. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of the National Institutes of Health (NIH), the Program Support Center (PSC), and the Substance Abuse and Mental Health Services Administration (SAMHSA). In addition to these sources, information gathered from the National Library of Medicine, the United States Patent Office, the European Union, and their related organizations has been invaluable in the creation of this book. Some of the work represented was financially supported by the Research and Development Committee at INSEAD. This support is gratefully acknowledged. Finally, special thanks are owed to Tiffany Freeman for her excellent editorial support.

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About the Editors James N. Parker, M.D. Dr. James N. Parker received his Bachelor of Science degree in Psychobiology from the University of California, Riverside and his M.D. from the University of California, San Diego. In addition to authoring numerous research publications, he has lectured at various academic institutions. Dr. Parker is the medical editor for health books by ICON Health Publications. Philip M. Parker, Ph.D. Philip M. Parker is the Eli Lilly Chair Professor of Innovation, Business and Society at INSEAD (Fontainebleau, France and Singapore). Dr. Parker has also been Professor at the University of California, San Diego and has taught courses at Harvard University, the Hong Kong University of Science and Technology, the Massachusetts Institute of Technology, Stanford University, and UCLA. Dr. Parker is the associate editor for ICON Health Publications.

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About ICON Health Publications To discover more about ICON Health Publications, simply check with your preferred online booksellers, including Barnes&Noble.com and Amazon.com which currently carry all of our titles. Or, feel free to contact us directly for bulk purchases or institutional discounts: ICON Group International, Inc. 4370 La Jolla Village Drive, Fourth Floor San Diego, CA 92122 USA Fax: 858-546-4341 Web site: www.icongrouponline.com/health

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Table of Contents FORWARD .......................................................................................................................................... 1 CHAPTER 1. STUDIES ON HALITOSIS ................................................................................................. 3 Overview........................................................................................................................................ 3 The Combined Health Information Database................................................................................. 3 Federally Funded Research on Halitosis ........................................................................................ 6 E-Journals: PubMed Central ......................................................................................................... 7 The National Library of Medicine: PubMed .................................................................................. 8 CHAPTER 2. NUTRITION AND HALITOSIS ....................................................................................... 23 Overview...................................................................................................................................... 23 Finding Nutrition Studies on Halitosis....................................................................................... 23 Federal Resources on Nutrition ................................................................................................... 25 Additional Web Resources ........................................................................................................... 25 CHAPTER 3. ALTERNATIVE MEDICINE AND HALITOSIS ................................................................. 27 Overview...................................................................................................................................... 27 National Center for Complementary and Alternative Medicine.................................................. 27 Additional Web Resources ........................................................................................................... 30 General References ....................................................................................................................... 32 CHAPTER 4. PATENTS ON HALITOSIS.............................................................................................. 35 Overview...................................................................................................................................... 35 Patents on Halitosis ..................................................................................................................... 35 Patent Applications on Halitosis ................................................................................................. 46 Keeping Current .......................................................................................................................... 59 CHAPTER 5. BOOKS ON HALITOSIS ................................................................................................. 61 Overview...................................................................................................................................... 61 Book Summaries: Federal Agencies.............................................................................................. 61 Book Summaries: Online Booksellers........................................................................................... 62 Chapters on Halitosis ................................................................................................................... 62 CHAPTER 6. PERIODICALS AND NEWS ON HALITOSIS ................................................................... 67 Overview...................................................................................................................................... 67 News Services and Press Releases................................................................................................ 67 Newsletter Articles ...................................................................................................................... 69 Academic Periodicals covering Halitosis ..................................................................................... 69 APPENDIX A. PHYSICIAN RESOURCES ............................................................................................ 73 Overview...................................................................................................................................... 73 NIH Guidelines............................................................................................................................ 73 NIH Databases............................................................................................................................. 75 Other Commercial Databases....................................................................................................... 78 APPENDIX B. PATIENT RESOURCES ................................................................................................. 79 Overview...................................................................................................................................... 79 Patient Guideline Sources............................................................................................................ 79 Finding Associations.................................................................................................................... 82 APPENDIX C. FINDING MEDICAL LIBRARIES .................................................................................. 85 Overview...................................................................................................................................... 85 Preparation................................................................................................................................... 85 Finding a Local Medical Library.................................................................................................. 85 Medical Libraries in the U.S. and Canada ................................................................................... 85 ONLINE GLOSSARIES.................................................................................................................. 91 Online Dictionary Directories ..................................................................................................... 93 HALITOSIS DICTIONARY........................................................................................................... 95

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INDEX .............................................................................................................................................. 127

1

FORWARD In March 2001, the National Institutes of Health issued the following warning: "The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading."1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with halitosis is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about halitosis, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you where and how to find reliable information covering virtually all topics related to halitosis, from the essentials to the most advanced areas of research. Public, academic, government, and peer-reviewed research studies are emphasized. Various abstracts are reproduced to give you some of the latest official information available to date on halitosis. Abundant guidance is given on how to obtain free-of-charge primary research results via the Internet. While this book focuses on the field of medicine, when some sources provide access to non-medical information relating to halitosis, these are noted in the text. E-book and electronic versions of this book are fully interactive with each of the Internet sites mentioned (clicking on a hyperlink automatically opens your browser to the site indicated). If you are using the hard copy version of this book, you can access a cited Web site by typing the provided Web address directly into your Internet browser. You may find it useful to refer to synonyms or related terms when accessing these Internet databases. NOTE: At the time of publication, the Web addresses were functional. However, some links may fail due to URL address changes, which is a common occurrence on the Internet. For readers unfamiliar with the Internet, detailed instructions are offered on how to access electronic resources. For readers unfamiliar with medical terminology, a comprehensive glossary is provided. For readers without access to Internet resources, a directory of medical libraries, that have or can locate references cited here, is given. We hope these resources will prove useful to the widest possible audience seeking information on halitosis. The Editors

1

From the NIH, National Cancer Institute (NCI): http://www.cancer.gov/cancerinfo/ten-things-to-know.

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CHAPTER 1. STUDIES ON HALITOSIS Overview In this chapter, we will show you how to locate peer-reviewed references and studies on halitosis.

The Combined Health Information Database The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and halitosis, you will need to use the advanced search options. First, go to http://chid.nih.gov/index.html. From there, select the “Detailed Search” option (or go directly to that page with the following hyperlink: http://chid.nih.gov/detail/detail.html). The trick in extracting studies is found in the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Journal Article.” At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display “whole records.” We recommend that you type “halitosis” (or synonyms) into the “For these words:” box. Consider using the option “anywhere in record” to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select this option in the “Search in these fields” drop box. The following is what you can expect from this type of search: •

Relationship Between Volatile Sulfur Compounds and Major Halitosis-Inducing Factors Source: Journal of Periodontology. 74(1): 32-37. January 2003. Contact: Available from American Academy of Periodontology. Suite 800, 737 North Michigan Avenue, Chicago, IL 60611-2690. (312) 573-3220. Fax (312) 573-3225. Summary: Although tongue coating and periodontal conditions have been reported to be major factors inducing halitosis (bad breath), the relationship between volatile sulfur compounds (VSC) and these two major factors is not yet fully understood. This article reports on a study undertaken to investigate the relationship of VSC concentrations to tongue coating and periodontal health in 40 subjects (mean age 33.3 years, range 14 to 64 years). Gas chromatography was performed to analyze each VSC component from the

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mouth air sampled prior to tongue scraping, after tongue scraping, and after a subsequent prophylaxis on the interdental spaces. Results showed that the tongue coating was demonstrated to be a primary halitosis-inducing factors. Periodontal health was also shown to contribute to VSC production. 2 figures. 3 tables. 24 references. •

Self-Perception of Breath Odor Source: JADA. Journal of the American Dental Association. 132(5): 621-626. May 2001. Contact: Available from American Dental Association. ADA Publishing Co, Inc., 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2867. Website: www.ada.org. Summary: Bad breath (halitosis) is a common concern for millions of people. Yet there is almost no reliable way for people to properly assess their breath odor. While many people develop faulty perceptions about having bad breath that affect their entire lives, others who have halitosis are unaware of their condition. In this article, the authors discuss the issues affecting self perception of breath odor in patients who complain of halitosis, as well as in a more general 'noncomplaining' population. The authors present self perception of breath odor as a multifactorial, psychophysiological issue that is related closely to one's body image and psychopathological profile. Based on their data, the authors suggest that every patient has a breath odor self image. This self image ranges from little or no distortion to severe psychopathology. Because treating patients with a specific complaint of oral malodor primarily is the responsibility of the dental practitioner, several treatment approaches are outlined: collecting odor samples from the mouth to increase objectivity, involving a confidant in diagnosis and follow up, corroborating odor judges' scores with objective measurements, increasing the patient's sense of control over the problem, and obtaining guidance from mental health professionals, when necessary. 3 figures. 2 tables. 32 references.

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Halitosis: Discussing a Difficult Subject Source: Journal of Practical Hygiene. 8(4): 56. July-August 1999. Summary: Oral malodor (bad breath, or halitosis) is an often devastating problem for many individuals. This brief article for dental hygienists offers strategies for helping patients deal with halitosis. The author discusses the need to rule out any systemic illness that could contribute to halitosis (e.g., diabetes), to include questions about malodor on patient health history forms, to review the responses on the health history form without judgment, to look for hidden messages in questions asked by patients, to design office brochures discussing the causes of malodor and possible treatment methods, and to include tongue cleaning as a part of every recare appointment. The article includes a 10 question oral malodor questionnaire that may help to pinpoint the cause of any halitosis problem. 1 figure. 1 table.

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Examination, Classification, and Treatment of Halitosis: Clinical Perspectives Source: Journal of the Canadian Dental Association. 66(5): 257-261. May 2000. Contact: Available from Canadian Dental Association. 1815 Alta Vista Drive, Ottowa, ON K1G 3Y6. (613) 523-1770. E-mail: [email protected]. Website: www.cda-adc.ca. Summary: Patients with halitosis (bad breath) may seek treatment from dental clinicians for their perceived oral malodor. In this article, the authors outline an examination protocol, classification system, and treatment needs for such patients. Physiologic halitosis, oral pathologic halitosis, and pseudohalitosis are in the treatment realm of dental practitioners. Management may include periodontal or restorative treatment or

Studies

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both, as well as simple treatment measures such as instruction in oral hygiene, tongue cleaning, and mouth rinsing. Psychosomatic halitosis is more difficult to diagnose and manage, and patients with this condition are often mismanaged in that they receive only treatments for genuine halitosis, even though they do not have oral malodor. A classification system can be used to identify patients with halitophobia (fear of bad breath). Additionally, a questionnaire can be used to assess the psychological condition of patients claiming to have halitosis, which enables the clinician to identify patients with psychosomatic halitosis. The authors stress that the classification and management of halitosis patients is very useful for general practitioners, especially with regard to patients with pseudohalitosis, who may seek treatment from general practitioners. 3 tables. 38 references. •

Halitosis: A Common Oral Problem Source: New York State Dental Journal. 62(10): 36-42. December 1996. Contact: Available from Dental Society of the State of New York. 7 Elk Street, Albany, NY 12207. (518) 465-0044. Fax (518) 427-0461. Summary: This article discusses halitosis (bad breath), a common oral problem that is caused primarily by bacterial putrefaction and the generation of volatile sulfur compounds. In many instances, morning halitosis is a temporary affliction produced by oral bacteria that have accumulated during sleep. Ninety percent halitosis cases have oral causes such as poor oral hygiene, periodontal disease, tongue coat, food impaction, unclean dentures, faulty restorations, oral carcinomas, and throat infections. The remaining 10 percent of people with halitosis have systemic causes including renal or hepatic failure, carcinomas, diabetes, or trimethylaminuria. Modern analytical and microbiological techniques permit diagnosis of bad breath. The management of halitosis involves maintaining proper oral hygiene and periodontal treatment, including tongue brushing. References available from the publisher. 2 figures. (AA-M).

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Halitosis Source: American Family Physician. 53(4): 1215-1224. March 1996. Summary: This article presents the most common nonpathologic and pathologic causes of halitosis and their management. The authors note that although halitosis is generally thought of as a social handicap related to poor oral hygiene or disease of the oral cavity, it may also indicate a serious systemic illness that requires diagnosis and treatment. Nonpathologic causes of halitosis covered include morning breath, mouth appliances, age, hunger, tobacco, food, and drugs. Pathologic causes discussed include chronic periodontal disease; necrotizing ulcerative gingivitis; stomatitis; glossitis; parotid dysfunction; systemic diseases including diabetes, liver disorders, and dehydration; digestive problems; conditions that alter the mucous of the nose; pulmonary conditions; and psychiatric causes. Other topics covered include diagnostic considerations and treatment options. The article includes a reproducible, one-page patient education handout on halitosis. 2 tables. 16 references. (AA-M).

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Characteristics of Patients Complaining of Halitosis and the Usefulness of Gas Chromatography for Diagnosing Halitosis Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 91(5): 531-534. May 2001.

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Contact: Available from Mosby, Inc. 6277 Sea Harbor Drive, Orlando, FL 32887-4800. (800) 654-2452 or (407) 345-4000. Website: www.harcourthealth.com. Summary: This article reports on a study undertaken to examine the characteristics of patients complaining of halitosis (bad breath, oral malodor) and to evaluate the diagnostic accuracy of three methods of measuring halitosis. The actual degree of halitosis was determined through use of an organoleptic test in 155 patients aged 46 years (plus or minus 17 years). The volatile sulfur compounds (VSCs) were determined with gas chromatography and with sulfide monitoring. The organoleptic test revealed that 55 percent of the subjects had either no mouth odor or slight mouth odor. There was a significant correlation between the organoleptic score and the total VSC level determined through use of other methods. The amount of tongue coating was significantly greater in the halitosis positive group than in the halitosis negative group, whereas there was no difference in salivary flow rate between the groups. These results indicate that determining VSCs with gas chromatography is a useful means of diagnosing halitosis. 3 tables. 17 references. •

What You Should Know About Bad Breath Source: JADA. Journal of the American Dental Association. 134(1): 135. January 2003. Contact: Available from American Dental Association. ADA Publishing Co, Inc., 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2867. Website: www.ada.org. Summary: This patient education handout offers basic information about halitosis (bad breath) and how it can be controlled. The fact sheet notes that, in a small percentage of cases, bad breath may have a systemic origin such as a respiratory tract condition or other ailments. However, a major source of bad breath in healthy people is microbial deposits on the tongue, especially the back of the tongue, where a bacterial coating harbors organisms and debris that contribute to bad breath. Also, inadequate or ineffective cleaning of the teeth or dentures, xerostomia (dry mouth), or periodontal disease can all result in unpleasant odors. The fact sheet offers a list of practical strategies for controlling bad breath and encourages readers to consult their dental care provider with any concerns about halitosis.

Federally Funded Research on Halitosis The U.S. Government supports a variety of research studies relating to halitosis. These studies are tracked by the Office of Extramural Research at the National Institutes of Health.2 CRISP (Computerized Retrieval of Information on Scientific Projects) is a searchable database of federally funded biomedical research projects conducted at universities, hospitals, and other institutions. Search the CRISP Web site at http://crisp.cit.nih.gov/crisp/crisp_query.generate_screen. You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to halitosis.

2 Healthcare projects are funded by the National Institutes of Health (NIH), Substance Abuse and Mental Health Services (SAMHSA), Health Resources and Services Administration (HRSA), Food and Drug Administration (FDA), Centers for Disease Control and Prevention (CDCP), Agency for Healthcare Research and Quality (AHRQ), and Office of Assistant Secretary of Health (OASH).

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For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore halitosis. The following is typical of the type of information found when searching the CRISP database for halitosis: •

Project Title: DENTICOLA

H2S

PRODUCTION

AND

VIRULENCE

OF

TREPONEMA

Principal Investigator & Institution: Chu, Lianrui; Research Instructor; Periodontics; University of Texas Hlth Sci Ctr San Ant 7703 Floyd Curl Dr San Antonio, Tx 78229 Timing: Fiscal Year 2001; Project Start 01-SEP-2000; Project End 30-JUN-2003 Summary: (Adapted from the Investigator's Abstract): A characteristic feature of periodontitis is the existence of a variety of volatile sulfur compounds produced at sites of destructive disease. Hydrogen sulfide (H2S) is a major component of this family, which is a primary factor in halitosis related to periodontitis, and importantly, can affect host molecules and cells. Previous studies have identified a limited repertoire of oral microorganisms that can produce and survive in microenvironments with large amounts of H2S; however, the metabolic enzymes involved in the production of H2S are poorly understood. Substantial literature has identified T. denticola as one of the few oral bacteria with the capacity to produce and grow in high levels of H2S. The Principal Investigator has previously isolated and characterized an enzyme, cystalysin. This enzyme is unique to T. denticola and has a substrate specificity for L-cysteine, yielding pyruvate, NH3, and importantly, H2S. This proposal develops the general hypothesis that H2S is a significant effector of host responses in the local microenvironment of the periodontal disease site and, furthermore, that H2S-forming enzymes should be considered virulence determinants for T. denticola. Three specific aims are developed using biochemical, molecular genetic, and cell biologic studies to address this hypothesis: Specific Aim 1: To construct isogenic mutants altered in cystalysin-directed H2S producing capacity; Specific Aim 2: To biochemically characterize the enzyme pathway(s) involved in H2S production from glutathione; and, Specific Aim 3: To determine the effects of an H2S environment created by T. denticola on host inflammatory/immune functions. T. denticola has been identified as an important member of a specific consortia of microorganisms considered as etiologic in the development and progression of destruction of the periodontium. This proposal is designed to provide critical information related to the production of H2S by T. denticola, and for the first time to delineate the potential functions of H2S, which could deleteriously affect the homeostasis, maintained by molecules and cells in the periodontium. The outcomes would also be expected to provide an impetus to further target the enzymatic pathways contributing to H2S production as an innovative intervention strategy. Website: http://crisp.cit.nih.gov/crisp/Crisp_Query.Generate_Screen

E-Journals: PubMed Central3 PubMed Central (PMC) is a digital archive of life sciences journal literature developed and managed by the National Center for Biotechnology Information (NCBI) at the U.S. National

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Adapted from the National Library of Medicine: http://www.pubmedcentral.nih.gov/about/intro.html.

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Library of Medicine (NLM).4 Access to this growing archive of e-journals is free and unrestricted.5 To search, go to http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=Pmc, and type “halitosis” (or synonyms) into the search box. This search gives you access to fulltext articles. The following is a sample of items found for halitosis in the PubMed Central database: •

Diversity of Bacterial Populations on the Tongue Dorsa of Patients with Halitosis and Healthy Patients. by Kazor CE, Mitchell PM, Lee AM, Stokes LN, Loesche WJ, Dewhirst FE, Paster BJ.; 2003 Feb; http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=149706

The National Library of Medicine: PubMed One of the quickest and most comprehensive ways to find academic studies in both English and other languages is to use PubMed, maintained by the National Library of Medicine.6 The advantage of PubMed over previously mentioned sources is that it covers a greater number of domestic and foreign references. It is also free to use. If the publisher has a Web site that offers full text of its journals, PubMed will provide links to that site, as well as to sites offering other related data. User registration, a subscription fee, or some other type of fee may be required to access the full text of articles in some journals. To generate your own bibliography of studies dealing with halitosis, simply go to the PubMed Web site at http://www.ncbi.nlm.nih.gov/pubmed. Type “halitosis” (or synonyms) into the search box, and click “Go.” The following is the type of output you can expect from PubMed for halitosis (hyperlinks lead to article summaries): •

“An unexpected cause of halitosis”. Author(s): Lovewell R. Source: British Dental Journal. 1984 December 8; 157(11): 384. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6595002&dopt=Abstract

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A new era in halitosis and periodontal treatment. Author(s): Cohen M. Source: Dent Today. 1998 August; 17(8): 88-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10752414&dopt=Abstract

4 With PubMed Central, NCBI is taking the lead in preservation and maintenance of open access to electronic literature, just as NLM has done for decades with printed biomedical literature. PubMed Central aims to become a world-class library of the digital age. 5 The value of PubMed Central, in addition to its role as an archive, lies in the availability of data from diverse sources stored in a common format in a single repository. Many journals already have online publishing operations, and there is a growing tendency to publish material online only, to the exclusion of print. 6 PubMed was developed by the National Center for Biotechnology Information (NCBI) at the National Library of Medicine (NLM) at the National Institutes of Health (NIH). The PubMed database was developed in conjunction with publishers of biomedical literature as a search tool for accessing literature citations and linking to full-text journal articles at Web sites of participating publishers. Publishers that participate in PubMed supply NLM with their citations electronically prior to or at the time of publication.

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A new protocol for halitosis treatment. Author(s): Malcmacher LJ. Source: Dent Today. 2000 September; 19(9): 122-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12524732&dopt=Abstract

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A randomized placebo-controlled trial of mebendazole for halitosis. Author(s): Ermis B, Aslan T, Beder L, Unalacak M. Source: Archives of Pediatrics & Adolescent Medicine. 2002 October; 156(10): 995-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12361444&dopt=Abstract

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A study of the mechanism of halitosis occurrence in periodontal patients. Author(s): Sato H, Ohkushi T, Kaizu T, Tsunoda M, Sato T. Source: Bull Tokyo Dent Coll. 1980 November; 21(4): 271-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6938329&dopt=Abstract

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An unexpected cause of halitosis. Author(s): Bennett JD. Source: J R Army Med Corps. 1988 October; 134(3): 151-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3193395&dopt=Abstract

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An unexpected cause of halitosis. Author(s): Sharma NK. Source: British Dental Journal. 1984 October 20; 157(8): 281-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6594151&dopt=Abstract

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Bad breath. Author(s): Levit B. Source: The Journal of the American Dental Association. 2003 June; 134(6): 682, 684. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12839400&dopt=Abstract

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Bad breath: a brief update. Author(s): Rosenberg M. Source: Alpha Omegan. 2002 October; 95(3): 10-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12408090&dopt=Abstract

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Bad breath--a major disability according to the Talmud. Author(s): Shifman A, Orenbuch S, Rosenberg M. Source: Isr Med Assoc J. 2002 October; 4(10): 843-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12389360&dopt=Abstract

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Characteristics of patients complaining of halitosis and the usefulness of gas chromatography for diagnosing halitosis. Author(s): Oho T, Yoshida Y, Shimazaki Y, Yamashita Y, Koga T. Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2001 May; 91(5): 531-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11346730&dopt=Abstract

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Chronic halitosis from tonsilloliths: a common etiology. Author(s): Fletcher SM, Blair PA. Source: J La State Med Soc. 1988 June; 140(6): 7-9. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3392528&dopt=Abstract

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Classification and examination of halitosis. Author(s): Murata T, Yamaga T, Iida T, Miyazaki H, Yaegaki K. Source: Int Dent J. 2002 June; 52 Suppl 3: 181-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12090449&dopt=Abstract

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Clinical application of a questionnaire for diagnosis and treatment of halitosis. Author(s): Yaegaki K, Coil JM. Source: Quintessence Int. 1999 May; 30(5): 302-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10635283&dopt=Abstract

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Clinical characteristics of halitosis: differences in two patient groups with primary and secondary complaints of halitosis. Author(s): Iwakura M, Yasuno Y, Shimura M, Sakamoto S. Source: Journal of Dental Research. 1994 September; 73(9): 1568-74. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7929993&dopt=Abstract

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Clinical dilemmas posed by patients with psychosomatic halitosis. Author(s): Yaegaki K, Coil JM. Source: Quintessence Int. 1999 May; 30(5): 328-33. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10635288&dopt=Abstract

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Clinical effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc-lactate on oral halitosis. A dual-center, double-blind placebocontrolled study. Author(s): Winkel EG, Roldan S, Van Winkelhoff AJ, Herrera D, Sanz M. Source: Journal of Clinical Periodontology. 2003 April; 30(4): 300-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12694427&dopt=Abstract

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Correlation between measurements using a new halitosis monitor and organoleptic assessment. Author(s): Shimura M, Watanabe S, Iwakura M, Oshikiri Y, Kusumoto M, Ikawa K, Sakamoto S. Source: J Periodontol. 1997 December; 68(12): 1182-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9444593&dopt=Abstract

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Counseling and treating bad breath patients: a step-by-step approach. Author(s): Lenton P, Majerus G, Bakdash B. Source: The Journal of Contemporary Dental Practice [electronic Resource]. 2001 May 15; 2(2): 46-61. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12167933&dopt=Abstract

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Delayed halitosis-a rare cause. Author(s): Lawson RA, Carroll K. Source: Postgraduate Medical Journal. 1982 January; 58(675): 52-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7088763&dopt=Abstract

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Delusional halitosis. Review of the literature and analysis of 32 cases. Author(s): Iwu CO, Akpata O. Source: British Dental Journal. 1990 April 7; 168(7): 294-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2185809&dopt=Abstract

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Delusions of halitosis. Author(s): Goldberg RL, Buongiorno PA, Henkin RI. Source: Psychosomatics. 1985 April; 26(4): 325-7, 331. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3991864&dopt=Abstract

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Diagnosing and treating halitosis. Author(s): McDowell JD, Kassebaum DK. Source: The Journal of the American Dental Association. 1993 July; 124(7): 55-64. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8335800&dopt=Abstract

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Diagnosis and treatment of halitosis. Author(s): Richter JL. Source: Compend Contin Educ Dent. 1996 April; 17(4): 370-2, 374-6 Passim; Quiz 388. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9051972&dopt=Abstract

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Diversity of bacterial populations on the tongue dorsa of patients with halitosis and healthy patients. Author(s): Kazor CE, Mitchell PM, Lee AM, Stokes LN, Loesche WJ, Dewhirst FE, Paster BJ. Source: Journal of Clinical Microbiology. 2003 February; 41(2): 558-63. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12574246&dopt=Abstract

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Dry mouth and halitosis. Author(s): Nally F. Source: The Practitioner. 1990 June 8; 234(1490): 603. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2392411&dopt=Abstract

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Effects of a two-phase oil-water mouthwash on halitosis. Author(s): Yaegaki K, Sanada K. Source: Clin Prev Dent. 1992 January-February; 14(1): 5-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1499240&dopt=Abstract

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Endoscopic diagnosis and treatment of persistent halitosis after pharyngeal flap surgery. Author(s): Finkelstein Y, Talmi YP, Zohar Y, Ophir D. Source: Plastic and Reconstructive Surgery. 1993 November; 92(6): 1176-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8234515&dopt=Abstract

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Examination, classification, and treatment of halitosis; clinical perspectives. Author(s): Yaegaki K, Coil JM. Source: Journal (Canadian Dental Association). 2000 May; 66(5): 257-61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10833869&dopt=Abstract

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Extraoral etiology of halitosis. Author(s): Tomas Carmona I, Limeres Posse J, Diz Dios P, Fernandez Feijoo J, Vazquez Garcia E. Source: Medicina Oral : Organo Oficial De La Sociedad Espanola De Medicina Oral Y De La Academia Iberoamericana De Patologia Y Medicina Bucal. 2001 January-February; 6(1): 40-7. Review. English, Spanish. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11488130&dopt=Abstract

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Extrinsic duodenal obstruction and halitosis. Author(s): Stephenson BM, Rees BI. Source: Postgraduate Medical Journal. 1990 July; 66(777): 568-70. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2217018&dopt=Abstract

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Fetor ex ore and halitosis. Author(s): Massler M. Source: Compend Contin Educ Dent. 1981 March-April; 2(2): 113-5, 118. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6950851&dopt=Abstract

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Gastrointestinal diseases and halitosis: association of gastric Helicobacter pylori infection. Author(s): Hoshi K, Yamano Y, Mitsunaga A, Shimizu S, Kagawa J, Ogiuchi H. Source: Int Dent J. 2002 June; 52 Suppl 3: 207-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12090454&dopt=Abstract

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Genuine halitosis, pseudo-halitosis, and halitophobia: classification, diagnosis, and treatment. Author(s): Yaegaki K, Coil JM. Source: Compend Contin Educ Dent. 2000 October; 21(10A): 880-6, 888-9; Quiz 890. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11908365&dopt=Abstract

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Halitosis - foeter ex ore. A literature review. Author(s): Wikesjo U. Source: Swed Dent J. 1978; 2(2): 55-9. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=349750&dopt=Abstract

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Halitosis and abuse of antibiotics. Report of a case. Author(s): Ogunwande SA. Source: Ceylon Med J. 1989 September; 34(3): 131-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2620377&dopt=Abstract

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Halitosis and gastric outlet obstruction in infants. Author(s): Madarikan BA, Rees BI. Source: Br J Clin Pract. 1990 October; 44(10): 419. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=2268525&dopt=Abstract

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Halitosis and Helicobacter pylori. A possible link? Author(s): Tiomny E, Arber N, Moshkowitz M, Peled Y, Gilat T. Source: Journal of Clinical Gastroenterology. 1992 October; 15(3): 236-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1479169&dopt=Abstract

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Halitosis and Helicobacter pylori: a possible relationship. Author(s): Ierardi E, Amoruso A, La Notte T, Francavilla R, Castellaneta S, Marrazza E, Monno RA, Francavilla A. Source: Digestive Diseases and Sciences. 1998 December; 43(12): 2733-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9881507&dopt=Abstract

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Halitosis in children. Author(s): Amir E, Shimonov R, Rosenberg M. Source: The Journal of Pediatrics. 1999 March; 134(3): 338-43. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10064672&dopt=Abstract

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Halitosis in medicine: a review. Author(s): Tangerman A. Source: Int Dent J. 2002 June; 52 Suppl 3: 201-6. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12090453&dopt=Abstract

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Halitosis measurement by an industrial sulphide monitor. Author(s): Rosenberg M, Septon I, Eli I, Bar-Ness R, Gelernter I, Brenner S, Gabbay J. Source: J Periodontol. 1991 August; 62(8): 487-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1920015&dopt=Abstract

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Halitosis or bad breath. Author(s): Ewart N. Source: Bull N Z Soc Periodontol. 1975 August; (40): 11-3. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1073981&dopt=Abstract

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Halitosis prevention campaign: a report of oral health promotion activities in Japan. Author(s): Saito H, Kawaguchi Y. Source: Int Dent J. 2002 June; 52 Suppl 3: 197-200. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12090452&dopt=Abstract

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Halitosis research. Author(s): Read B. Source: Journal (Canadian Dental Association). 2000 July-August; 66(7): 355. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10946488&dopt=Abstract

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Halitosis, or the meaning of bad breath. Author(s): Johnson BE. Source: Journal of General Internal Medicine : Official Journal of the Society for Research and Education in Primary Care Internal Medicine. 1992 November-December; 7(6): 64956. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1453251&dopt=Abstract

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Halitosis. Author(s): Attia EL, Marshall KG. Source: Can Med Assoc J. 1982 June 1; 126(11): 1281-5. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7074455&dopt=Abstract

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Halitosis. Author(s): Scully C, Rosenberg M. Source: Dent Update. 2003 May; 30(4): 205-10. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12830698&dopt=Abstract

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Halitosis. Author(s): Messadi DV, Younai FS. Source: Dermatologic Clinics. 2003 January; 21(1): 147-55, Viii. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12622277&dopt=Abstract

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Halitosis. Author(s): Hockman M. Source: J Dent Assoc S Afr. 1996 March; 51(3): 130-1. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9461895&dopt=Abstract

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Halitosis. Author(s): Lee NC. Source: South African Medical Journal. Suid-Afrikaanse Tydskrif Vir Geneeskunde. 1997 September; 87(9): 1148. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9411813&dopt=Abstract

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Halitosis. Author(s): Replogle WH, Beebe DK. Source: American Family Physician. 1996 March; 53(4): 1215-8, 1223. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8629567&dopt=Abstract

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Halitosis. Author(s): Bogdasarian RS. Source: Otolaryngologic Clinics of North America. 1986 February; 19(1): 111-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3951867&dopt=Abstract

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Halitosis. A common oral problem. Author(s): Spielman AI, Bivona P, Rifkin BR. Source: The New York State Dental Journal. 1996 December; 62(10): 36-42. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9002736&dopt=Abstract

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Halitosis: a breath of fresh air. Author(s): Nachnani S, Clark GT. Source: Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 1997 September; 25 Suppl 2: S218-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9310683&dopt=Abstract

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Halitosis: a brief review. Author(s): Swenson HM. Source: Alumni Bull Sch Dent Indiana Univ. 1977 Fall; : 33-4, 109. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=281122&dopt=Abstract

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Halitosis: a delayed complication of splenectomy. Author(s): Boyce KE, Cobb RA. Source: Int J Clin Pract. 1998 November-December; 52(8): 590. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10622061&dopt=Abstract

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Halitosis: a review. Author(s): Young K, Oxtoby A, Field EA. Source: Dent Update. 1993 March; 20(2): 57-9, 61. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8593913&dopt=Abstract

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Halitosis: a review. Author(s): Jonsson R. Source: Can Dent Hyg. 1985 Summer; 19(2): 52-4. Review. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3896431&dopt=Abstract

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Halitosis: an etiologic classification, a treatment approach, and prevention. Author(s): Lu DP. Source: Oral Surg Oral Med Oral Pathol. 1982 November; 54(5): 521-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=6960306&dopt=Abstract

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Halitosis: an interdisciplinary approach. Author(s): Ben-Aryeh H, Horowitz G, Nir D, Laufer D. Source: American Journal of Otolaryngology. 1998 January-February; 19(1): 8-11. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9470944&dopt=Abstract

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Halitosis: causes, diagnosis, and treatment. Author(s): Ayers KM, Colquhoun AN. Source: N Z Dent J. 1998 December; 94(418): 156-60. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9889536&dopt=Abstract

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Halitosis: knowing when 'bad breath' signals systemic disease. Author(s): Durham TM, Malloy T, Hodges ED. Source: Geriatrics. 1993 August; 48(8): 55-9. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8339942&dopt=Abstract

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Halitosis--a call for affirmative action. Author(s): Rosenberg M, Gabbay J. Source: Refuat Hashinayim. 1987 April; 5(2): 13-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3476227&dopt=Abstract

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Halitosis--a dental perspective. Author(s): Chemaly A. Source: J Dent Assoc S Afr. 1996 June; 51(6): 331-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9461969&dopt=Abstract

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Halitosis--the need for further research and education. Author(s): Rosenberg M. Source: Journal of Dental Research. 1992 February; 71(2): 424. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1556302&dopt=Abstract

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Halothane or halitosis? Author(s): Scott PV. Source: Anaesthesia. 1997 August; 52(8): 811. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9291795&dopt=Abstract

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Helicobacter halitosis. Author(s): Norfleet RG. Source: Journal of Clinical Gastroenterology. 1993 April; 16(3): 274. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8505512&dopt=Abstract

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Imagined halitosis: a social phobia symptom? Author(s): Bohn P. Source: J Calif Dent Assoc. 1997 February; 25(2): 161-4. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9534446&dopt=Abstract

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Letter: Halitosis from isosorbide dinitrate. Author(s): Bauman D. Source: Jama : the Journal of the American Medical Association. 1975 November 3; 234(5): 482. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=1242163&dopt=Abstract

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Letter: Halitosis. Author(s): Smith RN. Source: British Medical Journal. 1974 August 31; 3(5930): 575. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4414245&dopt=Abstract

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Managing halitosis. Remember the tongue. Author(s): Parmar SC, Naik PC. Source: Bmj (Clinical Research Ed.). 1994 March 5; 308(6929): 652. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8148721&dopt=Abstract

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Microbiology and treatment of halitosis. Author(s): Loesche WJ, Kazor C. Source: Periodontology 2000. 2002; 28: 256-79. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12013345&dopt=Abstract

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Monitoring ammonia to assess halitosis. Author(s): Amano A, Yoshida Y, Oho T, Koga T. Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2002 December; 94(6): 692-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12464892&dopt=Abstract

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Oral and nonoral sources of halitosis. Author(s): Messadi DV. Source: J Calif Dent Assoc. 1997 February; 25(2): 127-31. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9534442&dopt=Abstract

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Orofacial disease: update for the dental clinical team: 10. Halitosis and disturbances of taste, orofacial movement or sensation. Author(s): Scully C, Porter S. Source: Dent Update. 1999 December; 26(10): 464-8. Erratum In: Dent Update 2000 May; 27(4): 186. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10765792&dopt=Abstract

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Patient education. Halitosis. Author(s): Murtagh J. Source: Aust Fam Physician. 1995 April; 24(4): 649, 690. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7771974&dopt=Abstract

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Phenolic antibacterials from Piper betle in the prevention of halitosis. Author(s): Ramji N, Ramji N, Iyer R, Chandrasekaran S. Source: Journal of Ethnopharmacology. 2002 November; 83(1-2): 149-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12413722&dopt=Abstract

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Practice building with halitosis treatment. Author(s): Miller RA. Source: Dent Today. 1997 October; 16(10): 114-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9560662&dopt=Abstract

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Psychological condition of patients complaining of halitosis. Author(s): Oho T, Yoshida Y, Shimazaki Y, Yamashita Y, Koga T. Source: Journal of Dentistry. 2001 January; 29(1): 31-3. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11137636&dopt=Abstract

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Pyloric stenosis presenting with halitosis. Author(s): Tydd TF, Dyer NH. Source: British Medical Journal. 1974 August 3; 3(5926): 321. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=4415408&dopt=Abstract

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Real and imaginary halitosis. Author(s): Hawkins C. Source: British Medical Journal (Clinical Research Ed.). 1987 January 24; 294(6566): 200-1. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3101808&dopt=Abstract

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Schizophrenia and halitosis. Author(s): Diz Dios P, Limeres Posse J, Tomas Carmona I. Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2000 June; 89(6): 661. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10846116&dopt=Abstract

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Some thoughts on halitosis. Author(s): van Eck C. Source: J N Z Soc Periodontol. 1988 November; (66): 19-21. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3272939&dopt=Abstract

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Speech impediment and chronic halitosis due to an extensive palatal fibroma. Author(s): Block PL, Houston GD. Source: Ann Dent. 1987 Summer; 46(1): 20-2. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3476011&dopt=Abstract

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Successful treatment of gut-caused halitosis with a suspension of living nonpathogenic Escherichia coli bacteria--a case report. Author(s): Henker J, Schuster F, Nissler K. Source: European Journal of Pediatrics. 2001 October; 160(10): 592-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11686501&dopt=Abstract

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The effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc lactate on the microflora of oral halitosis patients: a dual-centre, doubleblind placebo-controlled study. Author(s): Roldan S, Winkel EG, Herrera D, Sanz M, Van Winkelhoff AJ. Source: Journal of Clinical Periodontology. 2003 May; 30(5): 427-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12716335&dopt=Abstract

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The effects of oral rinses on halitosis. Author(s): Nachnani S. Source: J Calif Dent Assoc. 1997 February; 25(2): 145-50. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9534444&dopt=Abstract

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The hygienist's role in halitosis treatment. Author(s): Malcmacher L. Source: Rdh. 1999 March; 19(3): 50-2, 72. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10825897&dopt=Abstract

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The relationship between the presence of periodontopathogenic bacteria in saliva and halitosis. Author(s): Awano S, Gohara K, Kurihara E, Ansai T, Takehara T. Source: Int Dent J. 2002 June; 52 Suppl 3: 212-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12090455&dopt=Abstract

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The relationship between volatile sulfur compounds and major halitosis-inducing factors. Author(s): Lee CH, Kho HS, Chung SC, Lee SW, Kim YK. Source: J Periodontol. 2003 January; 74(1): 32-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12593593&dopt=Abstract

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The science of bad breath. Author(s): Rosenberg M. Source: Scientific American. 2002 April; 286(4): 72-9. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11905111&dopt=Abstract

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The use of tongue cleaners in the treatment of halitosis. Author(s): Carlson-Mann L. Source: Probe. 1998 May-June; 32(3): 114-5. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9852860&dopt=Abstract

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Tongue brushing and mouth rinsing as basic treatment measures for halitosis. Author(s): Yaegaki K, Coil JM, Kamemizu T, Miyazaki H. Source: Int Dent J. 2002 June; 52 Suppl 3: 192-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12090451&dopt=Abstract

•

Treating halitosis. Author(s): Miller RA. Source: The Journal of the American Dental Association. 1997 January; 128(1): 12, 14. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9002398&dopt=Abstract

•

Treating halitosis: a new opportunity. Author(s): Miller RA. Source: Dent Today. 1996 September; 15(9): 118-20. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9567837&dopt=Abstract

•

Treatment needs (TN) and practical remedies for halitosis. Author(s): Coil JM, Yaegaki K, Matsuo T, Miyazaki H. Source: Int Dent J. 2002 June; 52 Suppl 3: 187-91. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12090450&dopt=Abstract

•

Treatment of halitosis. Author(s): Ingram CS. Source: N Z Dent J. 1999 June; 95(420): 66. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10409052&dopt=Abstract

•

Treatment of oral and nonoral sources of halitosis in elderly patients. Author(s): McDowell JD, Kassebaum DK. Source: Drugs & Aging. 1995 May; 6(5): 397-408. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7647427&dopt=Abstract

•

What to do about halitosis. Author(s): Scully C, Porter S, Greenman J. Source: Bmj (Clinical Research Ed.). 1994 January 22; 308(6923): 217-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8111254&dopt=Abstract

23

CHAPTER 2. NUTRITION AND HALITOSIS Overview In this chapter, we will show you how to find studies dedicated specifically to nutrition and halitosis.

Finding Nutrition Studies on Halitosis The National Institutes of Health’s Office of Dietary Supplements (ODS) offers a searchable bibliographic database called the IBIDS (International Bibliographic Information on Dietary Supplements; National Institutes of Health, Building 31, Room 1B29, 31 Center Drive, MSC 2086, Bethesda, Maryland 20892-2086, Tel: 301-435-2920, Fax: 301-480-1845, E-mail: [email protected]). The IBIDS contains over 460,000 scientific citations and summaries about dietary supplements and nutrition as well as references to published international, scientific literature on dietary supplements such as vitamins, minerals, and botanicals.7 The IBIDS includes references and citations to both human and animal research studies. As a service of the ODS, access to the IBIDS database is available free of charge at the following Web address: http://ods.od.nih.gov/databases/ibids.html. After entering the search area, you have three choices: (1) IBIDS Consumer Database, (2) Full IBIDS Database, or (3) Peer Reviewed Citations Only. Now that you have selected a database, click on the “Advanced” tab. An advanced search allows you to retrieve up to 100 fully explained references in a comprehensive format. Type “halitosis” (or synonyms) into the search box, and click “Go.” To narrow the search, you can also select the “Title” field.

7 Adapted from http://ods.od.nih.gov. IBIDS is produced by the Office of Dietary Supplements (ODS) at the National Institutes of Health to assist the public, healthcare providers, educators, and researchers in locating credible, scientific information on dietary supplements. IBIDS was developed and will be maintained through an interagency partnership with the Food and Nutrition Information Center of the National Agricultural Library, U.S. Department of Agriculture.

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Halitosis

The following information is typical of that found when using the “Full IBIDS Database” to search for “halitosis” (or a synonym): •

Clinical assessment of bad breath: current concepts. Author(s): Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Ramat Aviv, Israel. “[email protected]” Source: Rosenberg, M J-Am-Dent-Assoc. 1996 April; 127(4): 475-82 0002-8177

•

Effects of a two-phase oil-water mouthwash on halitosis. Author(s): Nippon Dental University, Niigata. Source: Yaegaki, K Sanada, K Clin-Prev-Dent. 1992 Jan-February; 14(1): 5-9 0163-9633

•

Halitosis and Helicobacter pylori. A possible link? Author(s): Department of Gastroenterology, Tel-Aviv Souraski Medical Center, Ichilov Hospital, Israel. Source: Tiomny, E Arber, N Moshkowitz, M Peled, Y Gilat, T J-Clin-Gastroenterol. 1992 October; 15(3): 236-7 0192-0790

•

Microbiology and treatment of halitosis. Author(s): Department of Microbiology and Immunology, School of Medicine, University of Michigan, Ann Arbor, USA. Source: Loesche, Walter J Kazor, Christopher Periodontol-2000. 2002; 28: 256-79 09066713

•

Morning breath odor: influence of treatments on sulfur gases. Author(s): ACOS for Research, Minneapolis Veterans Affairs Medical Center, MN 55417, USA. Source: Suarez, F L Furne, J K Springfield, J Levitt, M D J-Dent-Res. 2000 October; 79(10): 1773-7 0022-0345

•

Successful treatment of gut-caused halitosis with a suspension of living nonpathogenic Escherichia coli bacteria--a case report. Author(s): Children's Hospital, Technical University Dresden, Germany. [email protected] Source: Henker, J Schuster, F Nissler, K Eur-J-Pediatr. 2001 October; 160(10): 592-4 03406199

•

The clinical effectiveness of a dentifrice containing triclosan and a copolymer for providing long-term control of breath odor measured chromatographically. Author(s): Colgate-Palmolive Technology Center, Piscataway, NJ, USA. [email protected] Source: Niles, H P Vazquez, J Rustogi, K N Williams, M Gaffar, A Proskin, H M J-ClinDent. 1999; 10(4): 135-8 0895-8831

•

Tongue brushing and mouth rinsing as basic treatment measures for halitosis. Author(s): Department of Oral Biological and Medical Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, Canada. [email protected] Source: Yaegaki, K Coil, J M Kamemizu, T Miyazaki, H Int-Dent-J. 2002 June; 52 Suppl 3: 192-6 0020-6539

Nutrition

25

Federal Resources on Nutrition In addition to the IBIDS, the United States Department of Health and Human Services (HHS) and the United States Department of Agriculture (USDA) provide many sources of information on general nutrition and health. Recommended resources include: •

healthfinder®, HHS’s gateway to health information, including diet and nutrition: http://www.healthfinder.gov/scripts/SearchContext.asp?topic=238&page=0

•

The United States Department of Agriculture’s Web site dedicated to nutrition information: www.nutrition.gov

•

The Food and Drug Administration’s Web site for federal food safety information: www.foodsafety.gov

•

The National Action Plan on Overweight and Obesity sponsored by the United States Surgeon General: http://www.surgeongeneral.gov/topics/obesity/

•

The Center for Food Safety and Applied Nutrition has an Internet site sponsored by the Food and Drug Administration and the Department of Health and Human Services: http://vm.cfsan.fda.gov/

•

Center for Nutrition Policy and Promotion sponsored by the United States Department of Agriculture: http://www.usda.gov/cnpp/

•

Food and Nutrition Information Center, National Agricultural Library sponsored by the United States Department of Agriculture: http://www.nal.usda.gov/fnic/

•

Food and Nutrition Service sponsored by the United States Department of Agriculture: http://www.fns.usda.gov/fns/

Additional Web Resources A number of additional Web sites offer encyclopedic information covering food and nutrition. The following is a representative sample: •

AOL: http://search.aol.com/cat.adp?id=174&layer=&from=subcats

•

Family Village: http://www.familyvillage.wisc.edu/med_nutrition.html

•

Google: http://directory.google.com/Top/Health/Nutrition/

•

Healthnotes: http://www.healthnotes.com/

•

Open Directory Project: http://dmoz.org/Health/Nutrition/

•

Yahoo.com: http://dir.yahoo.com/Health/Nutrition/

•

WebMD®Health: http://my.webmd.com/nutrition

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

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Halitosis

The following is a specific Web list relating to halitosis; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

Minerals Selenium Source: Healthnotes, Inc.; www.healthnotes.com Zinc Source: Healthnotes, Inc.; www.healthnotes.com

•

Food and Diet Eggplants Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/foods_view/0,1523,19,00.html Garlic Source: Prima Communications, Inc.www.personalhealthzone.com Garlic Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,786,00.html Water Source: Healthnotes, Inc.; www.healthnotes.com

27

CHAPTER 3. ALTERNATIVE MEDICINE AND HALITOSIS Overview In this chapter, we will begin by introducing you to official information sources on complementary and alternative medicine (CAM) relating to halitosis. At the conclusion of this chapter, we will provide additional sources.

National Center for Complementary and Alternative Medicine The National Center for Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health (http://nccam.nih.gov/) has created a link to the National Library of Medicine’s databases to facilitate research for articles that specifically relate to halitosis and complementary medicine. To search the database, go to the following Web site: http://www.nlm.nih.gov/nccam/camonpubmed.html. Select “CAM on PubMed.” Enter “halitosis” (or synonyms) into the search box. Click “Go.” The following references provide information on particular aspects of complementary and alternative medicine that are related to halitosis: •

Antimicrobial activity of garlic, tea tree oil, and chlorhexidine against oral microorganisms. Author(s): Groppo FC, Ramacciato JC, Simoes RP, Florio FM, Sartoratto A. Source: Int Dent J. 2002 December; 52(6): 433-7. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12553397&dopt=Abstract

•

Choicest “receipts” from “The Complete Servant-maid”, London, 1685. Author(s): Geshwind M. Source: Bull Hist Dent. 1987 October; 35(2): 127-8. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3325113&dopt=Abstract

•

Comparative analysis of some mouthrinses on the production of volatile sulfurcontaining compounds. Author(s): Rosing CK, Jonski G, Rolla G.

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Source: Acta Odontologica Scandinavica. 2002 January; 60(1): 10-2. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11902607&dopt=Abstract •

Differentiation of mouth versus gut as site of origin of odoriferous breath gases after garlic ingestion. Author(s): Suarez F, Springfield J, Furne J, Levitt M. Source: The American Journal of Physiology. 1999 February; 276(2 Pt 1): G425-30. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=9950816&dopt=Abstract

•

Effects of new fish oil derivative on fatty acid phospholipid-membrane pattern in a group of Crohn's disease patients. Author(s): Belluzzi A, Brignola C, Campieri M, Camporesi EP, Gionchetti P, Rizzello F, Belloli C, De Simone G, Boschi S, Miglioli M, et al. Source: Digestive Diseases and Sciences. 1994 December; 39(12): 2589-94. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7995183&dopt=Abstract

•

Garlic breath explained: why brushing your teeth won't help. Author(s): Hasler WL. Source: Gastroenterology. 1999 November; 117(5): 1248-50. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10535893&dopt=Abstract

•

Garlic breath. Author(s): Nash A, Galbraith D, Mooney C, Austin M. Source: The Veterinary Record. 1995 February 11; 136(6): 155. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7747390&dopt=Abstract

•

Garlic breath. Author(s): Chivers AW. Source: The Veterinary Record. 1995 February 4; 136(5): 132. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7740739&dopt=Abstract

•

Garlic breath. Author(s): Rohrbach JA. Source: The Veterinary Record. 1995 February 4; 136(5): 132. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7605467&dopt=Abstract

•

Garlic powder in the treatment of moderate hyperlipidaemia: a controlled trial and meta-analysis. Author(s): Neil HA, Silagy CA, Lancaster T, Hodgeman J, Vos K, Moore JW, Jones L, Cahill J, Fowler GH.

Alternative Medicine 29

Source: Journal of the Royal College of Physicians of London. 1996 July-August; 30(4): 329-34. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=8875379&dopt=Abstract •

Inhibitory effect of betel quid on the volatility of methyl mercaptan. Author(s): Wang CK, Chen SL, Wu MG. Source: Journal of Agricultural and Food Chemistry. 2001 April; 49(4): 1979-83. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11308356&dopt=Abstract

•

Knowledge of dental health and diseases among dental patients, a multicentre study in Saudi Arabia. Author(s): Almas K, Albaker A, Felembam N. Source: Indian J Dent Res. 2000 October-December; 11(4): 145-55. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11307638&dopt=Abstract

•

Organic solvents and oils as vehicles for triclosan in mouthrinses: a clinical study. Author(s): Kjaerheim V, Waaler SM, Rolla G. Source: Scand J Dent Res. 1994 October; 102(5): 306-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=7817156&dopt=Abstract

•

Phenolic antibacterials from Piper betle in the prevention of halitosis. Author(s): Ramji N, Ramji N, Iyer R, Chandrasekaran S. Source: Journal of Ethnopharmacology. 2002 November; 83(1-2): 149-52. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=12413722&dopt=Abstract

•

Self-perception of breath odor. Author(s): Eli I, Baht R, Koriat H, Rosenberg M. Source: The Journal of the American Dental Association. 2001 May; 132(5): 621-6. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11367966&dopt=Abstract

•

Successful treatment of gut-caused halitosis with a suspension of living nonpathogenic Escherichia coli bacteria--a case report. Author(s): Henker J, Schuster F, Nissler K. Source: European Journal of Pediatrics. 2001 October; 160(10): 592-4. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11686501&dopt=Abstract

•

The benefits of toothpaste--real or imagined? The effectiveness of toothpaste in the control of plaque, gingivitis, periodontitis, calculus and oral malodour. Author(s): Sheen S, Pontefract H, Moran J. Source: Dent Update. 2001 April; 28(3): 144-7. Review. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=11819975&dopt=Abstract

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Halitosis

•

The clinical effectiveness of a dentifrice containing triclosan and a copolymer for providing long-term control of breath odor measured chromatographically. Author(s): Niles HP, Vazquez J, Rustogi KN, Williams M, Gaffar A, Proskin HM. Source: J Clin Dent. 1999; 10(4): 135-8. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=10825863&dopt=Abstract

•

Using hypnotic phenomena for physiological change. Author(s): Golan HP. Source: Am J Clin Hypn. 1986 January; 28(3): 157-62. No Abstract Available. http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ uids=3511669&dopt=Abstract

Additional Web Resources A number of additional Web sites offer encyclopedic information covering CAM and related topics. The following is a representative sample: •

Alternative Medicine Foundation, Inc.: http://www.herbmed.org/

•


•

Chinese Medicine: http://www.newcenturynutrition.com/

•

drkoop.com®: http://www.drkoop.com/InteractiveMedicine/IndexC.html

•

Family Village: http://www.familyvillage.wisc.edu/med_altn.htm

•

Google: http://directory.google.com/Top/Health/Alternative/

•

Healthnotes: http://www.healthnotes.com/

•

MedWebPlus: http://medwebplus.com/subject/Alternative_and_Complementary_Medicine

•

Open Directory Project: http://dmoz.org/Health/Alternative/

•

HealthGate: http://www.tnp.com/

•

WebMD®Health: http://my.webmd.com/drugs_and_herbs

•

WholeHealthMD.com: http://www.wholehealthmd.com/reflib/0,1529,00.html

•

Yahoo.com: http://dir.yahoo.com/Health/Alternative_Medicine/

The following is a specific Web list relating to halitosis; please note that any particular subject below may indicate either a therapeutic use, or a contraindication (potential danger), and does not reflect an official recommendation: •

General Overview Bulimia Nervosa Source: Integrative Medicine Communications; www.drkoop.com


Cancer Prevention (reducing the Risk) Source: Prima Communications, Inc.www.personalhealthzone.com Chronic Candidiasis Source: Healthnotes, Inc.; www.healthnotes.com Dysphagia Source: Integrative Medicine Communications; www.drkoop.com Gastroesophageal Reflux Disease Source: Integrative Medicine Communications; www.drkoop.com Gingivitis Source: Healthnotes, Inc.; www.healthnotes.com Heartburn Source: Integrative Medicine Communications; www.drkoop.com High Cholesterol Source: Prima Communications, Inc.www.personalhealthzone.com Sinus Congestion Source: Healthnotes, Inc.; www.healthnotes.com Sinusitis Source: Healthnotes, Inc.; www.healthnotes.com •

Alternative Therapy Fasting Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,694,00.html

•

Chinese Medicine Guya Alternative names: Millet Sprout; Fructus Setariae Germinatus Source: Chinese Materia Medica Peilan Alternative names: Fortune Eupatorium Herb; Herba Eupatorii Source: Chinese Materia Medica

•

Herbs and Supplements Acidophilus Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,748,00.html

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Baking Soda Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,835,00.html Bloodroot Alternative names: Sanguinaria canadensis Source: Healthnotes, Inc.; www.healthnotes.com Chlorophyll Source: Healthnotes, Inc.; www.healthnotes.com Coenzyme Q10 Source: Healthnotes, Inc.; www.healthnotes.com Fennel Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,849,00.html Myrrh Alternative names: Commiphora molmol Source: Healthnotes, Inc.; www.healthnotes.com Parsley Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,869,00.html Peppermint Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,812,00.html Spirulina and Kelp Source: WholeHealthMD.com, LLC.; www.wholehealthmd.com Hyperlink: http://www.wholehealthmd.com/refshelf/substances_view/0,1525,10058,00.html Tea Tree Alternative names: Melaleuca alternifolia Source: Healthnotes, Inc.; www.healthnotes.com Thyme Alternative names: Thymus vulgaris Source: Healthnotes, Inc.; www.healthnotes.com

General References A good place to find general background information on CAM is the National Library of Medicine. It has prepared within the MEDLINEplus system an information topic page


dedicated to complementary and alternative medicine. To access this page, go to the MEDLINEplus site at http://www.nlm.nih.gov/medlineplus/alternativemedicine.html. This Web site provides a general overview of various topics and can lead to a number of general sources.

35

CHAPTER 4. PATENTS ON HALITOSIS Overview Patents can be physical innovations (e.g. chemicals, pharmaceuticals, medical equipment) or processes (e.g. treatments or diagnostic procedures). The United States Patent and Trademark Office defines a patent as a grant of a property right to the inventor, issued by the Patent and Trademark Office.8 Patents, therefore, are intellectual property. For the United States, the term of a new patent is 20 years from the date when the patent application was filed. If the inventor wishes to receive economic benefits, it is likely that the invention will become commercially available within 20 years of the initial filing. It is important to understand, therefore, that an inventor’s patent does not indicate that a product or service is or will be commercially available. The patent implies only that the inventor has “the right to exclude others from making, using, offering for sale, or selling” the invention in the United States. While this relates to U.S. patents, similar rules govern foreign patents. In this chapter, we show you how to locate information on patents and their inventors. If you find a patent that is particularly interesting to you, contact the inventor or the assignee for further information. IMPORTANT NOTE: When following the search strategy described below, you may discover non-medical patents that use the generic term “halitosis” (or a synonym) in their titles. To accurately reflect the results that you might find while conducting research on halitosis, we have not necessarily excluded non-medical patents in this bibliography.

Patents on Halitosis By performing a patent search focusing on halitosis, you can obtain information such as the title of the invention, the names of the inventor(s), the assignee(s) or the company that owns or controls the patent, a short abstract that summarizes the patent, and a few excerpts from the description of the patent. The abstract of a patent tends to be more technical in nature, while the description is often written for the public. Full patent descriptions contain much more information than is presented here (e.g. claims, references, figures, diagrams, etc.). We

8Adapted

from the United States Patent and Trademark Office: http://www.uspto.gov/web/offices/pac/doc/general/whatis.htm.

36

Halitosis

will tell you how to obtain this information later in the chapter. The following is an example of the type of information that you can expect to obtain from a patent search on halitosis: •

Breath mint with tooth decay and halitosis prevention characteristics Inventor(s): Thistle; Robert (P.O. Box 19296, Johnston, RI 02919) Assignee(s): none reported Patent Number: 6,083,527 Date filed: November 5, 1998 Abstract: A candy-like confection which contains a natural sweetener is provided. The confection preferably includes XYLITOL as the natural sweetener and calcium hydroxide which increases the pH level of the saliva in the mouth to reduced the presence of bacteria in the mouth. As a result, resultant tooth decay and associated bad breath are prevented. Vitamins may be added to the confection to enable the simultaneous delivery of vitamins, prevention of tooth decay prevention and bad breath while enjoying a candy-like confection. Excerpt(s): The present invention relates generally to the field of oral hygiene. More specifically, this invention relates to the field of tooth decay and halitosis prevention. It is known that plaque is a microbial coating on tooth surfaces, bound together by natural polymers (mucopolysaccharides), formed by microbial action on the cell debris, food remnants, sugars and starches in the mouth. Embedded in this polymer matrix are the bacteria normal to the oral cavity but, when trapped against tooth surfaces and protected by the matrix from easy removal, problems result. Most dental texts implicate plaque in the formation of tooth decay. In addition, these embedded bacteria release toxins that cause gingivitis, bleeding and swelling of the gums. Gingivitis can lead to periodontis in which gums recede, pockets of infection form and teeth loosen. Plaque formation is an ongoing process. Various gel and paste dentrifice preparations, mouth rinse and mouth prerinse preparations made plaque and/or tartar control claims. One disadvantage of these preparations is that only a relatively short time during which the teeth are being cleaned or the mouth is being rinsed is available for the preparations to take effect. These preparations generally have little residual effect on plaque formation. Additionally, some of these preparations such as mouth rinses and prerinses contain various antimicrobial substances which may alter the critically balanced microflora of the mouth. Another disadvantage of these preparations is the general infrequency of use. That is, most are used once or perhaps twice daily and seldom when they are most needed, e.g., after meals, snacks, smoking, drinking, coffeebreaks, etc. Web site: http://www.delphion.com/details?pn=US06083527__

•

Canine and feline toothbrush Inventor(s): Shipp; Anthony D. (351 N. Foothill Rd., Beverly Hills, CA 90210) Assignee(s): none reported Patent Number: 4,738,001 Date filed: June 9, 1986 Abstract: This application relates generally to animal tooth brushes specifically designed for cleaning the teeth of animals whose teeth and mouth shape is different from human, and whose gums are more sensitive. This will enable pet owners a means of offering

Patents 37

oral hygiene which will aid in the prevention of periodontal and related diseases and the reduction of halitosis.The toothbrush comprises an elongated handle securing brush heads which have a plurality of bristle tufts. The heads and the tufts attached thereto taper vertically and horizontally to easily fit and reach the inner reaches of a pet's mouth. Individual bristles make up each tuft which have a diameter of in the range of 0.0025 to 0.005 to accommodate the sensitive nature of pet's gums as compared to those of humans. The tufts are arranged in columns increasing in length toward the handle to form a trapezoidal or tapered bristle surface which aids in preventing slippage from the pet's teeth into the gums, as well as fit the shape of the animal mouth. Excerpt(s): The invention relates generally to canine and feline dental health care products, and more particularly, to a toothbrush specifically designed for use with dogs and cats to provide for the cleaning of teeth, the prevention of periodontal and related diseases, and the reduction of halitosis. The invention, of course can also be used on other animals whose tooth structure is similar to cats and dogs. Conventional methods of cleaning the teeth of dogs and cats by the pet owner have included chew toys, typically made of leather or rawhide strips, and biscuits, which when chewed purport to exhibit a cleaning effect on the animal's teeth. Other methods have included applying an abrasive powder to a gauze which is wrapped about the finger and applied directly to the animal's teeth. Cat and dog teeth can also be professionally cleaned by a veterinarian employing a method of ultrasonic scaling which involves anesthetizing the animal before performing the cleaning operation. Human toothbrushes have also been used to brush the teeth of dogs and cats, but as will be discussed in later sections, and do not lead themselves well for this purpose. All of the above-described prior art methods have exhibited major drawbacks. Chew toys and biscuits have proven ineffective against the tartar build-up which leads to periodontal disease. The gauze and powder cleaning technique is difficult and ineffective in many respects since areas between teeth are not cleaned and other teeth are not reached at all, not to mention the fact that the owner is often place at risk of being bitten by the pet during application. Further, the gauze and powder process is impractical for the cleaning of cat teeth due to the limited access to the mouth area. Ultrasonic scaling by a veterinarian, while effective, is expensive, and extremely unsafe for use with older animals due to the risk of death associated with anesthesia. Web site: http://www.delphion.com/details?pn=US04738001__ •

Cardamom seed preparation being effective against bad breath Inventor(s): Stock; Karl-Wilhelm (Buettelborn, DE), Wienecke; Horst G. P. (Gross-Gerau, DE) Assignee(s): Richardson-Vicks Inc. (Wilton, CT) Patent Number: 4,626,427 Date filed: September 16, 1985 Abstract: Preparation being effective against bad breath, particularly caused by strongly smelling food stuffs or cigarettes, alcohol and the like, consisting of cardamom seeds which are individually or jointly coated by a shell mass comprising a sugar mass or the like. Excerpt(s): Subject matter of the invention is a preparation being effective against bad breath. There are various reasons for bad breath. Firstly, it can be caused by bacterial or enzymatic degradation of food particles in the oral cavity or by generally bad state of

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the dentures. Here the reason for development is directly in the oral cavity itself. But it may also occur after the consumption of strong smelling food stuffs, like onions or garlic, or from consumption of alcohol. Here the bad breath originates in the stomach. Against the unpleasant smells developing in the oral cavity numerous measures can be taken, like regular dental care several times a day with tooth brush and tooth paste, mouth rinses, the consumption of chewing gum or the sucking of special products. Web site: http://www.delphion.com/details?pn=US04626427__ •

Dental and oral preparation Inventor(s): Judas; Herbert (5 Habrosh St., Raanana, IL), Rosenberg; Melvin (12 Yeda-am St., Ramat-gan, IL), Weiss; Ervin (18 Kley St., Tel Aviv, IL) Assignee(s): none reported Patent Number: 4,525,342 Date filed: February 21, 1984 Abstract: There are provided compositions for dental and oral hygiene which desorb microorganisms and which adsorb odorous mercapto-compounds which cause halitosis. The compositions comprise as active ingredient hydrophobic materials selected from vegetable oils, certain mineral oils and hydrocarbons. Excerpt(s): The invention relates to novel compositions for removing bacteria and other microorganisms from the oral cavity, and especially from the surface of teeth, and removing odor producing materials from oral cavity. The compositions are based on hydrophobic constituents which desorb microorganisms from teeth and other surfaces. The compositions are provided as tooth-pastes, gels, mouthwash, etc. Tooth decay and periodontal disease are due to bacterial accumulations on the surfaces of teeth in the form of a macroscopic layer generally referred to as dental plaque. Generation of dental caries (cariogenesis) is linked to the presence of certain types of bacteria on the surfaces of teeth. Marginal gingivitis and also certain cases of halitosis have been attributed to the presence and activity of bacteria in the oral cavity. The most widely practiced treatment of teeth is by brushing with a toothbrush, using certain dentifrices. These generally contain abrasives and detergents. By the mechanical and abrasive action dental plaque is removed from the surfaces of teeth and from crevices. The efficacy of conventional dentrifices is due to the action of the abrasive components and of the detergent ingredients. Such dentifrices may also contain substances such as fluorides and antibacterial agents. The detergents cause foaming, which gives the user a psychological feeling of cleaning action. The use of detergents in the oral cavity also has adverse effects, amongst which there have been reported: gum recession, circulatory impairment, hyperhydration of the exposed tissue, edema, as well as allergic reactions. Detergents are apt to cause stratum corneum swelling, separation between cells as well as increased permeability of human epidermis. It is apparent that the use of less harsh means ought to have an overall beneficial effect. Web site: http://www.delphion.com/details?pn=US04525342__

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Halitosis detector device Inventor(s): Nakamura; Katunori (Iwatsuki, JP) Assignee(s): Winners Japan Company Limited (Tokyo, JP) Patent Number: 4,823,803 Date filed: March 24, 1988 Abstract: A device for testing human exhalation for halitosis, comprising a chamber having an air inlet through which the exhalation to be tested is admitted into the chamber and an air outlet through which the exhalation tested is discharged from the chamber, a sensor element located in the chamber and, when heated to a first temperature, sensitive to malodorant gases of predetermined chemical compositions for producing a signal variable with the detected concentration of the malodorant gases, a heater element which, when electrically activated, is operative to heat the sensor element selectively to the first temperature or a second temperature, the second temperature being higher than the first temperature and being selected to regenerate the sensing means, a control circuit responsive to the signal from the sensor element for determining the degree of malodorousness on the basis of the signal and producing a signal representative of the degree of malodorousness determined, and a display screen or a plurality of indicators responsive to the signal from the control circuit for displaying information relating to the degree of malodorousness represented by the signal from the control circuit. Excerpt(s): The present invention relates to a halitosis detector device for detecting malodorants in human exhalations and, more particularly, to a halitosis detector device capable of detecting human halitosis and/or quantitatively determining the degree of malodorousness of human exhalation. The present invention further relates to a method of detecting halitosis and/or quantitatively determining the degree of malodorousness of human exhalation and to a method of diagnosing a case suspected of ozostomnia. Only organoleptic tests relying on human olefactory senses are used for the detection of oral malodors and determination of the degree of halitosis or malodorousness of human exhalations. Such organoleptic tests are conducted ordinarily by a panel which is organized by several trained specialists to cooperatively estimate the degrees of halitosis simply by having recourse to the sense of smell. The organoleptic tests by panelling are however ineffectual for the quantitation of the seriousness of halitosis, much less the concentrations of malodorants in the human exhalations. Quantitative analysis of malodorants in human exhalations can be and has actually been conducted by gas chromatography typically using a flame photometer or a hydrogen flame ionization detector device. In the flame photometric gas chromatographic measurement of malodorants, the air breathed out by a subject or examined suspected of ozostomnia is directed toward an adsorbent material so that the chemical components of the breath are applied to the adsorbent material. The adsorbent material to which the malodorant gases which may be contained in the subject's exhalation has thus been exposed is combusted for the detection, identification and quantitation of the malodorant gases through measurement of the intensity of the illumination from the combustion of the gases. Such quantitative measurement of malodorants in human exhalations requires the use of a large-scaled, elaborate and accordingly expensive testing equipment which is not adapted for home or personal use or for use at a private dental clinic. Web site: http://www.delphion.com/details?pn=US04823803__

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Method for diagnosing the presence and extent of halitosis activity Inventor(s): Diamond; Howard (Ann Arbor, MI), Musinski; Donald L. (Saline, MI) Assignee(s): Diamond General Development Corporation (Ann Arbor, MI) Patent Number: 6,264,615 Date filed: January 19, 2000 Abstract: A method and apparatus for diagnosing the presence and extent of halitosis activity are disclosed. A method includes assaying for the presence of sulfides on the surface of a subject's tongue in order to determine the concentrations of sulfides in the fluids. Excerpt(s): The subject invention generally relates to the field of detecting halitosis or bad breath and, more particularly, to an improved method for measuring the concentration of sulfides within the mouth of a subject to determine the presence and extent of halitosis activity. Halitosis, commonly known as bad breath, is a common concern for many people. The most common source of halitosis is thought to be the tongue. Gram negative, anaerobic bacteria are prone to proliferate in the papilla structure at the posterior or rear of the tongue. The papilla form a multitude of niches or irregularities which are favored breeding grounds for the anaerobic bacteria as they simulate non-oxygenated micro environments. The anaerobic bacteria break down specific components such as amino acids found in the saliva generating or producing sulfur containing metabolic by-products. These sulfur containing by-products are volatile and have been implicated as the major cause of odor and/or halitosis. It is interesting to note that these same bacteria which are associated with the causation of halitosis are often the same bacteria considered as the etiological agent for periodontal disease. The detection and diagnosis of halitosis has traditionally involved selfmonitoring which is typically accomplished by breathing into one's own hand and then sniffing the trapped contents or a person suspecting that they have halitosis can utilize another person to sample their breath and render a subjective diagnosis. Web site: http://www.delphion.com/details?pn=US06264615__

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Method for reducing oral malodor Inventor(s): Perez; Narciso C. (16339 SR 65, Wapakoneta, OH 45895), Perez; Virginia C. (16339 SR 65, Wapakoneta, OH 45895) Assignee(s): none reported Patent Number: 6,132,701 Date filed: December 17, 1998 Abstract: A method for reducing oral malodor associated with halitosis includes containing the oral cavity of a person with an aqueous solution containing calcium hydroxide. The method includes the steps of mixing approximately one-half ounce of pure lime with every two gallons of water which causes an exothermic chemical reaction to form calcium hydroxide. The calcium hydroxide is slightly soluble in water and is thus allowed to settle to the bottom of the container, leaving an aqueous solution having a predetermined proportion of dissolved and suspended calcium hydroxide. This solution is withdrawn from the container for ingestion or for oral cavity rinse by a person.

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Excerpt(s): The present invention generally relates to methods and compositions for the treatment or prevention of mouth odors and, more particularly, to a method of using a calcium hydroxide solution to reduce or eliminate oral malodor related to halitosis. Halitosis, better known as oral malodor or bad breath, is a socially undesirable condition caused by anaerobic bacteria which accumulates at the back of the tongue. The bacteria generate malodorous volatile sulfur compounds which are then expelled from the mouth through normal breathing. Various methods and compositions have been proposed in the prior art for managing, reducing, or eliminating halitosis. Some compositions propose the use of chlorine dioxide, the disadvantages of which are discussed in U.S. Pat. No. 5,747,079 to Hoffman. Other methods require multiple chemicals or expensive industrial processes. Web site: http://www.delphion.com/details?pn=US06132701__ •

Multilayered soft capsule for eliminating bad breath and process for producing the same Inventor(s): Kagawa; Masaru (Osaka, JP), Kamaguchi; Ryosei (Osaka, JP), Miura; Yuko (Itami, JP), Nishikawa; Masashi (Osaka, JP), Sunohara; Hideki (Osaka, JP) Assignee(s): Morishita Jintan Co., Ltd. (Osaka, JP) Patent Number: 6,426,089 Date filed: April 28, 2000 Abstract: The present invention provides a multi-layered soft capsule for effectively eliminating bad breath, and a method for producing the same. The multi-layered soft capsule (10) for eliminating bad breath of the present invention comprises a first soft capsule composed of a first soft capsule layer (1) and a first soft capsule content (3), and a second soft capsule composed of a second soft capsule layer (2) and a second soft capsule content (4), which is contained in the first soft capsule. Both the contents (3) and (4) contain a component having an effect of eliminating bad breath. The multi-layered soft capsule (10) of the present invention is characterized in that the second soft capsule (2) is solved in a stomach. Excerpt(s): The present invention relates to a multi-layered soft capsule for eliminating bad breath, having capsule-in-capsule structure (that is called a multiple structure) and effectively eliminating bad breath. Hitherto, oral compositions which are (orally) administered to eliminate bad breath in an oral cavity have been studied for a long period of time, as described in for example Japanese Patent Kokai Publication Hei 3(1991)-220117, and some of them are commercially available. Among them, there may be one effectively eliminating not only normal foul halitosis such as mercaptan odor, but also odor generated by a certain food, including garlic odor (particularly, diarylsulfide odor) and alcoholic odor, because it contains some components for eliminating bad breath. However, the oral compositions conventionally available do not totally eliminate bad breath originated from the ingested food. Web site: http://www.delphion.com/details?pn=US06426089__

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Oral anti-halitosis preparations Inventor(s): Blasco Canfran; Alejandro (10 Plaza Urquinaona, 08010 Barcelona, ES), Dachs Pujadas; Michel (2 Paseo Manuel Girona, 9th Floor, 08034 Barcelona, ES), Fitzig; Simon (122 Casanova St., 14th Floor, 08036 Barcelona, ES), Wechsler Blecher; Pablo (59 Manila St., 12th Floor, 08034 Barcelona, ES) Assignee(s): none reported Patent Number: 5,401,496 Date filed: December 29, 1992 Abstract: An oral anti-halitosis preparation adapted to desorb microorganisms and to absorb materials causing halitosis, includes as an active ingredient a synthetic oil, preferably one containing the ester of an alcholol and an aliphatic acid of at least six carbon atoms. Particularly good results were obtained when the synthetic oil is caprylic triglyceride, capric triglyceride, or mixtures thereof. Excerpt(s): The present invention relates to preparations of oral (buccal) compositions effective against halitosis. There exist on the market different mouthwashes (mouth rinses), dentifrices, masticables (chewables) and other dental application products which are palliatives for oral hygiene, acting in different manners. A. Some prevent dental caries, and are based on fluorinated compounds, such as sodium fluoride, stannous fluoride or sodium monofluorophosphate. Web site: http://www.delphion.com/details?pn=US05401496__

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Oral composition Inventor(s): Ogawa; Yuka (Kyoto, JP), Suga; Yoshio (Osaka, JP) Assignee(s): Sunstar Inc. (Osaka, JP) Patent Number: 5,882,631 Date filed: April 24, 1998 Abstract: Oral compositions containing a water-insoluble noncationic bactericide showing improved stability with time and improved rheologic properties, and exerting excellent effects of eliminating dental plaque, preventing halitosis and eliminating tooth-staining substances.Addition of porous calcium carbonate to the oral compositions makes it possible to prevent the decrease in the bactericidal activity of water-insoluble noncationic bactericides such as triclosan and improve the stability thereof while exerting excellent effects of eliminating dental plaque, preventing halitosis and eliminating tooth-staining substances. Furthermore, addition of sodium carboxymethyl cellulose to the oral compositions makes it possible to improve rheologic properties and stability with time. Excerpt(s): This invention relates to oral compositions showing stabilized bactericidal activity of water-insoluble noncationic bactericides when packed in containers having the innermost layer made of synthetic resins. More particularly, it relates to oral compositions exerting excellent effects of suppressing thixotropic properties and variation in viscosity at a high temperature, and preventing solid-liquid separation in stability with time, and further exerting excellent effects of eliminating dental plaque, preventing halitosis and eliminating tooth-staining substances. It has been pointed out that dental plaque adsorbed onto teeth is an important factor causing gingivitis. To eliminate the dental plaque, it has been a practice to physically cleaning the oral cavity

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by brushing, etc. However, it takes a long time to clean the oral cavity by brushing and the dental plaque-controlling effect thus achieved is still insufficient. Under these circumstances, studies have been made to develop oral compositions such as dentifrices containing bactericides so as to achieve supplemental effects of eliminating the dental plaque. In particular, it is known that cationic bactericides are efficacious in preventing the formation of dental plaque. However, cationic bactericides can be hardly processed into preparations due to the poor compatibility with other components in compositions. To overcome this problem, it has been recently proposed to add water-insoluble noncationic bactericides (triclosan, etc.), which are highly compatible with other components in compositions, to oral compositions. Web site: http://www.delphion.com/details?pn=US05882631__ •

Oral hygiene formulation containing sodium alginate Inventor(s): Pera; Ivo (314 McBrien Rd., Royal Arms Apt. 5107-8, Chattanooga, TN 37411) Assignee(s): none reported Patent Number: 4,775,525 Date filed: December 16, 1985 Abstract: A dental treating composition and method are disclosed which reduces dental plaque and inhibits future formation of the same, when the dental treating composition is used on regular basis. Sodium alginate is used as a calcium ion chelating agent which weakens the bond between the plaque and the teeth thereby allowing easy removal by subsequent brushing. The use of benzalkonium chloride and zinc sulfate with the composition provides for desensitizing the teeth and elimination of halitosis. Excerpt(s): This invention pertains to formulations and methods for promoting oral hygiene and in particular to formulations and methods for reducing tooth decay by removing dental plaque. The etiology of dental conditions involves complex interactions of various natural oral substances and chemical reactions between the same and dentifrices. Enough conditions exist to warrant not only a health professional, namely a dentist devoted solely to a person's teeth and gums, but also specialization within that profession. For example, periodontics, endodontics, and orthodontics are some of such areas of specialization. Notwithstanding the relatively large number of professionals devoted to the care and treatment of teeth and gums, it may safely be said that tooth decay caused by bad oral hygiene is one of the more prevalent health problems in the United States today. Generalized factors that predispose individuals to poor oral health include endogenous (microbiological) hose (habit and custom) and exogenous (diet) aspects. Web site: http://www.delphion.com/details?pn=US04775525__

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Oral rinse and method of treating halitosis Inventor(s): Richter; Jon L. (Philadelphia, PA) Assignee(s): Profresh Properties, Inc. (Philadelphia, PA) Patent Number: 5,738,840 Date filed: February 14, 1997

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Abstract: An aqueous composition for the treatment and prevention of malodor of the oral cavity has molecular chlorine dioxide at a concentration of about 1 ppm to about 200 ppm and a pH in the range of about 5.0 to about 7.5. The oral rinse may be used as part of a specific regimen of professional care and/or home use. The oral rinse may be prepared by mixing sodium hypochlorite or other chlorine-releasing agent with sodium chlorite. A convenient kit for preparing the oral rinse treatment contains aqueous sodium chlorite and aqueous sodium hypochlorite in buffered solutions. Excerpt(s): The invention is generally directed to compositions and their method of use in oral hygiene, and more specifically directed to oral rinse treatments for remediation of halitosis, and to methods of using the oral rinse treatment as part of a daily regimen to eliminate or reduce halitosis. The invention is also directed to a kit containing ingredients with which to prepare the oral rinse treatment. Malodor of the oral cavity, also known as halitosis or bad breath, is an undesirable condition for many people. It is generally believed that a significant cause of such malodor is the presence of anaerobic bacteria at the back of the tongue. The bacteria generate volatile sulfur compounds by degrading sulfur-containing amino acids present in the mouth, and the exhalation of the volatile sulfur compounds is perceived as bad breath. The prior art has attempted to treat halitosis through methods whereby the oral cavity is rinsed with an aqueous solution of stabilized chlorine dioxide. Examples include U.S. Pat. Nos. 5,200,171; 4,975,285; 4,925,656; 4,889,714; 4,886,657; 4,855,135; 4,851,213; 4,837,009; 4,818,519; 4,808,389; 4,792,442; 4,788,053; 4,786,492; 4,696,811; and 4,689,215, all issued to Perry A. Ratcliff. Web site: http://www.delphion.com/details?pn=US05738840__ •

Oxygenated beverage Inventor(s): Hoffman; Howard L. (3402 Waverley St., Palo Alto, CA 94306) Assignee(s): none reported Patent Number: 5,747,079 Date filed: December 12, 1996 Abstract: The invention provides oxygenated solutions, such as beverages, useful for the alleviation of halitosis. Further provided are methods of using these solutions in remediating mouth odor. Excerpt(s): This invention is generally directed to compositions and their methods of use as a beverage, beneficial to oral hygiene, and more specifically, for the remediation of halitosis and to methods of using an oxygenated beverage as part of a regimen to reduce, control or eliminate halitosis. Malador of the oral cavity, also known as halitosis or bad breath, is an undesirable condition for many people. It is generally believed that a significant cause of such malador is the presence of anaerobic bacteria at the back of the tongue. The bacteria generate volatile sulfur compounds by degrading sulfur containing amino acids present in the mouth, and the exhalation of the volatile sulfur compounds is perceived as bad breath. The volatile sulfur compounds, primarily hydrogen sulfide, methyl mercaptan, and dimethyl mercaptan, are recognized in the current dental literature as being major contributors to oral malador. In most persons, hydrogen sulfide and methylmercaptan constitute over 90% of the total volatile sulfur content identified in mouth air. These maladorous sulfur compounds are generated primarily through the putrefactive action of oral microorganisms on sulfur containing amino acids, peptones or proteins found in the mouth. These substrates are readily

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available in saliva and dental plaque or may be derived from proteinaceous food particles trapped between the teeth, in the gingival crevice or adhering to the mucous membranes and the irregular surface of the tongue. People with periodontal disease also have an attendant increase in malador due to disintegrated epithelial cells in periodontal pockets. Web site: http://www.delphion.com/details?pn=US05747079__ •

Tongue cleaning device Inventor(s): Kim; Han-Joon (c/o KIM Orthodontic Clinic, Pain-Kurakuen 2F, 3-3, Ishibane-cho, Nishinomiya-shi, Hyogo-ken 662-0074, JP) Assignee(s): none reported Patent Number: 6,159,226 Date filed: May 11, 1999 Abstract: A tongue cleaning device has not been available which ensures easy and satisfactory tongue cleaning for prevention of halitosis. To solve the problem, a tongue cleaning device is provided which is adapted to suck a tongue surface through a cylindrical member 11 by a suction system while scraping the tongue surface with spatulate members 14 and brushes 15. Papillae on the tongue surface are successively raised or laid down by scraping the tongue surface with the spatulate members 14 and brushes 15. Therefore, fossae of the tongue papillae and fissurae and sulci between the tongue papillae are spread so that bacterial plaque and bacteria can be sucked out of the sulci and the like by the suction system. Thus, the tongue can easily be cleaned. Excerpt(s): This application is based on an application No. 10-129194 filed in Japan, the content of which is incorporated hereinto by reference. The present invention relates to a tongue cleaning device for cleaning a tongue. In recent years, a treatment for prevention of halitosis has widely been performed in Western countries. The halitosis is supposedly caused by periodontal diseases, a furry tongue, oral dryness; stresses, and irritative food and drink. A tongue cleaning treatment receives attention as one of the most effective methods for the prevention of the halitosis. Web site: http://www.delphion.com/details?pn=US06159226__

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Use of bismuth-containing compounds in topical oral dosage forms for the treatment of halitosis Inventor(s): Athanikar; Narayan K. (Irvine, CA) Assignee(s): Josman Laboratories Inc. (Orange, CA) Patent Number: 6,426,085 Date filed: May 24, 2000 Abstract: This invention provides for a method for treatment of corneal and dermal wounds by administering bismuth compounds in topical dosage forms. Bismuth compounds cause stimulation of release of growth factors in damaged tissue to promote regeneration of epithelial cells and hence accelerate wound healing. These bismuth compounds also have good antimicrobial activity against several anaerobic bacteria involved in diaper rash exacerbation.

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Excerpt(s): Until recently, excessive gastric acidity and mental stress were thought to be major pathophysiological reasons for occurrence of peptic ulcers. In the early 1980, Marshall and Warren (Warren, Lancet, 1:1273-1275, 1983 and Marshall et al., Lancet, 2:1311-1315, 1984) first reported an unidentified curved bacilli in the stomach of patients with gastritis and peptic ulcers. These bacilli, which later were identified as a gram negative spiral bacterium and named Helicobacter pylori (Goodwin et al., Int. J. Syst. Bacteriol. 39:397-405, 1989), have been demonstrated to be associated with gastritis and peptic ulcers (Buck et al., J. Infect. Dis. 153:664-669, 1986 and Graham, Gastroenterology 96:615-625, 1989), and are thought to be transmitted by person-to-person contact. Recent clinical investigations have shown a definitive presence of H. Pylori in the dental plaque (Nguyen et al., Journal of Clinical Microbiology 31(4):783-787, 1993; Desai et al., Scandinavian Journal of Gastroenterology 26:1205-1208, 1991; and Lambert et al., Lancet 341(8850):957, 1993), and have also shown that standard oral hygiene practice does not help reduce H. Pylori presence in the oral cavity (Nguyen et al., Journal of Clinical Microbiology 31(4):783-787, 1993). As a result of these recent discoveries associating bacterial infection in the causation of peptic ulcer disease, questions regarding the previously established paradigms of ulcer treatment and healing processes have been raised. H.sub.2 receptor blockers which suppress acid secretion, such as cimetidine (Tagamet.RTM.) and ranitidine (Zantac.RTM.), have been used to treat and heal duodenal ulcers (Jones et al., Gut. 28:1120-1127, 1987; McIsaac et al., Aliment. Pharmacol. Therap. 1:369-381, 1987; and Boyed et al., Amsterdam:Excerpta Medica, 1442, 1984). Recently, however, a number of clinical investigations have demonstrated that 70-80% of healed duodenal ulcers reoccur within the next year (Goodwin et al., Int. J. Syst. Bacteriol 39:397-407, 1989), and that these drugs do not reverse the tendency for ulcers to form (Wormsley, British Medical Journal 293: 1501, 1986; Gudman et al., British Medical Journal i:1095-1097, 1978; and Bardhan et al., British Medical Journal 84:621-623, 1982). Web site: http://www.delphion.com/details?pn=US06426085__

Patent Applications on Halitosis As of December 2000, U.S. patent applications are open to public viewing.9 Applications are patent requests which have yet to be granted. (The process to achieve a patent can take several years.) The following patent applications have been filed since December 2000 relating to halitosis: •

Composition Inventor(s): Buch, Robert Michael; (Randolph, NJ) Correspondence: Smithkline Beecham Corporation; Corporate Intellectual Property-us, Uw2220; P. O. Box 1539; King OF Prussia; PA; 19406-0939; US Patent Application Number: 20030206876 Date filed: September 25, 2002 Abstract: Oral hygiene compositions comprising chlorhexidine are described for treating halitosis.

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This has been a common practice outside the United States prior to December 2000.

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Excerpt(s): The present invention relates to oral hygiene compositions comprising the cationic antibacterial agent, chlorhexidine, for combating halitosis. Cationic antibacterial agents such as chlorhexidine have long been recognised as useful therapeutic agents for treating various oral health conditions such as plaque, caries, periodontal diseases and halitosis due not only to their intrinsic in vitro antibacterial activity but also because of their substantivity to oral tissue. They are thus adsorbed onto oral surfaces and gradually released over a period of time, to produce a prolonged antibacterial effect. EPA-920857 describes an oral composition for the treatment of halitosis comprising a combination of 0.025 to 0.20% by weight of a chlorhexidine salt, 0.025 to 0.10% by weight of a quaternary ammonium salt such as cetylpyridinium chloride and a Zn or Cu salt providing 100 to 1000 ppm of Zn or Cu ions. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Composition for the treatment of halitosis Inventor(s): Alvarez Hernandez, Maria; (Madrid, ES) Correspondence: Ladas & Parry; 26 West 61st Street; New York; NY; 10023; US Patent Application Number: 20020054859 Date filed: November 28, 2001 Abstract: The composition comprises a mixture of olive oil (Olea europea L.) and parsley oil (Petroselinum sativum Hoffm., Petroselinum crispum Mill., Carum petroselinum Benth & Hooker), in a ratio of olive oil: parsley oil, by weight, comprised between 1 and 7. Additionally the composition may contain other vegetable oils, mint oil, menthol and chlorophyll. These compositions may be presented in several forms including sweets, chewing-gum, dentifrice paste, mouthwashes and pharmaceutical compositions, especially as soft gelatine capsules, for which purpose they incorporate the suitable additives, vehicles and excipients for its processing in the desired form of presentation. The composition is suitable for the treatment of halitosis. Excerpt(s): This invention refers to a composition suitable for the treatment of halitosis which comprises a mixture of olive and parsley oils, and to presentations thereof. Halitosis, or bad breath, are terms employed to describe unpleasant odours detectable in exhaled air. This is a problem which affects many people, those who suffer it and those surrounding the former which, often, perceive the situation as socially unacceptable. Halitosis is produced by the production and liberation of volatile compounds, mainly volatile derivatives of sulphur, such as hydrogen sulphide and methyl-mercaptane and, according to the localisation of the origin of the unpleasant odour, it can be classified as oral (localised in lips, tongue, teeth, dental prosthetic elements, periodontal tissues, oropharynx) or non-oral [caused by diseases of the respiratory tract, systemic diseases (hepatic dysfunction, cirrhosis, diabetic ketoacidosis, carcinomas and certain metabolic diseases in which an enzymatic anomaly occurs), diseases of the gastrointestinal tract and certain foods, drinks, tobacco and medicaments). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Device and method for reducing halitosis associated with smoking Inventor(s): Gerassi, Ofer; (Ramat Hasharon, IL) Correspondence: DR. Mark Friedman LTD.; C/o Bill Polkinghorn; Discovery Dispatch; 9003 Florin Way; Upper Marlboro; MD; 20772; US Patent Application Number: 20030211049 Date filed: May 9, 2002 Abstract: A combination device for reduction of smoking related halitosis. The device includes a lighter with a fuel reservoir and means of ignition, and an attachment mechanism, the mechanism designed and constructed to facilitate attachment of a breath freshening aid to the lighter Excerpt(s): The present invention relates to a device and method for reducing halitosis associated with smoking and, more particularly, to a combination of a lighter and a breath freshening aid into a single compact unit. It is well established that smoking tobacco (cigarettes, pipe, cigar) contributes to bad breath and/or unsightly stains on the teeth. As a result, many smokers use breath freshening aids such as gum, candies and sprays to reduce halitosis. However, this requires that the smoker make a conscious effort to carry a breath freshening aid as well as tobacco and a source of ignition. Often, these smokers find that they have "forgotten" the breath freshening aid, although they rarely forget their tobacco or source of ignition. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method and kit for indicating the level of bad breath Inventor(s): Rosenberg, Melvyn Nevo; (Ramat-Gan, IL), Sterer, Nir; (Hod HaSharon, IL) Correspondence: Baker & Botts; 30 Rockefeller Plaza; New York; NY; 10112 Patent Application Number: 20030100842 Date filed: October 25, 2001 Abstract: The invention provides a method for the rapid assessment of the degree of halitosis comprising the steps of a) obtaining a sample of fluid and/or tissue from the oral cavity of a subject, b) assessing the amount of.beta.-galactosidase in said sample, c) determining the degree of halitosis in said subject, by comparing the result obtained in step b) with appropriate reference values. Excerpt(s): This application is a continuation of International Publication Number WO 00/65033, published in English on Nov. 2, 2000, filed as International Application Number PCT/IL00/00240 on Apr. 24, 2000, which claims priority from U.S. Provisional Patent Application No. 60/130,970 filed on Apr. 26, 1999. The present invention is concerned with a method for gauging the presence and degree of bad breath. More specifically, a method for the measurement of bad breath based on the estimation of.beta.-galactosidase activity is disclosed, together with a diagnostic kit that employs this method. Oral malodor, (halitosis, fetor ex ore) is a common human condition dating back to ancient times. Bad breath usually originates within the oral cavity itself, due to the production of putrid smelling gases by deposits of microorganisms, generally under anaerobic conditions. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Method of making chewing gum containing colloidal bismuth subcitrate Inventor(s): Athanikar, Narayan K.; (Irvine, CA) Correspondence: Marc V. Richards; Brinks Hofer Gilson & Lione; P.O. Box 10395; Chicago; IL; 60610; US Patent Application Number: 20010036445 Date filed: June 6, 2001 Abstract: The invention provides a chewing gum composition containing a water soluble bulk portion, a water insoluble chewing gum base portion, a flavoring agent, and bismuth-containing compounds. The invention provides a bismuth-containing gum which when chewed multiple times per day, over the period of two weeks, is effective in reducing peptic ulcers by eradicating H. pylori. The chewing gum is also effective in eliminating forms of halitosis. The chewing gum does not have undesirable side effects, unpleasant taste and poor chewing characteristics. Excerpt(s): This application is a continuation-in-part of application Ser. No. 08/741,781, filed Nov. 1, 1996, incorporated herein by reference, which is a continuation-in-part of application Ser. No. 08/385,060, filed Feb. 7, 1995. This invention relates to chewing gum compositions containing active ingredients. More particularly, this invention relates to producing chewing gums that contain compounds for treating ulcers and halitosis. Chewing gum compositions, typically, include a water soluble bulk portion, a water insoluble chewing gum base portion and water insoluble flavoring agents. Also, chewing gum compositions can be formulated to provide the delivery of active agents. These active agents may be a variety of breath fresheners, or medicaments, such as laxatives, aspirin or nicotine. Delivering these medicaments through a chewing gum vehicle is desirable for people who have difficulty swallowing pills. Also, the bad taste of some of the agents may be disguised by stronger flavoring agents in the chewing gum, which may make gum a suitable vehicle for delivery of certain medicines. Moreover, some medicines may be absorbed directly into the bloodstream through the tissue lining the mouth, making the medicine more readily available than if absorbed through the gastrointestinal walls. Accordingly, many people can benefit from new discoveries of how to effectively deliver active ingredients through a chewing gum formulation. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Methods and products for bad breath Inventor(s): Zielinski, Jan; (Vista, CA) Correspondence: Robert D. Fish; Rutan & Tucker, Llp; P.O. Box 1950; 611 Anton BLVD., 14th Floor; Costa Mesa; CA; 92628-1950; US Patent Application Number: 20030124230 Date filed: December 4, 2002 Abstract: A food product includes at least silymarin, betaine, or a combination thereof, and one of an antioxidant, glutathione, a methyl group donor, a sulfur group donor, acetyl CoA, or glucuronic acid in an amount effective to significantly reduce bad breath. Especially preferred food products include significant quantities of silymarin and betaine. The food product is advantageously advertised as reducing bad breath,

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improving liver function, digestion, and/or periodontal health. Contemplated food products include animal treats, and especially dog biscuits or other treats. Excerpt(s): This application claims the benefit of International application PCT/US01/17863, which was filed Jun. 1, 2001 and of U.S. provisional application 60/366378, which was filed on Mar. 20, 2002, which is incorporated by reference herein. The field of the invention is food products and related methods. Bad breath is unfortunately relatively common among humans and animals, and may be caused by various factors including certain types of food, inability to properly digest, and periodontal diseases. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Methods of diagnosing and treating small intestinal bacterial overgrowth (SIBO) and SIBO-related conditions Inventor(s): Lin, Henry C.; (Manhattan Beach, CA), Pimentel, Mark; (Los Angeles, CA) Correspondence: Sidley & Austin; 555 West Fifth Street; Los Angeles; CA; 90071-2909; US Patent Application Number: 20020039599 Date filed: April 17, 2001 Abstract: Disclosed is a method of treating small intestinal bacterial overgrowth (SIBO) or a SIBO-caused condition in a human subject. SIBO-caused conditions include irritable bowel syndrome, fibromyalgia, chronic pelvic pain syndrome, chronic fatigue syndrome, depression, impaired mentation, impaired memory, halitosis, tinnitus, sugar craving, autism, attention deficit/hyperactivity disorder, drug sensitivity, an autoimmune disease, and Crohn's disease. Also disclosed are a method of screening for the abnormally likely presence of SIBO in a human subject and a method of detecting SIBO in a human subject. A method of determining the relative severity of SIBO or a SIBO-caused condition in a human subject, in whom small intestinal bacterial overgrowth (SIBO) has been detected, is also disclosed. Excerpt(s): This application is is a continuation-in-part of U.S. patent application Ser. No. 09/374,142, filed on Aug. 11, 1999. This application is also a continuation-in-part of U.S. patent application Ser. No. 09/546,119, filed on Apr. 10, 2000, which is a continuation-in-part of U.S. patent application Ser. No. 09/420,046, filed Oct. 18, 1999, which is a continuation-in-part of U.S. patent application Ser. No. 09/359,583, filed on Jul. 22, 1999, abandoned, which was a continuation of U.S. patent application Ser. No. 08/832,307, filed on Apr. 3, 1997 and issued as U.S. Pat. No. 5,977,175 on Nov. 2, 1999, which was a continuation of U.S. patent application Ser. No. 08/442,843, filed on May 17,1995, abandoned. Throughout this application various publications are referenced within parentheses. The disclosures of these publications in their entireties are hereby incorporated by reference in this application in order to more fully describe the state of the art to which, this invention pertains. Small intestinal bacterial overgrowth (SIBO), also known as small bowel bacterial overgrowth (SBBO), is an abnormal condition in which aerobic and anaerobic enteric bacteria from the colon proliferate in the small intestine, which is normally relatively free of bacterial contamination. SIBO is defined as greater than 10.sup.6 CFU/mL small intestinal effluent (R. M. Donaldson, Jr., Normal bacterial populations of the intestine and their relation to intestinal function, N. Engl. J. Med. 270:938-45 [1964]). Typically, the symptoms include abdominal pain, bloating, gas and alteration in bowel habits, such as constipation and diarrhea.

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Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Mouth Hygienic Composition For The Treatment of Halitosis Inventor(s): Pedersen, Ejvind Jersie; (Stege, DK) Correspondence: Jacobson Holman Pllc; 400 Seventh Street N.W.; Suite 600; Washington; DC; 20004; US Patent Application Number: 20030012744 Date filed: December 30, 1999 Abstract: A mouth hygienic composition effective in treating halitosis. The composition comprises a chelate comprising a metal ion, preferably a zinc ion, and an amino acid, preferably glycine. Excerpt(s): This invention relates to a mouth hygienic composition, which is useful in preventing or reducing bad breath, in particular for the treatment of halitosis, in the prevention of plaque formation, gingivitis and calculus and thus suitably facilitate the development of a healthy mouth hygiene. It also relates to the use of a particular metal chelate in the composition and a method for using the composition. It is widely accepted that for many people the affliction of halitosis (bad breath) may constitute a serious problem, particularly in social encounters. The breath malodour may be very severe and it may occur e.g. occasionally, regularly, or chronically and at specific times of the day or month. For the purposes of this application, the terms "bad breath", "halitosis" and "breath malodour" all mean an unpleasant breath odour that is objectionable to others. Public awareness and concern for this phenomenon are evidenced e.g. by the support of an estimated $850 million mouth wash industry in the United States of America, despite reports that commercially available products have no significant effect on breath malodour. Recent public opinion polls (taken between 1994 and 1995) have for example revealed that about 55 to 75 million Americans consider bad breath a principle concern in social encounters (J. L. Richter: Diagnosis and Treatment of Halitosis; Compendium 17 (1996); p. 370-386, and references quoted therein). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Novel lactic acid bacteria Inventor(s): Oh, Jong Suk; (Kwangju-City, KR) Correspondence: Frommer Lawrence & Haug; 745 Fifth Avenue- 10th FL.; New York; NY; 10151; US Patent Application Number: 20030077814 Date filed: April 15, 2002 Abstract: Enterococcus spp. 1357, Lactobacillus spp. V20 and Lactococcus spp. 1370, and H.sub.2O.sub.2-producing Streptococci have a potent and lasting inhibitory activity on the production of water-insoluble glucan (mutan) and dental plaque in human mouth, or the growth of anaerobic bacteria causing gingivitis, periodontitis, and accompanied halitosis. Excerpt(s): The present invention relates to some novel lactic acid bacteria which inhibit the production of dental plaque in human mouths. More specifically, the production of water-insoluble glucan (mutan), a major component of dental plaque, which is produced

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by bacteria normally inhibiting in human mouths, can be inhibited by the novel bacteria. Oral anaerobic bacteria causing gingivitis, periodontitis, and accompanied halitosis (malodor) can be inhibited by the novel bacteria, too. These lactic acid bacteria belong to Enterococcus spp., Lactobacillus spp., Lactococcus spp., and Stretococcus spp. which inhibit the production of water-insoluble glucan or antagonize against the bacteria playing a role in forming water-insoluble glucan, or inhibit the growth of anaerobic bacteria causing gingivitis and periodontitis. Lactic acid bacteria generally ferment carbohydrates to lactic acid. Lactic acid bacteria live in the oral cavities and the alimentary tracts of men and animals and are utilized for the manufacture of fermentative foods, such as yogurt, cheese, etc. In addition, they are used for the production of biologically active materials, such as medicines. Representatives of these lactic acid-producing bacteria are Streptococcus thermophilus, Enterococcus faecalis, Enterococcus durans, Lactococcus lactis, Lactobacillus acidophilus, Lactobacillus bulgaricus, Lactobacillus casei, and Lactobacillus plantarum. As inhabitants in the entrails of men and animals, these Gram-positive lactic acid bacteria are known to play an important role in maintaining the entrails healthy by the production of lactic acid and antibacterial materials which inhibit the growth of pathogenic bacteria. The most important component of dental plaque is glucan. Glucan is either water-soluble glucan, dextran having 1,6-.alpha. linkage as a predominant linkage, or water-insoluble glucan (mutan) having 1,3-.alpha. linkage as a predominant linkage. The solubility in water is inversely proportional to the number of 1,3-.alpha. linkage. Therefore, water-insoluble glucan (mutan) serves as a main matrix of dental plaque. Dextranase (.alpha.-1,6 glucan hydrolase) which digests dextran, was tested as to its ability to prevent dental plaque. But the effectiveness value of dextranse to prevent dental plaque was questionable (Essential Dental Microbiology: Appleton & Lange, Norwalk, San Mateo, p.337, 1991), because dextranase can not digest mutan, the main matrix of dental plaque. Mutanase (endo-.alpha.-1,3-glucanase) which decomposes mutan was found to have some effect on the digestion of dental plaque. The decomposition effect of the mutanase on dental plaque, however, was trivial and it took too much time to express its effectivity. Therefore, these enzymes were found to have an insignificant effect on dental plaque formation in human oral cavity. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Oral composition containing NSAIDs and essential oils Inventor(s): Pan, Pauline; (Morris Plains, NJ), Rubin, Michael; (Boonton, NJ), Volpe, Frank; (Kinnelon, NJ) Correspondence: Evan J. Federman; Legal Division; Warner-lambert Company; 201 Tabor Road; Morris Plains; NJ; 07950; US Patent Application Number: 20010049363 Date filed: January 16, 2001 Abstract: Oral compositions for treating and/or preventing gingivitis are provided. The compositions include at least one NSAID, thymol, methyl salicylate, menthol and eucalyptol. The NSAID, thymol, methyl salicylate, menthol and eucalyptol are present in the composition in synergistically effective amounts. The compositions can be provided in the form of, e.g., mouthwashes or toothpastes, and are not only effective against gingivitis, but can also prevent or treat halitosis and other detrimental conditions of the oral cavity.

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Excerpt(s): This invention relates to oral compositions for treating and/or preventing diseases of the mouth, and more particularly to oral compositions for treating and/or preventing gingivitis. Gingivitis is a disease characterized by inflammation of the gingiva or gums. It is generally accepted that this inflammation is typically caused by an overabundance of bacterial plaque about the base of the teeth. Thus, a good deal of research has focused on preventing or treating gingivitis by minimizing the amount of bacterial plaque on the teeth and countering the inflammatory response of the gingiva. The amount of bacterial plaque on the teeth can be controlled by good hygiene, including mechanical removal by frequent brushing, flossing and the like. As an adjunct to the traditional mechanical methods for limiting the amount of bacterial plaque on the teeth, chemical methods have been developed that typically function by killing the bacteria responsible for forming plaque on the teeth. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Oral hygiene preparation for inhibiting halitosis Inventor(s): Rolla, Gunnar; (Oslo, NO) Correspondence: Wenderoth, Lind & Ponack, L.L.P.; 2033 K Street N. W.; Suite 800; Washington; DC; 20006-1021; US Patent Application Number: 20020114767 Date filed: November 20, 2001 Abstract: An oral hygiene preparation for inhibiting halitosis, in the form of a tablet or a powder forming a mouthwash upon dissolution in water, which contains copper(ll)gluconate and a disintegrating agent selected from sodium and calcium bicarbonate. Excerpt(s): It is well established that oral malodour is caused by volatile sulfur compounds (VSC) produced by bacterial catabolization of proteins in the oral cavity, in particular in the crypts at the back of the tongue and in periodontal pockets. The VSC are mainly hydrogen sulfide and methyl mercaptan, which have a very unpleasant odour, even in low concentrations. The VSC are also known to be able to penetrate oral epithelium and damage cells in the underlying connective tissue and bone, a process which is believed to be an important aspect of the initiation and progression of periodontal disease. It is furthermore known that water-soluble salts of certain metals, such as divalent cations of zinc, copper and tin, can inhibit oral malodour. The metals mentioned above have high affinity for sulfur and eliminate the VSC by forming insoluble sulfides with precursors of the volatile sulfur compounds, a reaction which inhibits further formation of the odiferous gases in the oral cavity. It is also well known that water soluble, cationic, antibacterial agents such as the bis-biguanides and the quaternary ammonium compounds are able to inhibit oral malodour when used as mouth rinses. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Pullulan free edible film compositions and methods of making the same Inventor(s): Barkalow, David G.; (Deerfield, IL), Chapdelaine, Albert H.; (Naperville, IL), Dzija, Michael R.; (LaGrange Park, IL) Correspondence: Robert M. Barrett; Bell, Boyd & Lloyd; P.O. Box 1135; Chicago; IL; 60690-1135; US Patent Application Number: 20020131990 Date filed: November 8, 2001 Abstract: Improved and inexpensive pullulan free edible film formulations and methods for making the same are provided. The edible pullulan free film compositions comprise effective amounts of at least one film forming agent; at least one bulk filler agent; at least one plasticizing agent; and optionally at least one thickening agent. Medicaments and other additive agents can also be incorporated into the edible films. The present invention further provides methods of delivering a medicament, treating halitosis, treating xerostomia, and treating plaque or gingivitis using the pullulan free edible film compositions. Excerpt(s): The present invention generally relates to edible films. More specifically, the present invention relates to pullulan free edible film compositions and methods of making the same. Oral cleansing and breath freshening may be difficult or inconvenient at times, depending on the nature of the breath freshening desired and the situation in which the breath freshening must occur. Brushing, flossing, cleaning your tongue and gargling using a variety of devices and compositions are common oral care practices well-suited for the privacy of one's home. However, such devices and compositions are less convenient to use away from the home where bathroom facilities might be scarce, unavailable or unsanitary. However, less obtrusive oral products have been developed. These include breath-freshening gums, lozenges, mouth sprays, and edible films. Many thin edible films are made of pullulan, which may be used to deliver medicaments or other agents such as flavors and sweeteners to the oral cavity. However, pullulan is an expensive ingredient to use in the manufacture of such edible films because it has limited availability within the film formulation industry. Other edible materials such as modified starches and cellulosics have been employed as a replacement for pullulan within edible film compositions. Unfortunately, such materials typically lack one or more of pullulan's desirable film properties. Those properties include for example: rapid dissolution, flexibility, non-hygroscopity, clean mouth feel, clean flavor and ease of manufacture. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Sweet with a rough texture intended for the treatment of halitosis Inventor(s): Ribadeau-Dumas, Guillaume; (Verlinghem, FR), Saniez, Marie-Helene; (Saint-Andre Lez Lille, FR), Taillez, Celine; (Thumeries, FR) Correspondence: Henderson & Sturm Llp; 1213 Midland Building; 206 Sixth Avenue; Des Moines; IA; 50309-4076; US Patent Application Number: 20020132000 Date filed: January 11, 2002 Abstract: A subject-matter of the invention is a sweet of boiled sugar type, characterized in that it exhibits a rough texture intended for the treatment of halitosis.Another

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subject-matter of the invention is a process for the preparation of such a sweet and its use for the treatment of halitosis. Excerpt(s): A subject-matter of the invention is a sweet of "boiled sugar" type with a rough texture which can be used for treating problems of halitosis by reducing the lingual bacterial load. The expression "boiled sugar" denotes, in the field of confectionery, hard sweets which are well known to the consumer and which exhibit a brittle consistency and a glassy appearance. Bad breath, also known as halitosis, generally arises in the buccal cavity. Hydrogen sulphide and methyl mercaptan are the main malodorous components which are formed from bacterial decomposition of protein substrates comprising thiol groups and disulphides, which are primary derivatives of the cellular components in the saliva. The content of volatile sulphur compounds in the breath is particularly high in the case of an inflammatory condition or after long periods of reduction in salivary flow during sleep and after buccal cleaning processes have ceased. This content of volatile sulphur compounds in the breath can be significantly reduced in the majority of cases by means of careful brushing of the buccal cavity, including the dorsal-posterior surface of the tongue, or by rinsing with a mouthwash comprising zinc salts. The tongue is very often the cause of halitosis. This is because it comprises numerous villi which retain the bacteria responsible for bad breath and form a lingual deposit. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Systems and methods of enhancing consumable products Inventor(s): Rast, Robert W.; (Rancho Cordova, CA), Rast, Rodger H.; (Rancho Cordova, CA) Correspondence: Rastar Corporation; 11230 Gold Express DR.; STE. 310; Gold River; CA; 95670-4484; US Patent Application Number: 20030129291 Date filed: December 13, 2001 Abstract: Enhanced consumables providing an enhanced consumption rate adjustable firelog wherein the consumer can select the burning rate, baked buns which are resistant to hinge splitting when a consumer inserts food items therein, wine bottle corks which may be easily removed by the consumer without specific hardware such as corkscrews, electronic soap for entertaining bathing children, bathroom mirror defog sheets which facilitate consumer use of mirrors subject to steam fogging, and a breath "equalizer" preparation which reduces the sensitivity of the consumer to specific forms of breath born halitosis, such as garlic and onions. Excerpt(s): This application claims priority from U.S. provisional application serial No. 60/256,887 filed on Dec. 15, 2000 and serial No. 60/256/888 filed on Dec. 15, 2000 which are incorporated herein by reference. The invention pertains generally to consumables and more particularly to an enhanced consumption rate adjustable firelog, no-split baked buns, easily removable wine bottle corks, entertaining electronic soap, bathroom mirror defog sheets, and breath equalizing preparations. The number of products in the consumables category continues to rise, and the need for continuous improvement provides a competitive edge for manufacturers. Following are six typically molded consumables and a number of enhancements described for each. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Tongue cleaner Inventor(s): Jousson, Pierre J.; (Geneva, CH) Correspondence: Pitney, Hardin, Kipp And Szuch; 711 Third Avenue; New York; NY; 10017-4014; US Patent Application Number: 20030083680 Date filed: October 31, 2001 Abstract: A tongue cleaner having a housing in which a mechanical scraping blade is attached to a spraying fixture which can draw from a water source possibly with a chemical additive. When the user applies scraping blade of the tongue cleaner to the tongue, the surface of the tongue and the papillac of the tongue are exposed and sprayed with water; engaging and reducing bacteria buildup, which is the cause of Halitosis or bad breath. Excerpt(s): This invention relates to a device for cleaning the tongue of the user wherein the device combines mechanical scraping of the tongue with the spray action of a liquid, preferably water and possibly water with a chemical additive. When operated, this tongue cleaning device should reduce the amount of odorous bacteria located at the surface and in the papillac of the tongue. In the prior art, it is well known that halitosis or bad breathe is caused by a buildup of bacteria in the mouth where there is an emission of hydrogen sulfide and sulfide methlmercaptan from these bacteria. These bacteria are needed because they assist the digestion process. However, for some persons, these particular bacteria are found in higher numbers causing noticeable cases of halitosis or bad breath. Instances of these noticeable cases of bad breath are evenly split between men and women. The bacteria of the condition known as Halitosis, are classified as anaerobics meaning that these bacteria grow in an area where oxygen is not present. For the tongue, this area is not exclusively on the surface of the tongue but is mostly between the papillac that make up the body of the human tongue. Various devices exist that attempt the elimination of the bacteria which causes Halitosis. In U.S. Pat., Des. 267,508 a tongue cleaning device is disclosed with a depiction of tongue scraper. The tongue scraper has an edge which is run over the surface of the tongue in a scraping motion. This scraping eliminates a minimal amount of bacteria since most bacteria grow beneath the surface in the papillac of the tongue. Since scraping the tongue alone is inadequate, continued scraping for effect without noticeable results could lead to soreness or even bleeding on the tongue. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

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Topical oral dosage forms containing bismuth compounds Inventor(s): Athanikar, Narayan K.; (US), Gubler, Scott A.; (Saint George, UT) Correspondence: Brinks Hofer Gilson & Lione; P.O. Box 10395; Chicago; IL; 60610; US Patent Application Number: 20030118517 Date filed: March 19, 2002 Abstract: Topical oral dosage forms containing bismuth compounds are described, which are useful for treating H. pylori and other bacterial infections that cause gastrointestinal disorders and halitosis, as well as for treating ocular and dermal wounds. Methods of employing topical oral dosage forms for treating bacterial

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infections that cause gastrointestinal disorders and halitosis, and for treating ocular and dermal wounds, are also described. Excerpt(s): This application is a continuation-in-part of co-pending U.S. application Ser. No. 09/578,824, filed May 24, 2000, which is a continuation of U.S. application Ser. No. 09/363,077, filed Jul. 28, 1999, which is a continuation of U.S. application Ser. No. 09/080,583, filed May 18, 1998, which is a continuation of U.S. application Ser. No. 08/594,148, filed Jan. 31, 1996, which is a continuation-in-part of U.S. application Ser. No. 08/518,971, filed Aug. 24, 1995, which is a continuation-in-part of U.S. application Ser. No. 08/385,060, filed Feb. 7, 1995, which in turn claims priority under 35 U.S.C.sctn.119 to Japanese Application No. 6-93518, filed May 2, 1994. The entire contents of each of the above-identified United States and foreign applications are incorporated herein by reference, except that in the event of any inconsistent disclosure or definition from the present application, the disclosure or definition herein shall be deemed to prevail. Until recently, excessive gastric acidity and mental stress were thought to be major pathophysiological reasons for occurrence of peptic ulcers. In the early 1980s, Marshall and Warren (Warren, Lancet, 1:1273-1275, 1983 and Marshall et al., Lancet, 2:1311-1315, 1984) first reported an unidentified curved bacilli in the stomach of patients with gastritis and peptic ulcers. These bacilli, which later were identified as gram negative spiral bacteria and named Helicobacter pylori (Goodwin et al., Int. J. Syst. Bacteriol. 39:397-405, 1989), have been demonstrated to be associated with gastritis and peptic ulcers (Buck et al., J. Infect. Dis. 153:664-669, 1986 and Graham, Gastroenterology 96:615-625, 1989), and are thought to be transmitted by person-to-person contact. Recent clinical investigations have shown a definitive presence of H. pylori in the dental plaque (Nguyen et al., Journal of Clinical Microbiology 31(4):783-787, 1993; Desai et al., Scandinavian Journal of Gastroenterology 26:1205-1208, 1991; and Lambert et al., Lancet 341(8850):957, 1993), and have also shown that standard oral hygiene practice does not help reduce H. pylori presence in the oral cavity (Nguyen et al., Journal of Clinical Microbiology 31(4):783-787, 1993). As a result of these recent discoveries associating bacterial infection in the causation of peptic ulcer disease, questions regarding the previously established paradigms of ulcer treatment and healing processes have been raised. Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Trace level detection of analytes using artificial olfactometry Inventor(s): Kelso, David; (Wilmette, IL), Lewis, Nathan; (La Canada, CA), Munoz, Beth; (Pasadena, CA), Severin, Erik; (Hayward, CA), Wong, Bernard; (Los Angeles, CA) Correspondence: Townsend And Townsend And Crew; Two Embarcadero Center; Eighth Floor; San Francisco; CA; 94111-3834; US Patent Application Number: 20010041366 Date filed: May 14, 2001 Abstract: The present invention provides methods for detecting the presence of an analyte indicative of various medical conditions, including halitosis, periodontal disease and other diseases are also disclosed. Excerpt(s): This application claims priority to U.S. Provisional Applications Ser. No. 60/090,012, filed Jun. 19, 1998, and Ser. No. 60/091,179, filed Jun. 30, 1998, the disclosures of which are incorporated herein by reference in their entirety. An artificial olfactory system is a device that is capable of detecting a wide variety of analytes in

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fluids such as vapors, gases and liquids. The device comprises an array of sensors that in the presence of an analyte produces a response. The device produces a unique signature output for a particular analyte. Using pattern recognition algorithms, the output signature, such as an electrical response, can be correlated and compared to a particular analyte or mixture of substances that are known. By comparing the unknown signature with the stored or known signatures, the analyte can be detected, identified and quantified. There are many instances where it is desirable to measure trace amounts of analytes. However, in certain instances, the analytes are found at levels that are too low to register a robust signal by direct exposure to currently available sensors. In headspace analysis of applications in agricultural, wine, tobacco, perfume, plastics, and the food industries, the detection and classification of trace levels of gases are present in the sub part per million (ppm) range, making detection difficult. Moreover, in residue analysis of pesticides on crops, the trace levels of certain herbicides must meet federal guidelines. For certain crops, these residues are present on the crops in the part per billion levels (ppb). Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html •

Visual optical device for the control of halitosis Inventor(s): Lopez-Fernandez, Regina; (Cangas De Onis, ES), Pereiro-Garcia, Rosario; (Oviedo, ES), Rodriguez-Fernandez, Julio; (Oviedo, ES), Sanz-Medel, Alfredo; (Gijon, ES) Correspondence: Steinberg & Raskin, P.C.; 1140 Avenue OF The Americas, 15th Floor; New York; NY; 10036-5803; US Patent Application Number: 20010056246 Date filed: January 17, 2001 Abstract: The invention refers to a colorimetric sensor of halitosis, sensitive to volatile sulphur compounds. Said sensor comprises a solid support and a redox calorimetric reagent sensitive to volatile sulphur compounds.The invention also refers to a device for the detection of halitosis, which comprises said sensor located inside a transparent tube. Said device undergoes a visually perceptible colour change when the concentration of volatile sulphur compounds in the analysed gas sample is higher than 200 ppb, preferably higher than 250 ppb. Excerpt(s): The present invention refers to a new visual optical sensing element for the detection of volatile sulphur compounds (CVSs) in gas samples, based on a visually perceptible change of colour. This sensing element consists of a solid support on which a redox reagent sensitive to CVSs is adsorbed. Said sensor is applied mainly to the determination of volatile sulphur compounds in breath and to the indirect determination of halitosis. Likewise, the present invention refers to the development of a visual optical device for the detection of CVSs in breath of possible halitosis patients. Said device consists of a transparent tube of an inert material in which is retained a solid sensing element according to the invention, sensitive to said sulphur compounds. Said sensing element, which consists of a solid support on which a redox reagent sensitive to the CVSs is adsorbed, undergoes a colour change upon passage thereof when the concentration of such CVSs exceeds a critical value. The device is coupled to an instrument that regulates the gas sample volume used by the device or that passes through it, to assure the homogeneity of sampling (preferably a sample of breath). The present invention also refers to a process for halitosis detection (preferably in a patient's breath) by using the device described above.

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Web site: http://appft1.uspto.gov/netahtml/PTO/search-bool.html

Keeping Current In order to stay informed about patents and patent applications dealing with halitosis, you can access the U.S. Patent Office archive via the Internet at the following Web address: http://www.uspto.gov/patft/index.html. You will see two broad options: (1) Issued Patent, and (2) Published Applications. To see a list of issued patents, perform the following steps: Under “Issued Patents,” click “Quick Search.” Then, type “halitosis” (or synonyms) into the “Term 1” box. After clicking on the search button, scroll down to see the various patents which have been granted to date on halitosis. You can also use this procedure to view pending patent applications concerning halitosis. Simply go back to http://www.uspto.gov/patft/index.html. Select “Quick Search” under “Published Applications.” Then proceed with the steps listed above.

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CHAPTER 5. BOOKS ON HALITOSIS Overview This chapter provides bibliographic book references relating to halitosis. In addition to online booksellers such as www.amazon.com and www.bn.com, excellent sources for book titles on halitosis include the Combined Health Information Database and the National Library of Medicine. Your local medical library also may have these titles available for loan.

Book Summaries: Federal Agencies The Combined Health Information Database collects various book abstracts from a variety of healthcare institutions and federal agencies. To access these summaries, go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. You will need to use the “Detailed Search” option. To find book summaries, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer. For the format option, select “Monograph/Book.” Now type “halitosis” (or synonyms) into the “For these words:” box. You should check back periodically with this database which is updated every three months. The following is a typical result when searching for books on halitosis: •

Halitosis: Oral Malodor Source: Torrance, CA: Homestead Schools, Inc. 2000. 33 p. Contact: Available from Homestead Schools, Inc. 23844 Hawthorne Boulevard, Suite 200, Torrance, CA 90505. (310) 791-9975. Fax (310) 791-0135. E-mail: [email protected]. Website: www.homesteadschools.com. PRICE: $24.00 plus shipping and handling. Course No. 6565. Summary: The terms bad breath, halitosis, and oral malodor all refer to an unpleasant breath odor that is objectionable to others. This continuing education program for dentists focuses on halitosis. Topics include major reasons why individuals seek out dental treatment; the difference between transitory and chronic malodor; why the problem of oral malodor has been largely ignored by the dental community; socioeconomic perspectives on the problem of oral malodor; common sources or causes of halitosis; the pathogenesis of halitosis in periodontally healthy patients as well as in

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patients with periodontal disease; psychogenic halitosis and olfactory reference syndrome; strategies to identify oral malodor; mechanical deplaquing and the chemotherapeutic approach to the management of oral malodor; the clinical protocol for oral malodor management and aesthetic assessment; and the use of diagnostic questions to elicit patient medical history items including oral hygiene, diet, medications. The document includes a posttest with which readers can qualify for continuing education credit. The document is illustrated with black and white photographs. 4 figures. 73 references.

Book Summaries: Online Booksellers Commercial Internet-based booksellers, such as Amazon.com and Barnes&Noble.com, offer summaries which have been supplied by each title’s publisher. Some summaries also include customer reviews. Your local bookseller may have access to in-house and commercial databases that index all published books (e.g. Books in Print®). IMPORTANT NOTE: Online booksellers typically produce search results for medical and non-medical books. When searching for “halitosis” at online booksellers’ Web sites, you may discover non-medical books that use the generic term “halitosis” (or a synonym) in their titles. The following is indicative of the results you might find when searching for “halitosis” (sorted alphabetically by title; follow the hyperlink to view more details at Amazon.com): •

Beating Bad Breath: Your Complete Guide to Eliminating and Preventing Halitosis by Richard A. Miller; ISBN: 1561672025; http://www.amazon.com/exec/obidos/ASIN/1561672025/icongroupinterna

Chapters on Halitosis In order to find chapters that specifically relate to halitosis, an excellent source of abstracts is the Combined Health Information Database. You will need to limit your search to book chapters and halitosis using the “Detailed Search” option. Go to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find book chapters, use the drop boxes at the bottom of the search page where “You may refine your search by.” Select the dates and language you prefer, and the format option “Book Chapter.” Type “halitosis” (or synonyms) into the “For these words:” box. The following is a typical result when searching for book chapters on halitosis: •

Miscellaneous Orofacial Lesions Source: in Wray, D., et al. Textbook of General and Oral Medicine. Edinburgh, Scotland: Churchill Livingstone. 1999. p. 329-343. Contact: Available from Harcourt Health Sciences. 11830 Westline Industrial Drive, St. Louis, MO 63146. (800) 325-4177. Fax (800) 874-6418. Website: www.harcourthealth.com. PRICE: $50.00 plus shipping and handling. ISBN: 0443051895. Summary: A whole range of simple lump, bumps, and other lesions that occur in the mouth commonly cause diagnostic problems and unnecessary concern. This chapter on miscellaneous orofacial lesions is the final chapter in an undergraduate dentistry textbook that covers both general medicine and surgery, and oral medicine, emphasizing the overlap between them. The author discusses buccal swellings, denture induced hyperplasia (overgrowth), fibroma, fordyce spots, gingival (gum) swellings,

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giant cell epulis, pregnancy gingivitis, lumps and swellings related to drug therapy, hemangioma, lipoma, lymphangioma, neurofibroma, papilloma, pyogenic granuloma, brown or black lesions, amalgam tattoo, bluish lesions, geographic tongue, glossitis (tongue discomfort or burning), lip lesions, bony lesions, halitosis (bad breath), and disturbance of taste. The authors also cover extraoral lesions, including facial swelling, and neck lumps. Clinical points to remember are highlighted in text boxes. 26 figures. 9 tables. •

Gastrointestinal Disease Source: in Scully, C.; Cawson, R.A. Medical Problems in Dentistry. 3rd ed. Woburn, MA: Butterworth-Heinemann. 1993. p. 189-214. Contact: Available from Butterworth-Heinemann. 255 Wildwood Avenue, Woburn, MA 01801. (800) 366-2665. Fax (800) 446-6520. PRICE: $85.00. Summary: In this chapter, from an extensive text on medical problems in dentistry, the authors discuss gastrointestinal disease, limiting their discussion to those oral complaints for which there may be important medical implications. Topics include oral ulcers, including recurrent aphthae; dry mouth (xerostomia), including that caused by Sjogren's syndrome; HIV infection; sialorrhea (hypersalivation); salivary gland swellings; Frey's syndrome; cervical lymph node enlargement; oral pigmentation; discoloration of teeth; teething; burning mouth; halitosis and disturbed taste sensation; congenital disorders; esophageal disease; dysphagia; reflux esophagitis; the normal function of the stomach; peptic ulcer; cancer of the stomach; small intestine disease; dermatitis herpetiformis; Crohn's disease; acute pancreatitis; chronic pancreatitis; pancreatic tumors; ulcerative colitis; diverticular disease; irritable bowel syndrome; familial polyposis coli; carcinoma of the colon; and antibiotic-associated (pseudomembranous) colitis. For each condition discussed, the authors provide brief information about the clinical aspects, the general management, and the dental aspects. 1 figure. 12 tables. 50 references.

•

Dental Treatment for Adults: Oral Health for Adults with Disabilities Source: in Fenton, S.J.; Perlman, S.; Turner, H., eds. Oral Healthcare for People with Special Needs: Guidelines for Comprehensive Care. River Edge, NJ: Exceptional Parent, Psy-Ed Corp. 2003. p. 36-38. Contact: Available as part of a monograph from Exceptional Parent, Psy-Ed Corp. 65 East Route 4, River Edge, NJ 07661. (800) EPARENT or (800) 372-7368. E-mail: [email protected]. Website: www.eparent.com. PRICE: Contact publisher. Summary: Special care dentistry is a term commonly used for addressing the oral health needs of a person who is medically compromised or an individual with some type of mental, physical, or developmental disability. Special care dentistry may include consulting with the person's physician, coordinating dental treatment with other care providers, assisting a person with the aid of the family and direct support professionals, adaptations to the treatment procedure, communicating through an interpreter, and treatment planning with the person to mitigate future oral health problems. This article on dental treatment for adults is from a monograph that offers guidelines for the comprehensive oral health care for people with special needs. The monograph is designed to help oral health care providers embrace more fully all the members of their communities, while being respectful of a variety of special needs. In this article, the authors note that oral diseases for individuals with disabilities do not differ from those of individuals without disabilities, but that various factors related to disabilities can

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make preventing and treating dental disease more difficult. Topics include common changes seen as people with disabilities age, including broken teeth, dry mouth (xerostomia), cavities or caries (tooth decay), decayed roots (root caries), gum disease (gingivitis), missing teeth (tooth loss), tooth replacement, bad breath (halitosis), food pocketing (pouching), and regurgitation; appropriate dental care for adults with disabilities; oral hygiene; treatment goals; disease prevention and maintenance of the mouth; and barriers to treatment for adults with disabilities. •

Gastrointestinal Disorders Source: in Scully, C. and Cawson, R.A. Medical Problems in Dentistry. 4th ed. Woburn, MA: Butterworth-Heinemann. 1998. p. 173-196. Contact: Available from Butterworth-Heinemann. 225 Wildwood Avenue, Woburn, MA 01801-2041. (800) 366-2665 or (781) 904-2500. Fax (800) 446-6520 or (781) 933-6333. E-mail: [email protected]. Website: www.bh.com. PRICE: $110.00. ISBN: 0723610568. Summary: This chapter on gastrointestinal disorders is from a text that covers the general medical and surgical conditions relevant to the oral health care sciences. Topics include disorders affecting the teeth, including teething, discoloration of teeth, odontogenic infections, fascial space infections, and necrotizing fasciitis; disorders affecting the oral mucosa, including oral ulcers, recurrent aphthae (recurrent aphthous stomatitis, or RAS), white and red lesions, desquamative gingivitis, and oral hyperpigmentation; dry mouth (xerostomia), including that due to Sjogren's syndrome; HIV infection; sialorrhea (excessive salivation); salivary gland swellings; Frey's syndrome; lumps in the neck; cervical lymph node enlargement; halitosis (bad breath); disturbed taste sensation; congenital disorders; esophageal disease, including dysphagia (difficulty in swallowing), and reflux esophagitis; problems of the stomach, including peptic ulcer and cancer of the stomach; disorders of the small intestine, including celiac disease (gluten sensitive enteropathy), dermatitis herpetiformis, linear IgA disease, and Crohn's disease (regional enteritis or ileitis); disorders of the pancreas, including acute pancreatitis, chronic pancreatitis, pancreatic tumors, and pancreatic transplantation; and disorders of the large intestine, including ulcerative colitis, diverticular disease, irritable bowel syndrome (IBS or spastic colon), familial polyposis, carcinoma of the colon, and antibiotic-associated (pseudomembranous) colitis. For each disease, the authors discuss general aspects, diagnosis and management issues, dental aspects, and patient care strategies. The chapter includes a summary of the points covered. 1 figure. 12 tables. 96 references.

•

Oral Malodor Source: in Newman, M.G. and van Winkelhoff, A.J., eds. Antibiotic and Antimicrobial Use in Dental Practice. 2nd ed. Chicago, IL: Quintessence Publishing Co, Inc. 2001. p. 127-141. Contact: Available from Quintessence Publishing Co, Inc. 551 Kimberly Drive, Carol Stream, IL 60188-9981. (800) 621-0387 or (630) 682-3223. Fax (630) 682-3288. E-mail: [email protected]. Website: www.quintpub.com. PRICE: $32.00 plus shipping and handling. ISBN: 0867153970. Summary: This chapter outlines a basic overview of oral malodor (OM, bad breath or halitosis) and describes most of the antimicrobial agents presently involved or suggested in its treatment. The chapter is from a textbook that integrates basic facts and principles of antibiotic therapy with recently-emerged concepts of care. The author first reviews the oral and nonoral causes of OM, noting that the oral causes of OM can

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include periodontitis, gingivitis, and plaque coating on the tongue; nonoral causes include diabetic ketosis, uremia, gastrointestinal conditions, irregular bowel movement, hepatic (liver) and renal (kidney) failure, and certain types of carcinomas (cancer) such as leukemia. The author then outlines oral malodor assessment parameters, including organoleptic measurements, the portable sulfide meter, an 'electronic nose,' and the spoon test. Management strategies are then considered: proper oral hygiene, antimicrobial agents, zinc rinses, chlorhexidine rinses, chlorine dioxide rinses, triclosan rinses, two-phase rinses, hydrogen peroxide, topical antimicrobial agents, and alternative remedies. Important principles, key facts, and clinical insights are highlighted and the chapter concludes with a list of references. 8 figures. 57 references. •

Drug Reactions and Side Effects Source: in Bork, K., et al. Diseases of the Oral Mucosa and the Lips. Orlando, FL: W.B. Saunders Company. 1993. p. 190-204. Contact: Available from W.B. Saunders Company. Order Fulfillment, 6277 Sea Harbor Drive, Orlando, FL 32887-4430. (800) 545-2522 (individuals) or (800) 782-4479 (schools); Fax (800) 874-6418 or (407) 352-3445; http://www.wbsaunders.com. PRICE: $99.00 plus shipping and handling. ISBN: 0721640397. Summary: This chapter, from a textbook on diseases of the oral mucosa and the lips, discusses drug reactions and side effects. The authors note that drug reactions can occur in isolation on the oral mucosa or in association with similar changes on the skin. Both allergic and toxic reactions can occur, but in most cases the pathogenesis is so unclear that a simple classification is not possible. Topics include erosive stomatitis, cheilitis, macular and purpuric enanthems, urticaria and angioedema, fixed drug eruption, erythema multiforme, toxic epidermal necrolysis (TEN), pemphigus, lichenoid eruption, thrombocytopenic purpura, nonallergic purpura, pigmentary changes, halogen enanthems, discoloration of the tongue, discoloration and other changes of the teeth, gingival hyperplasia, xerostomia, increased salivary flow, disturbances of taste, halitosis, and local side effects such as that from applying aspirin to the oral mucosa. For each topic, the authors describe the clinical features and present brief therapeutic recommendations. Full-color photographs illustrate the chapter; references are provided for some sections. 20 figures. 73 references. (AA-M).

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CHAPTER 6. PERIODICALS AND NEWS ON HALITOSIS Overview In this chapter, we suggest a number of news sources and present various periodicals that cover halitosis.

News Services and Press Releases One of the simplest ways of tracking press releases on halitosis is to search the news wires. In the following sample of sources, we will briefly describe how to access each service. These services only post recent news intended for public viewing. PR Newswire To access the PR Newswire archive, simply go to http://www.prnewswire.com/. Select your country. Type “halitosis” (or synonyms) into the search box. You will automatically receive information on relevant news releases posted within the last 30 days. The search results are shown by order of relevance. Reuters Health The Reuters’ Medical News and Health eLine databases can be very useful in exploring news archives relating to halitosis. While some of the listed articles are free to view, others are available for purchase for a nominal fee. To access this archive, go to http://www.reutershealth.com/en/index.html and search by “halitosis” (or synonyms). The following was recently listed in this archive for halitosis: •

Tea compounds may fight bad breath Source: Reuters Health eLine Date: May 20, 2003

•

Halitosis could be sign of ulcer bug infection Source: Reuters Health eLine Date: January 31, 2003

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•

Halitosis could be marker for Helicobacter pylori infection Source: Reuters Industry Breifing Date: January 31, 2003

•

Parasites may be cause of child's bad breath Source: Reuters Health eLine Date: October 24, 2002

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Even in the cleanest mouths, bad breath may persist Source: Reuters Health eLine Date: November 23, 2000

•

Chronic Halitosis Could Be Due To H. Pylori Infection In Pediatric Patients Source: Reuters Medical News Date: April 24, 1997 The NIH

Within MEDLINEplus, the NIH has made an agreement with the New York Times Syndicate, the AP News Service, and Reuters to deliver news that can be browsed by the public. Search news releases at http://www.nlm.nih.gov/medlineplus/alphanews_a.html. MEDLINEplus allows you to browse across an alphabetical index. Or you can search by date at the following Web page: http://www.nlm.nih.gov/medlineplus/newsbydate.html. Often, news items are indexed by MEDLINEplus within its search engine. Business Wire Business Wire is similar to PR Newswire. To access this archive, simply go to http://www.businesswire.com/. You can scan the news by industry category or company name. Market Wire Market Wire is more focused on technology than the other wires. To browse the latest press releases by topic, such as alternative medicine, biotechnology, fitness, healthcare, legal, nutrition, and pharmaceuticals, access Market Wire’s Medical/Health channel at http://www.marketwire.com/mw/release_index?channel=MedicalHealth. Or simply go to Market Wire’s home page at http://www.marketwire.com/mw/home, type “halitosis” (or synonyms) into the search box, and click on “Search News.” As this service is technology oriented, you may wish to use it when searching for press releases covering diagnostic procedures or tests. Search Engines Medical news is also available in the news sections of commercial Internet search engines. See the health news page at Yahoo (http://dir.yahoo.com/Health/News_and_Media/), or you can use this Web site’s general news search page at http://news.yahoo.com/. Type in “halitosis” (or synonyms). If you know the name of a company that is relevant to halitosis, you can go to any stock trading Web site (such as http://www.etrade.com/) and search for

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the company name there. News items across various news sources are reported on indicated hyperlinks. Google offers a similar service at http://news.google.com/. BBC Covering news from a more European perspective, the British Broadcasting Corporation (BBC) allows the public free access to their news archive located at http://www.bbc.co.uk/. Search by “halitosis” (or synonyms).

Newsletter Articles Use the Combined Health Information Database, and limit your search criteria to “newsletter articles.” Again, you will need to use the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. Go to the bottom of the search page where “You may refine your search by.” Select the dates and language that you prefer. For the format option, select “Newsletter Article.” Type “halitosis” (or synonyms) into the “For these words:” box. You should check back periodically with this database as it is updated every three months. The following is a typical result when searching for newsletter articles on halitosis: •

Halitosis Research Spans the Globe: But Experts Agree More Data is Needed Source: ADA Dental News. 28(11): 1, 16, 18. June 2, 1997. Contact: Available from ADA Publishing Company. 211 East Chicago Avenue, Chicago, IL 60611. (312) 440-2867; E-mail: [email protected]. Summary: This newsletter article provides readers with an update on the work of Dr. Joseph Tonzetich, an oral biology professor widely regarded as a pioneer in halitosis research. His findings have helped to elevate the study of bad breath from a blur of conjecture to an area of legitimate scientific scrutiny. But even as basic research has accumulated at a steady pace, its progress is dwarfed by the recent commercialization of bad breath remedies. The author describes recent advances in portable sulfide monitors, the use of chlorhexidine and chlorine dioxide mouthrinses, the development of halitosis clinics to treat patients, and an upcoming conference on this topic. The article also describes the work of Dr. Israel Kleinberg, who has been studying the causes of chronic bad breath; Dr. Glenn Clark, who has been working with the portable sulfide monitor and has some concerns about its reliability; and Dr. Mel Rosenberg, who devised the sulfide instrument's application to dentistry and emphasizes its benefits. The article concludes with a list of central concepts in the diagnosis and treatment of oral malodor and a general call for more research in this area. Contact information and bibliographic information for the researchers and publications noted in the article are provided in a sidebar.

Academic Periodicals covering Halitosis Numerous periodicals are currently indexed within the National Library of Medicine’s PubMed database that are known to publish articles relating to halitosis. In addition to these sources, you can search for articles covering halitosis that have been published by any of the

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periodicals listed in previous chapters. To find the latest studies published, go to http://www.ncbi.nlm.nih.gov/pubmed, type the name of the periodical into the search box, and click “Go.” If you want complete details about the historical contents of a journal, you can also visit the following Web site: http://www.ncbi.nlm.nih.gov/entrez/jrbrowser.cgi. Here, type in the name of the journal or its abbreviation, and you will receive an index of published articles. At http://locatorplus.gov/, you can retrieve more indexing information on medical periodicals (e.g. the name of the publisher). Select the button “Search LOCATORplus.” Then type in the name of the journal and select the advanced search option “Journal Title Search.”

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APPENDICES

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APPENDIX A. PHYSICIAN RESOURCES Overview In this chapter, we focus on databases and Internet-based guidelines and information resources created or written for a professional audience.

NIH Guidelines Commonly referred to as “clinical” or “professional” guidelines, the National Institutes of Health publish physician guidelines for the most common diseases. Publications are available at the following by relevant Institute10: •

Office of the Director (OD); guidelines consolidated across agencies available at http://www.nih.gov/health/consumer/conkey.htm

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National Institute of General Medical Sciences (NIGMS); fact sheets available at http://www.nigms.nih.gov/news/facts/

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National Library of Medicine (NLM); extensive encyclopedia (A.D.A.M., Inc.) with guidelines: http://www.nlm.nih.gov/medlineplus/healthtopics.html

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National Cancer Institute (NCI); guidelines available at http://www.cancer.gov/cancerinfo/list.aspx?viewid=5f35036e-5497-4d86-8c2c714a9f7c8d25

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National Eye Institute (NEI); guidelines available at http://www.nei.nih.gov/order/index.htm

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National Heart, Lung, and Blood Institute (NHLBI); guidelines available at http://www.nhlbi.nih.gov/guidelines/index.htm

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National Human Genome Research Institute (NHGRI); research available at http://www.genome.gov/page.cfm?pageID=10000375

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National Institute on Aging (NIA); guidelines available at http://www.nia.nih.gov/health/

10

These publications are typically written by one or more of the various NIH Institutes.

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National Institute on Alcohol Abuse and Alcoholism (NIAAA); guidelines available at http://www.niaaa.nih.gov/publications/publications.htm

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National Institute of Allergy and Infectious Diseases (NIAID); guidelines available at http://www.niaid.nih.gov/publications/

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National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS); fact sheets and guidelines available at http://www.niams.nih.gov/hi/index.htm

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National Institute of Child Health and Human Development (NICHD); guidelines available at http://www.nichd.nih.gov/publications/pubskey.cfm

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National Institute on Deafness and Other Communication Disorders (NIDCD); fact sheets and guidelines at http://www.nidcd.nih.gov/health/

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National Institute of Dental and Craniofacial Research (NIDCR); guidelines available at http://www.nidr.nih.gov/health/

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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK); guidelines available at http://www.niddk.nih.gov/health/health.htm

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National Institute on Drug Abuse (NIDA); guidelines available at http://www.nida.nih.gov/DrugAbuse.html

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National Institute of Environmental Health Sciences (NIEHS); environmental health information available at http://www.niehs.nih.gov/external/facts.htm

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National Institute of Mental Health (NIMH); guidelines available at http://www.nimh.nih.gov/practitioners/index.cfm

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National Institute of Neurological Disorders and Stroke (NINDS); neurological disorder information pages available at http://www.ninds.nih.gov/health_and_medical/disorder_index.htm

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National Institute of Nursing Research (NINR); publications on selected illnesses at http://www.nih.gov/ninr/news-info/publications.html

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National Institute of Biomedical Imaging and Bioengineering; general information at http://grants.nih.gov/grants/becon/becon_info.htm

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Center for Information Technology (CIT); referrals to other agencies based on keyword searches available at http://kb.nih.gov/www_query_main.asp

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National Center for Complementary and Alternative Medicine (NCCAM); health information available at http://nccam.nih.gov/health/

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National Center for Research Resources (NCRR); various information directories available at http://www.ncrr.nih.gov/publications.asp

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Office of Rare Diseases; various fact sheets available at http://rarediseases.info.nih.gov/html/resources/rep_pubs.html

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Centers for Disease Control and Prevention; various fact sheets on infectious diseases available at http://www.cdc.gov/publications.htm

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NIH Databases In addition to the various Institutes of Health that publish professional guidelines, the NIH has designed a number of databases for professionals.11 Physician-oriented resources provide a wide variety of information related to the biomedical and health sciences, both past and present. The format of these resources varies. Searchable databases, bibliographic citations, full-text articles (when available), archival collections, and images are all available. The following are referenced by the National Library of Medicine:12 •

Bioethics: Access to published literature on the ethical, legal, and public policy issues surrounding healthcare and biomedical research. This information is provided in conjunction with the Kennedy Institute of Ethics located at Georgetown University, Washington, D.C.: http://www.nlm.nih.gov/databases/databases_bioethics.html

•

HIV/AIDS Resources: Describes various links and databases dedicated to HIV/AIDS research: http://www.nlm.nih.gov/pubs/factsheets/aidsinfs.html

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NLM Online Exhibitions: Describes “Exhibitions in the History of Medicine”: http://www.nlm.nih.gov/exhibition/exhibition.html. Additional resources for historical scholarship in medicine: http://www.nlm.nih.gov/hmd/hmd.html

•

Biotechnology Information: Access to public databases. The National Center for Biotechnology Information conducts research in computational biology, develops software tools for analyzing genome data, and disseminates biomedical information for the better understanding of molecular processes affecting human health and disease: http://www.ncbi.nlm.nih.gov/

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Population Information: The National Library of Medicine provides access to worldwide coverage of population, family planning, and related health issues, including family planning technology and programs, fertility, and population law and policy: http://www.nlm.nih.gov/databases/databases_population.html

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Cancer Information: Access to cancer-oriented databases: http://www.nlm.nih.gov/databases/databases_cancer.html

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Profiles in Science: Offering the archival collections of prominent twentieth-century biomedical scientists to the public through modern digital technology: http://www.profiles.nlm.nih.gov/

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Chemical Information: Provides links to various chemical databases and references: http://sis.nlm.nih.gov/Chem/ChemMain.html

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Clinical Alerts: Reports the release of findings from the NIH-funded clinical trials where such release could significantly affect morbidity and mortality: http://www.nlm.nih.gov/databases/alerts/clinical_alerts.html

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Space Life Sciences: Provides links and information to space-based research (including NASA): http://www.nlm.nih.gov/databases/databases_space.html

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MEDLINE: Bibliographic database covering the fields of medicine, nursing, dentistry, veterinary medicine, the healthcare system, and the pre-clinical sciences: http://www.nlm.nih.gov/databases/databases_medline.html

11

Remember, for the general public, the National Library of Medicine recommends the databases referenced in MEDLINEplus (http://medlineplus.gov/ or http://www.nlm.nih.gov/medlineplus/databases.html). 12 See http://www.nlm.nih.gov/databases/databases.html.

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Toxicology and Environmental Health Information (TOXNET): Databases covering toxicology and environmental health: http://sis.nlm.nih.gov/Tox/ToxMain.html

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Visible Human Interface: Anatomically detailed, three-dimensional representations of normal male and female human bodies: http://www.nlm.nih.gov/research/visible/visible_human.html The Combined Health Information Database

A comprehensive source of information on clinical guidelines written for professionals is the Combined Health Information Database. You will need to limit your search to one of the following: Brochure/Pamphlet, Fact Sheet, or Information Package, and “halitosis” using the “Detailed Search” option. Go directly to the following hyperlink: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For the publication date, select “All Years.” Select your preferred language and the format option “Fact Sheet.” Type “halitosis” (or synonyms) into the “For these words:” box. The following is a sample result: •

Preventing Tobacco Use Among Young People: A Report of the Surgeon General. Smokeless Tobacco Source: Atlanta, GA: Office on Smoking and Health, Centers for Disease Control (CDC), U.S. Department of Health and Human Services. 1994. 59 p. Contact: Available from U.S. Superintendent of Documents. U.S. Government Printing Office, Washington, DC 20402. (202) 512-1800. PRICE: Single copy free. Summary: This document on smokeless tobacco (spit tobacco, or ST) presents a reproduction of sections from Chapters 2, 3, 4, 5, and 6 of the full Report of the Surgeon General on preventing tobacco use among young people. Topics include the health consequences of ST use among young people, the epidemiology of tobacco use among young people, psychosocial risk factors for initiating ST use, smokeless tobacco advertising and promotional expenditures, and efforts to prevent tobacco use among young people. The most notable health consequences associated with ST use include halitosis (bad breath), discoloration of teeth and fillings, abrasion of teeth, dental caries, gum recession, leukoplakia, nicotine dependence, and various forms of oral cancer, including cancers of the gum, mouth, pharynx, larynx, and esophagus. This document also focuses on practical interventions to help young people avoid ST use or to quit already established ST use. 3 figures. 16 tables. 221 references. (AA-M).

The NLM Gateway13 The NLM (National Library of Medicine) Gateway is a Web-based system that lets users search simultaneously in multiple retrieval systems at the U.S. National Library of Medicine (NLM). It allows users of NLM services to initiate searches from one Web interface, providing one-stop searching for many of NLM’s information resources or databases.14 To use the NLM Gateway, simply go to the search site at http://gateway.nlm.nih.gov/gw/Cmd.

13 14

Adapted from NLM: http://gateway.nlm.nih.gov/gw/Cmd?Overview.x.

The NLM Gateway is currently being developed by the Lister Hill National Center for Biomedical Communications (LHNCBC) at the National Library of Medicine (NLM) of the National Institutes of Health (NIH).

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Type “halitosis” (or synonyms) into the search box and click “Search.” The results will be presented in a tabular form, indicating the number of references in each database category. Results Summary Category Journal Articles Books / Periodicals / Audio Visual Consumer Health Meeting Abstracts Other Collections Total

Items Found 610 3 927 0 0 1540

HSTAT15 HSTAT is a free, Web-based resource that provides access to full-text documents used in healthcare decision-making.16 These documents include clinical practice guidelines, quickreference guides for clinicians, consumer health brochures, evidence reports and technology assessments from the Agency for Healthcare Research and Quality (AHRQ), as well as AHRQ’s Put Prevention Into Practice.17 Simply search by “halitosis” (or synonyms) at the following Web site: http://text.nlm.nih.gov.

Coffee Break: Tutorials for Biologists18 Coffee Break is a general healthcare site that takes a scientific view of the news and covers recent breakthroughs in biology that may one day assist physicians in developing treatments. Here you will find a collection of short reports on recent biological discoveries. Each report incorporates interactive tutorials that demonstrate how bioinformatics tools are used as a part of the research process. Currently, all Coffee Breaks are written by NCBI staff.19 Each report is about 400 words and is usually based on a discovery reported in one or more articles from recently published, peer-reviewed literature.20 This site has new articles every few weeks, so it can be considered an online magazine of sorts. It is intended for general background information. You can access the Coffee Break Web site at the following hyperlink: http://www.ncbi.nlm.nih.gov/Coffeebreak/. 15

Adapted from HSTAT: http://www.nlm.nih.gov/pubs/factsheets/hstat.html.

16

The HSTAT URL is http://hstat.nlm.nih.gov/.

17

Other important documents in HSTAT include: the National Institutes of Health (NIH) Consensus Conference Reports and Technology Assessment Reports; the HIV/AIDS Treatment Information Service (ATIS) resource documents; the Substance Abuse and Mental Health Services Administration's Center for Substance Abuse Treatment (SAMHSA/CSAT) Treatment Improvement Protocols (TIP) and Center for Substance Abuse Prevention (SAMHSA/CSAP) Prevention Enhancement Protocols System (PEPS); the Public Health Service (PHS) Preventive Services Task Force's Guide to Clinical Preventive Services; the independent, nonfederal Task Force on Community Services’ Guide to Community Preventive Services; and the Health Technology Advisory Committee (HTAC) of the Minnesota Health Care Commission (MHCC) health technology evaluations. 18 Adapted from http://www.ncbi.nlm.nih.gov/Coffeebreak/Archive/FAQ.html. 19 The figure that accompanies each article is frequently supplied by an expert external to NCBI, in which case the source of the figure is cited. The result is an interactive tutorial that tells a biological story. 20 After a brief introduction that sets the work described into a broader context, the report focuses on how a molecular understanding can provide explanations of observed biology and lead to therapies for diseases. Each vignette is accompanied by a figure and hypertext links that lead to a series of pages that interactively show how NCBI tools and resources are used in the research process.

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Other Commercial Databases In addition to resources maintained by official agencies, other databases exist that are commercial ventures addressing medical professionals. Here are some examples that may interest you: •

CliniWeb International: Index and table of contents to selected clinical information on the Internet; see http://www.ohsu.edu/cliniweb/.

•

Medical World Search: Searches full text from thousands of selected medical sites on the Internet; see http://www.mwsearch.com/.

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APPENDIX B. PATIENT RESOURCES Overview Official agencies, as well as federally funded institutions supported by national grants, frequently publish a variety of guidelines written with the patient in mind. These are typically called “Fact Sheets” or “Guidelines.” They can take the form of a brochure, information kit, pamphlet, or flyer. Often they are only a few pages in length. Since new guidelines on halitosis can appear at any moment and be published by a number of sources, the best approach to finding guidelines is to systematically scan the Internet-based services that post them.

Patient Guideline Sources The remainder of this chapter directs you to sources which either publish or can help you find additional guidelines on topics related to halitosis. Due to space limitations, these sources are listed in a concise manner. Do not hesitate to consult the following sources by either using the Internet hyperlink provided, or, in cases where the contact information is provided, contacting the publisher or author directly. The National Institutes of Health The NIH gateway to patients is located at http://health.nih.gov/. From this site, you can search across various sources and institutes, a number of which are summarized below. Topic Pages: MEDLINEplus The National Library of Medicine has created a vast and patient-oriented healthcare information portal called MEDLINEplus. Within this Internet-based system are “health topic pages” which list links to available materials relevant to halitosis. To access this system, log on to http://www.nlm.nih.gov/medlineplus/healthtopics.html. From there you can either search using the alphabetical index or browse by broad topic areas. Recently, MEDLINEplus listed the following when searched for “halitosis”:

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•

Other guides Asthma in Children http://www.nlm.nih.gov/medlineplus/asthmainchildren.html Chemical Weapons http://www.nlm.nih.gov/medlineplus/chemicalweapons.html Child Dental Health http://www.nlm.nih.gov/medlineplus/childdentalhealth.html Dental Health http://www.nlm.nih.gov/medlineplus/dentalhealth.html Indoor Air Pollution http://www.nlm.nih.gov/medlineplus/indoorairpollution.html Mouth Disorders http://www.nlm.nih.gov/medlineplus/mouthdisorders.html Respiratory Diseases http://www.nlm.nih.gov/medlineplus/respiratorydiseases.html Sinusitis http://www.nlm.nih.gov/medlineplus/sinusitis.html Smokeless Tobacco http://www.nlm.nih.gov/medlineplus/smokelesstobacco.html

You may also choose to use the search utility provided by MEDLINEplus at the following Web address: http://www.nlm.nih.gov/medlineplus/. Simply type a keyword into the search box and click “Search.” This utility is similar to the NIH search utility, with the exception that it only includes materials that are linked within the MEDLINEplus system (mostly patient-oriented information). It also has the disadvantage of generating unstructured results. We recommend, therefore, that you use this method only if you have a very targeted search. The Combined Health Information Database (CHID) CHID Online is a reference tool that maintains a database directory of thousands of journal articles and patient education guidelines on halitosis. CHID offers summaries that describe the guidelines available, including contact information and pricing. CHID’s general Web site is http://chid.nih.gov/. To search this database, go to http://chid.nih.gov/detail/detail.html. In particular, you can use the advanced search options to look up pamphlets, reports, brochures, and information kits. The following was recently posted in this archive: •

Achieving Fresh Breath: Tips for Fighting Halitosis Source: San Bruno, CA: StayWell. 1998. [2 p.]. Contact: Available from StayWell. 1100 Grundy Lane, San Bruno, CA 94066-3030. (800) 333-3032. Fax (650) 244-4512. PRICE: $20.00 for 50 plus shipping and handling. Summary: This brochure describes halitosis (bad breath) and its causes. The brochure briefly discusses six common causes of bad breath, including bacteria and food particles, gum disease, dry mouth (xerostomia), certain foods, tobacco use, and other causes, including certain diseases. The brochure then explains how the dental care provider can

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help find a cause for bad breath and help the patient to treat the problem. The patient may be referred to another dental or medical specialist for evaluation and treatment. The brochure then lists and briefly describes strategies that readers can employ to help avoid bad breath: brush the tongue, keep a moist mouth, make dietary changes, stop smoking or chewing tobacco, and ask the dentist about prescription mouth rinses. The brochure is illustrated with simple line drawings. 13 figures. •

Battling Bad Breath Source: Chicago, IL: American Dental Association (ADA). 1999. [4 p.]. Contact: Available from American Dental Association (ADA). Catalog Sales, P.O. Box 776, St. Charles, IL 60174-0776. (800) 947-4746. Fax (888) 476-1880 or (630) 443-9970. Website: www.ada.org. PRICE: $20.00 for 50; nonmembers add 50 percent; bulk rates available. Item number W182. Summary: This brochure from the American Dental Association guides readers in strategies to fight bad breath (halitosis). The brochure reminds readers that dentists can help identify the cause of bad breath and, if it is due to an oral condition, develop a treatment plan to help eliminate it. Food that collects between teeth, around the gums, and on the tongue can leave an unpleasant odor, or attract bacteria that cause bad breath. Therefore, adequate toothbrushing and flossing can prevent bad breath. The brochure also discusses the role of certain foods, the problem of bad breath in people who are dieting, bad breath as a warning sign of periodontal (gum) disease, dry mouth (xerostomia) and related bad breath, the use of tobacco products, and systemic disease or medical disorders that can contribute to bad breath. The back cover of the brochure offers 5 tips for preventing bad breath.

•

What Do these Words Have in Common?: Gum Disease, Nicotine, Stained Teeth, Cancer, Bad Breath Source: Timonium, MD: American Lung Association of Maryland. 1993. 2 p. Contact: Available from American Lung Association of Maryland. 1840 York Road, Timonium, MD 21093. (800) 492-7527 (in Maryland) or (410) 560-2120. Also available from local American Lung Association chapters. PRICE: Single copy free. Stock Number 0606 8/93. Summary: This brochure, aimed at young adolescents, provides facts that encourage readers to avoid the use of smokeless tobacco. The brochure notes the different names used for smokeless tobacco and stresses that tobacco in any form is still tobacco, with the accompanying risks. Topics discussed include nicotine addiction, cancer, problems with bad breath, the impact of tobacco on the taste buds, and cost factors. The brochure includes a section of questions and answers on topics including: why some sports stars chew tobacco; the myth that smokeless tobacco is safer than smoking cigarettes; tobacco company ads; and legislation and warning labels on smokeless tobacco. The brochure concludes with a section of replies that young readers can use when someone offers them a chaw of tobacco. The brochure is illustrated with line drawings of young male adolescents and smokeless tobacco products.

•

Ask Your Dental Hygienist About Understanding and Eliminating Bad Breath Source: Chicago, IL: American Dental Hygienists' Association (ADHA). 2003. 1 p. Contact: Available from American Dental Hygienists' Association (ADHA). 444 North Michigan Avenue, Suite 3400, Chicago, IL 60611. (312) 440-8900. Fax (312) 467-1806. E-

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mail: [email protected]. Website: www.adha.org. PRICE: 1-24 copies at $0.75 each; bulk pricing available. Summary: This fact sheet from the American Dental Hygienists' Association (ADHA) reviews the current thinking about understanding and eliminating bad breath (halitosis or oral malodor). The author divides oral malodor into two distinctive categories: transitory and chronic, then discusses three basic causes of bad breath: an unclean mouth, medical problems, and lifestyle habits (such as smoking). Strategies for adequate oral hygiene, including tongue deplaquing, are offered. The fact sheet stresses that just as important to oral health and fresh breath as consistent home care and healthy lifestyle habits is oral health care delivered by a qualified oral health care professional. One sidebar lists ideas for keeping breath fresh, even when a toothbrush is temporarily unavailable. The fact sheet concludes with the contact information for the ADHA (www.adha.org or 800-847-6718). The NIH Search Utility The NIH search utility allows you to search for documents on over 100 selected Web sites that comprise the NIH-WEB-SPACE. Each of these servers is “crawled” and indexed on an ongoing basis. Your search will produce a list of various documents, all of which will relate in some way to halitosis. The drawbacks of this approach are that the information is not organized by theme and that the references are often a mix of information for professionals and patients. Nevertheless, a large number of the listed Web sites provide useful background information. We can only recommend this route, therefore, for relatively rare or specific disorders, or when using highly targeted searches. To use the NIH search utility, visit the following Web page: http://search.nih.gov/index.html. Additional Web Sources A number of Web sites are available to the public that often link to government sites. These can also point you in the direction of essential information. The following is a representative sample: •


•

Family Village: http://www.familyvillage.wisc.edu/specific.htm

•

Google: http://directory.google.com/Top/Health/Conditions_and_Diseases/

•

Med Help International: http://www.medhelp.org/HealthTopics/A.html

•

Open Directory Project: http://dmoz.org/Health/Conditions_and_Diseases/

•

Yahoo.com: http://dir.yahoo.com/Health/Diseases_and_Conditions/

•

WebMD®Health: http://my.webmd.com/health_topics

Finding Associations There are several Internet directories that provide lists of medical associations with information on or resources relating to halitosis. By consulting all of associations listed in

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this chapter, you will have nearly exhausted all sources for patient associations concerned with halitosis. The National Health Information Center (NHIC) The National Health Information Center (NHIC) offers a free referral service to help people find organizations that provide information about halitosis. For more information, see the NHIC’s Web site at http://www.health.gov/NHIC/ or contact an information specialist by calling 1-800-336-4797. Directory of Health Organizations The Directory of Health Organizations, provided by the National Library of Medicine Specialized Information Services, is a comprehensive source of information on associations. The Directory of Health Organizations database can be accessed via the Internet at http://www.sis.nlm.nih.gov/Dir/DirMain.html. It is composed of two parts: DIRLINE and Health Hotlines. The DIRLINE database comprises some 10,000 records of organizations, research centers, and government institutes and associations that primarily focus on health and biomedicine. To access DIRLINE directly, go to the following Web site: http://dirline.nlm.nih.gov/. Simply type in “halitosis” (or a synonym), and you will receive information on all relevant organizations listed in the database. Health Hotlines directs you to toll-free numbers to over 300 organizations. You can access this database directly at http://www.sis.nlm.nih.gov/hotlines/. On this page, you are given the option to search by keyword or by browsing the subject list. When you have received your search results, click on the name of the organization for its description and contact information. The Combined Health Information Database Another comprehensive source of information on healthcare associations is the Combined Health Information Database. Using the “Detailed Search” option, you will need to limit your search to “Organizations” and “halitosis”. Type the following hyperlink into your Web browser: http://chid.nih.gov/detail/detail.html. To find associations, use the drop boxes at the bottom of the search page where “You may refine your search by.” For publication date, select “All Years.” Then, select your preferred language and the format option “Organization Resource Sheet.” Type “halitosis” (or synonyms) into the “For these words:” box. You should check back periodically with this database since it is updated every three months. The National Organization for Rare Disorders, Inc. The National Organization for Rare Disorders, Inc. has prepared a Web site that provides, at no charge, lists of associations organized by health topic. You can access this database at the following Web site: http://www.rarediseases.org/search/orgsearch.html. Type “halitosis” (or a synonym) into the search box, and click “Submit Query.”

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APPENDIX C. FINDING MEDICAL LIBRARIES Overview In this Appendix, we show you how to quickly find a medical library in your area.

Preparation Your local public library and medical libraries have interlibrary loan programs with the National Library of Medicine (NLM), one of the largest medical collections in the world. According to the NLM, most of the literature in the general and historical collections of the National Library of Medicine is available on interlibrary loan to any library. If you would like to access NLM medical literature, then visit a library in your area that can request the publications for you.21

Finding a Local Medical Library The quickest method to locate medical libraries is to use the Internet-based directory published by the National Network of Libraries of Medicine (NN/LM). This network includes 4626 members and affiliates that provide many services to librarians, health professionals, and the public. To find a library in your area, simply visit http://nnlm.gov/members/adv.html or call 1-800-338-7657.

Medical Libraries in the U.S. and Canada In addition to the NN/LM, the National Library of Medicine (NLM) lists a number of libraries with reference facilities that are open to the public. The following is the NLM’s list and includes hyperlinks to each library’s Web site. These Web pages can provide information on hours of operation and other restrictions. The list below is a small sample of

21

Adapted from the NLM: http://www.nlm.nih.gov/psd/cas/interlibrary.html.

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libraries recommended by the National Library of Medicine (sorted alphabetically by name of the U.S. state or Canadian province where the library is located)22: •

Alabama: Health InfoNet of Jefferson County (Jefferson County Library Cooperative, Lister Hill Library of the Health Sciences), http://www.uab.edu/infonet/

•

Alabama: Richard M. Scrushy Library (American Sports Medicine Institute)

•

Arizona: Samaritan Regional Medical Center: The Learning Center (Samaritan Health System, Phoenix, Arizona), http://www.samaritan.edu/library/bannerlibs.htm

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California: Kris Kelly Health Information Center (St. Joseph Health System, Humboldt), http://www.humboldt1.com/~kkhic/index.html

•

California: Community Health Library of Los Gatos, http://www.healthlib.org/orgresources.html

•

California: Consumer Health Program and Services (CHIPS) (County of Los Angeles Public Library, Los Angeles County Harbor-UCLA Medical Center Library) - Carson, CA, http://www.colapublib.org/services/chips.html

•

California: Gateway Health Library (Sutter Gould Medical Foundation)

•

California: Health Library (Stanford University Medical Center), http://wwwmed.stanford.edu/healthlibrary/

•

California: Patient Education Resource Center - Health Information and Resources (University of California, San Francisco), http://sfghdean.ucsf.edu/barnett/PERC/default.asp

•

California: Redwood Health Library (Petaluma Health Care District), http://www.phcd.org/rdwdlib.html

•

California: Los Gatos PlaneTree Health Library, http://planetreesanjose.org/

•

California: Sutter Resource Library (Sutter Hospitals Foundation, Sacramento), http://suttermedicalcenter.org/library/

•

California: Health Sciences Libraries (University of California, Davis), http://www.lib.ucdavis.edu/healthsci/

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California: ValleyCare Health Library & Ryan Comer Cancer Resource Center (ValleyCare Health System, Pleasanton), http://gaelnet.stmarysca.edu/other.libs/gbal/east/vchl.html

•

California: Washington Community Health Resource Library (Fremont), http://www.healthlibrary.org/

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Colorado: William V. Gervasini Memorial Library (Exempla Healthcare), http://www.saintjosephdenver.org/yourhealth/libraries/

•

Connecticut: Hartford Hospital Health Science Libraries (Hartford Hospital), http://www.harthosp.org/library/

•

Connecticut: Healthnet: Connecticut Consumer Health Information Center (University of Connecticut Health Center, Lyman Maynard Stowe Library), http://library.uchc.edu/departm/hnet/

22

Abstracted from http://www.nlm.nih.gov/medlineplus/libraries.html.

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•

Connecticut: Waterbury Hospital Health Center Library (Waterbury Hospital, Waterbury), http://www.waterburyhospital.com/library/consumer.shtml

•

Delaware: Consumer Health Library (Christiana Care Health System, Eugene du Pont Preventive Medicine & Rehabilitation Institute, Wilmington), http://www.christianacare.org/health_guide/health_guide_pmri_health_info.cfm

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Delaware: Lewis B. Flinn Library (Delaware Academy of Medicine, Wilmington), http://www.delamed.org/chls.html

•

Georgia: Family Resource Library (Medical College of Georgia, Augusta), http://cmc.mcg.edu/kids_families/fam_resources/fam_res_lib/frl.htm

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Georgia: Health Resource Center (Medical Center of Central Georgia, Macon), http://www.mccg.org/hrc/hrchome.asp

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Hawaii: Hawaii Medical Library: Consumer Health Information Service (Hawaii Medical Library, Honolulu), http://hml.org/CHIS/

•

Idaho: DeArmond Consumer Health Library (Kootenai Medical Center, Coeur d’Alene), http://www.nicon.org/DeArmond/index.htm

•

Illinois: Health Learning Center of Northwestern Memorial Hospital (Chicago), http://www.nmh.org/health_info/hlc.html

•

Illinois: Medical Library (OSF Saint Francis Medical Center, Peoria), http://www.osfsaintfrancis.org/general/library/

•

Kentucky: Medical Library - Services for Patients, Families, Students & the Public (Central Baptist Hospital, Lexington), http://www.centralbap.com/education/community/library.cfm

•

Kentucky: University of Kentucky - Health Information Library (Chandler Medical Center, Lexington), http://www.mc.uky.edu/PatientEd/

•

Louisiana: Alton Ochsner Medical Foundation Library (Alton Ochsner Medical Foundation, New Orleans), http://www.ochsner.org/library/

•

Louisiana: Louisiana State University Health Sciences Center Medical LibraryShreveport, http://lib-sh.lsuhsc.edu/

•

Maine: Franklin Memorial Hospital Medical Library (Franklin Memorial Hospital, Farmington), http://www.fchn.org/fmh/lib.htm

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Maine: Gerrish-True Health Sciences Library (Central Maine Medical Center, Lewiston), http://www.cmmc.org/library/library.html

•

Maine: Hadley Parrot Health Science Library (Eastern Maine Healthcare, Bangor), http://www.emh.org/hll/hpl/guide.htm

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Maine: Maine Medical Center Library (Maine Medical Center, Portland), http://www.mmc.org/library/

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Maine: Parkview Hospital (Brunswick), http://www.parkviewhospital.org/

•

Maine: Southern Maine Medical Center Health Sciences Library (Southern Maine Medical Center, Biddeford), http://www.smmc.org/services/service.php3?choice=10

•

Maine: Stephens Memorial Hospital’s Health Information Library (Western Maine Health, Norway), http://www.wmhcc.org/Library/

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Manitoba, Canada: Consumer & Patient Health Information Service (University of Manitoba Libraries), http://www.umanitoba.ca/libraries/units/health/reference/chis.html

•

Manitoba, Canada: J.W. Crane Memorial Library (Deer Lodge Centre, Winnipeg), http://www.deerlodge.mb.ca/crane_library/about.asp

•

Maryland: Health Information Center at the Wheaton Regional Library (Montgomery County, Dept. of Public Libraries, Wheaton Regional Library), http://www.mont.lib.md.us/healthinfo/hic.asp

•

Massachusetts: Baystate Medical Center Library (Baystate Health System), http://www.baystatehealth.com/1024/

•

Massachusetts: Boston University Medical Center Alumni Medical Library (Boston University Medical Center), http://med-libwww.bu.edu/library/lib.html

•

Massachusetts: Lowell General Hospital Health Sciences Library (Lowell General Hospital, Lowell), http://www.lowellgeneral.org/library/HomePageLinks/WWW.htm

•

Massachusetts: Paul E. Woodard Health Sciences Library (New England Baptist Hospital, Boston), http://www.nebh.org/health_lib.asp

•

Massachusetts: St. Luke’s Hospital Health Sciences Library (St. Luke’s Hospital, Southcoast Health System, New Bedford), http://www.southcoast.org/library/

•

Massachusetts: Treadwell Library Consumer Health Reference Center (Massachusetts General Hospital), http://www.mgh.harvard.edu/library/chrcindex.html

•

Massachusetts: UMass HealthNet (University of Massachusetts Medical School, Worchester), http://healthnet.umassmed.edu/

•

Michigan: Botsford General Hospital Library - Consumer Health (Botsford General Hospital, Library & Internet Services), http://www.botsfordlibrary.org/consumer.htm

•

Michigan: Helen DeRoy Medical Library (Providence Hospital and Medical Centers), http://www.providence-hospital.org/library/

•

Michigan: Marquette General Hospital - Consumer Health Library (Marquette General Hospital, Health Information Center), http://www.mgh.org/center.html

•

Michigan: Patient Education Resouce Center - University of Michigan Cancer Center (University of Michigan Comprehensive Cancer Center, Ann Arbor), http://www.cancer.med.umich.edu/learn/leares.htm

•

Michigan: Sladen Library & Center for Health Information Resources - Consumer Health Information (Detroit), http://www.henryford.com/body.cfm?id=39330

•

Montana: Center for Health Information (St. Patrick Hospital and Health Sciences Center, Missoula)

•

National: Consumer Health Library Directory (Medical Library Association, Consumer and Patient Health Information Section), http://caphis.mlanet.org/directory/index.html

•

National: National Network of Libraries of Medicine (National Library of Medicine) provides library services for health professionals in the United States who do not have access to a medical library, http://nnlm.gov/

•

National: NN/LM List of Libraries Serving the Public (National Network of Libraries of Medicine), http://nnlm.gov/members/

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•

Nevada: Health Science Library, West Charleston Library (Las Vegas-Clark County Library District, Las Vegas), http://www.lvccld.org/special_collections/medical/index.htm

•

New Hampshire: Dartmouth Biomedical Libraries (Dartmouth College Library, Hanover), http://www.dartmouth.edu/~biomed/resources.htmld/conshealth.htmld/

•

New Jersey: Consumer Health Library (Rahway Hospital, Rahway), http://www.rahwayhospital.com/library.htm

•

New Jersey: Dr. Walter Phillips Health Sciences Library (Englewood Hospital and Medical Center, Englewood), http://www.englewoodhospital.com/links/index.htm

•

New Jersey: Meland Foundation (Englewood Hospital and Medical Center, Englewood), http://www.geocities.com/ResearchTriangle/9360/

•

New York: Choices in Health Information (New York Public Library) - NLM Consumer Pilot Project participant, http://www.nypl.org/branch/health/links.html

•

New York: Health Information Center (Upstate Medical University, State University of New York, Syracuse), http://www.upstate.edu/library/hic/

•

New York: Health Sciences Library (Long Island Jewish Medical Center, New Hyde Park), http://www.lij.edu/library/library.html

•

New York: ViaHealth Medical Library (Rochester General Hospital), http://www.nyam.org/library/

•

Ohio: Consumer Health Library (Akron General Medical Center, Medical & Consumer Health Library), http://www.akrongeneral.org/hwlibrary.htm

•

Oklahoma: The Health Information Center at Saint Francis Hospital (Saint Francis Health System, Tulsa), http://www.sfh-tulsa.com/services/healthinfo.asp

•

Oregon: Planetree Health Resource Center (Mid-Columbia Medical Center, The Dalles), http://www.mcmc.net/phrc/

•

Pennsylvania: Community Health Information Library (Milton S. Hershey Medical Center, Hershey), http://www.hmc.psu.edu/commhealth/

•

Pennsylvania: Community Health Resource Library (Geisinger Medical Center, Danville), http://www.geisinger.edu/education/commlib.shtml

•

Pennsylvania: HealthInfo Library (Moses Taylor Hospital, Scranton), http://www.mth.org/healthwellness.html

•

Pennsylvania: Hopwood Library (University of Pittsburgh, Health Sciences Library System, Pittsburgh), http://www.hsls.pitt.edu/guides/chi/hopwood/index_html

•

Pennsylvania: Koop Community Health Information Center (College of Physicians of Philadelphia), http://www.collphyphil.org/kooppg1.shtml

•

Pennsylvania: Learning Resources Center - Medical Library (Susquehanna Health System, Williamsport), http://www.shscares.org/services/lrc/index.asp

•

Pennsylvania: Medical Library (UPMC Health System, Pittsburgh), http://www.upmc.edu/passavant/library.htm

•

Quebec, Canada: Medical Library (Montreal General Hospital), http://www.mghlib.mcgill.ca/

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South Dakota: Rapid City Regional Hospital Medical Library (Rapid City Regional Hospital), http://www.rcrh.org/Services/Library/Default.asp

•

Texas: Houston HealthWays (Houston Academy of Medicine-Texas Medical Center Library), http://hhw.library.tmc.edu/

•

Washington: Community Health Library (Kittitas Valley Community Hospital), http://www.kvch.com/

•

Washington: Southwest Washington Medical Center Library (Southwest Washington Medical Center, Vancouver), http://www.swmedicalcenter.com/body.cfm?id=72

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ONLINE GLOSSARIES The Internet provides access to a number of free-to-use medical dictionaries. The National Library of Medicine has compiled the following list of online dictionaries: •

ADAM Medical Encyclopedia (A.D.A.M., Inc.), comprehensive medical reference: http://www.nlm.nih.gov/medlineplus/encyclopedia.html

•

MedicineNet.com Medical Dictionary (MedicineNet, Inc.): http://www.medterms.com/Script/Main/hp.asp

•

Merriam-Webster Medical Dictionary (Inteli-Health, Inc.): http://www.intelihealth.com/IH/

•

Multilingual Glossary of Technical and Popular Medical Terms in Eight European Languages (European Commission) - Danish, Dutch, English, French, German, Italian, Portuguese, and Spanish: http://allserv.rug.ac.be/~rvdstich/eugloss/welcome.html

•

On-line Medical Dictionary (CancerWEB): http://cancerweb.ncl.ac.uk/omd/

•

Rare Diseases Terms (Office of Rare Diseases): http://ord.aspensys.com/asp/diseases/diseases.asp

•

Technology Glossary (National Library of Medicine) - Health Care Technology: http://www.nlm.nih.gov/nichsr/ta101/ta10108.htm

Beyond these, MEDLINEplus contains a very patient-friendly encyclopedia covering every aspect of medicine (licensed from A.D.A.M., Inc.). The ADAM Medical Encyclopedia can be accessed at http://www.nlm.nih.gov/medlineplus/encyclopedia.html. ADAM is also available on commercial Web sites such as drkoop.com (http://www.drkoop.com/) and Web MD (http://my.webmd.com/adam/asset/adam_disease_articles/a_to_z/a). The NIH suggests the following Web sites in the ADAM Medical Encyclopedia when searching for information on halitosis: •

Basic Guidelines for Halitosis Breath odor Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003058.htm

•

Signs & Symptoms for Halitosis Breath odor Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003058.htm Halitosis Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003058.htm Mouth sores Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003059.htm Sore throat Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003053.htm

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Vomiting Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003117.htm •

Diagnostics and Tests for Halitosis EGD Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003888.htm Endoscopy Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003338.htm Throat culture Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003746.htm X-ray of the abdomen Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003815.htm X-ray of the chest Web site: http://www.nlm.nih.gov/medlineplus/ency/article/003804.htm

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Background Topics for Halitosis Acute Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002215.htm Ammonia Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002759.htm Dental hygiene Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001957.htm Fistula Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002365.htm Incidence Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002387.htm Oral hygiene Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001957.htm Ozena Web site: http://www.nlm.nih.gov/medlineplus/ency/article/001627.htm Physical examination Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002274.htm Smoking Web site: http://www.nlm.nih.gov/medlineplus/ency/article/002032.htm

Online Glossaries 93

Online Dictionary Directories The following are additional online directories compiled by the National Library of Medicine, including a number of specialized medical dictionaries: •

Medical Dictionaries: Medical & Biological (World Health Organization): http://www.who.int/hlt/virtuallibrary/English/diction.htm#Medical

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MEL-Michigan Electronic Library List of Online Health and Medical Dictionaries (Michigan Electronic Library): http://mel.lib.mi.us/health/health-dictionaries.html

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Patient Education: Glossaries (DMOZ Open Directory Project): http://dmoz.org/Health/Education/Patient_Education/Glossaries/

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Web of Online Dictionaries (Bucknell University): http://www.yourdictionary.com/diction5.html#medicine

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HALITOSIS DICTIONARY The definitions below are derived from official public sources, including the National Institutes of Health [NIH] and the European Union [EU]. Abdomen: That portion of the body that lies between the thorax and the pelvis. [NIH] Abdominal: Having to do with the abdomen, which is the part of the body between the chest and the hips that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs. [NIH] Abdominal Pain: Sensation of discomfort, distress, or agony in the abdominal region. [NIH] Abrasion: 1. The wearing away of a substance or structure (such as the skin or the teeth) through some unusual or abnormal mechanical process. 2. An area of body surface denuded of skin or mucous membrane by some unusual or abnormal mechanical process. [EU] Acantholysis: Separation of the prickle cells of the stratum spinosum of the epidermis, resulting in atrophy of the prickle cell layer. It is seen in diseases such as pemphigus vulgaris (see pemphigus) and keratosis follicularis. [NIH] Acidosis: A pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate content) in the blood and body tissues, and characterized by an increase in hydrogen ion concentration. [EU] Adverse Effect: An unwanted side effect of treatment. [NIH] Aerobic: In biochemistry, reactions that need oxygen to happen or happen when oxygen is present. [NIH] Affinity: 1. Inherent likeness or relationship. 2. A special attraction for a specific element, organ, or structure. 3. Chemical affinity; the force that binds atoms in molecules; the tendency of substances to combine by chemical reaction. 4. The strength of noncovalent chemical binding between two substances as measured by the dissociation constant of the complex. 5. In immunology, a thermodynamic expression of the strength of interaction between a single antigen-binding site and a single antigenic determinant (and thus of the stereochemical compatibility between them), most accurately applied to interactions among simple, uniform antigenic determinants such as haptens. Expressed as the association constant (K litres mole -1), which, owing to the heterogeneity of affinities in a population of antibody molecules of a given specificity, actually represents an average value (mean intrinsic association constant). 6. The reciprocal of the dissociation constant. [EU] Agar: A complex sulfated polymer of galactose units, extracted from Gelidium cartilagineum, Gracilaria confervoides, and related red algae. It is used as a gel in the preparation of solid culture media for microorganisms, as a bulk laxative, in making emulsions, and as a supporting medium for immunodiffusion and immunoelectrophoresis. [NIH]

Agonist: In anatomy, a prime mover. In pharmacology, a drug that has affinity for and stimulates physiologic activity at cell receptors normally stimulated by naturally occurring substances. [EU] Agoraphobia: Obsessive, persistent, intense fear of open places. [NIH] Algorithms: A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. [NIH] Alimentary: Pertaining to food or nutritive material, or to the organs of digestion. [EU]

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Alkaline: Having the reactions of an alkali. [EU] Alkaloid: A member of a large group of chemicals that are made by plants and have nitrogen in them. Some alkaloids have been shown to work against cancer. [NIH] Alternative medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used instead of standard treatments. Alternative medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Amino Acids: Organic compounds that generally contain an amino (-NH2) and a carboxyl (COOH) group. Twenty alpha-amino acids are the subunits which are polymerized to form proteins. [NIH] Ammonia: A colorless alkaline gas. It is formed in the body during decomposition of organic materials during a large number of metabolically important reactions. [NIH] Ammonium Compounds: Inorganic and organic compounds that contain the hypothetical radical NH4. [NIH] Anaerobic: 1. Lacking molecular oxygen. 2. Growing, living, or occurring in the absence of molecular oxygen; pertaining to an anaerobe. [EU] Analytes: A component of a test sample the presence of which has to be demonstrated. The term "analyte" includes where appropriate formed from the analyte during the analyses. [NIH]

Anatomical: Pertaining to anatomy, or to the structure of the organism. [EU] Anesthesia: A state characterized by loss of feeling or sensation. This depression of nerve function is usually the result of pharmacologic action and is induced to allow performance of surgery or other painful procedures. [NIH] Angina: Chest pain that originates in the heart. [NIH] Anions: Negatively charged atoms, radicals or groups of atoms which travel to the anode or positive pole during electrolysis. [NIH] Anomalies: Birth defects; abnormalities. [NIH] Antibacterial: A substance that destroys bacteria or suppresses their growth or reproduction. [EU] Antibiotic: A drug used to treat infections caused by bacteria and other microorganisms. [NIH]

Antibody: A type of protein made by certain white blood cells in response to a foreign substance (antigen). Each antibody can bind to only a specific antigen. The purpose of this binding is to help destroy the antigen. Antibodies can work in several ways, depending on the nature of the antigen. Some antibodies destroy antigens directly. Others make it easier for white blood cells to destroy the antigen. [NIH] Antigen: Any substance which is capable, under appropriate conditions, of inducing a specific immune response and of reacting with the products of that response, that is, with specific antibody or specifically sensitized T-lymphocytes, or both. Antigens may be soluble substances, such as toxins and foreign proteins, or particulate, such as bacteria and tissue cells; however, only the portion of the protein or polysaccharide molecule known as the antigenic determinant (q.v.) combines with antibody or a specific receptor on a lymphocyte. Abbreviated Ag. [EU]

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Anti-infective: An agent that so acts. [EU] Anti-inflammatory: Having to do with reducing inflammation. [NIH] Anti-Inflammatory Agents: Substances that reduce or suppress inflammation. [NIH] Antimicrobial: Killing microorganisms, or suppressing their multiplication or growth. [EU] Antioxidant: A substance that prevents damage caused by free radicals. Free radicals are highly reactive chemicals that often contain oxygen. They are produced when molecules are split to give products that have unpaired electrons. This process is called oxidation. [NIH] Antiseptic: A substance that inhibits the growth and development of microorganisms without necessarily killing them. [EU] Anus: The opening of the rectum to the outside of the body. [NIH] Aphthous Stomatitis: Inflammation of the mucous membrane of the mouth. [NIH] Aqueous: Having to do with water. [NIH] Arterial: Pertaining to an artery or to the arteries. [EU] Arteries: The vessels carrying blood away from the heart. [NIH] Aspirin: A drug that reduces pain, fever, inflammation, and blood clotting. Aspirin belongs to the family of drugs called nonsteroidal anti-inflammatory agents. It is also being studied in cancer prevention. [NIH] Asymptomatic: Having no signs or symptoms of disease. [NIH] Autoantibodies: Antibodies that react with self-antigens (autoantigens) of the organism that produced them. [NIH] Autodigestion: Autolysis; a condition found in disease of the stomach: the stomach wall is digested by the gastric juice. [NIH] Autoimmune disease: A condition in which the body recognizes its own tissues as foreign and directs an immune response against them. [NIH] Bacteria: Unicellular prokaryotic microorganisms which generally possess rigid cell walls, multiply by cell division, and exhibit three principal forms: round or coccal, rodlike or bacillary, and spiral or spirochetal. [NIH] Bacterial Infections: Infections by bacteria, general or unspecified. [NIH] Bactericidal: Substance lethal to bacteria; substance capable of killing bacteria. [NIH] Bactericide: An agent that destroys bacteria. [EU] Bacteriophage: A virus whose host is a bacterial cell; A virus that exclusively infects bacteria. It generally has a protein coat surrounding the genome (DNA or RNA). One of the coliphages most extensively studied is the lambda phage, which is also one of the most important. [NIH] Bacteriostatic: 1. Inhibiting the growth or multiplication of bacteria. 2. An agent that inhibits the growth or multiplication of bacteria. [EU] Bacterium: Microscopic organism which may have a spherical, rod-like, or spiral unicellular or non-cellular body. Bacteria usually reproduce through asexual processes. [NIH] Basal cells: Small, round cells found in the lower part (or base) of the epidermis, the outer layer of the skin. [NIH] Base: In chemistry, the nonacid part of a salt; a substance that combines with acids to form salts; a substance that dissociates to give hydroxide ions in aqueous solutions; a substance whose molecule or ion can combine with a proton (hydrogen ion); a substance capable of donating a pair of electrons (to an acid) for the formation of a coordinate covalent bond. [EU]

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Benign: Not cancerous; does not invade nearby tissue or spread to other parts of the body. [NIH]

Benign tumor: A noncancerous growth that does not invade nearby tissue or spread to other parts of the body. [NIH] Bile: An emulsifying agent produced in the liver and secreted into the duodenum. Its composition includes bile acids and salts, cholesterol, and electrolytes. It aids digestion of fats in the duodenum. [NIH] Biliary: Having to do with the liver, bile ducts, and/or gallbladder. [NIH] Biliary Tract: The gallbladder and its ducts. [NIH] Biochemical: Relating to biochemistry; characterized by, produced by, or involving chemical reactions in living organisms. [EU] Biological therapy: Treatment to stimulate or restore the ability of the immune system to fight infection and disease. Also used to lessen side effects that may be caused by some cancer treatments. Also known as immunotherapy, biotherapy, or biological response modifier (BRM) therapy. [NIH] Biotechnology: Body of knowledge related to the use of organisms, cells or cell-derived constituents for the purpose of developing products which are technically, scientifically and clinically useful. Alteration of biologic function at the molecular level (i.e., genetic engineering) is a central focus; laboratory methods used include transfection and cloning technologies, sequence and structure analysis algorithms, computer databases, and gene and protein structure function analysis and prediction. [NIH] Bismuth: A metallic element that has the atomic symbol Bi, atomic number 83 and atomic weight 208.98. [NIH] Blister: Visible accumulations of fluid within or beneath the epidermis. [NIH] Bloating: Fullness or swelling in the abdomen that often occurs after meals. [NIH] Blood Coagulation: The process of the interaction of blood coagulation factors that results in an insoluble fibrin clot. [NIH] Blood pressure: The pressure of blood against the walls of a blood vessel or heart chamber. Unless there is reference to another location, such as the pulmonary artery or one of the heart chambers, it refers to the pressure in the systemic arteries, as measured, for example, in the forearm. [NIH] Body Fluids: Liquid components of living organisms. [NIH] Body Image: Individuals' personal concept of their bodies as objects in and bound by space, independently and apart from all other objects. [NIH] Bowel: The long tube-shaped organ in the abdomen that completes the process of digestion. There is both a small and a large bowel. Also called the intestine. [NIH] Bowel Movement: Body wastes passed through the rectum and anus. [NIH] Branch: Most commonly used for branches of nerves, but applied also to other structures. [NIH]

Breakdown: A physical, metal, or nervous collapse. [NIH] Breeding: The science or art of changing the constitution of a population of plants or animals through sexual reproduction. [NIH] Buccal: Pertaining to or directed toward the cheek. In dental anatomy, used to refer to the buccal surface of a tooth. [EU] Bullous: Pertaining to or characterized by bullae. [EU]

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Calcium: A basic element found in nearly all organized tissues. It is a member of the alkaline earth family of metals with the atomic symbol Ca, atomic number 20, and atomic weight 40. Calcium is the most abundant mineral in the body and combines with phosphorus to form calcium phosphate in the bones and teeth. It is essential for the normal functioning of nerves and muscles and plays a role in blood coagulation (as factor IV) and in many enzymatic processes. [NIH] Calcium Carbonate: Carbonic acid calcium salt (CaCO3). An odorless, tasteless powder or crystal that occurs in nature. It is used therapeutically as a phosphate buffer in hemodialysis patients and as a calcium supplement. [NIH] Calcium Hydroxide: Ca(OH)2. A white powder that has many therapeutic uses. Because of its ability to stimulate mineralization, it is found in many dental formulations. [NIH] Capsules: Hard or soft soluble containers used for the oral administration of medicine. [NIH] Carbohydrate: An aldehyde or ketone derivative of a polyhydric alcohol, particularly of the pentahydric and hexahydric alcohols. They are so named because the hydrogen and oxygen are usually in the proportion to form water, (CH2O)n. The most important carbohydrates are the starches, sugars, celluloses, and gums. They are classified into mono-, di-, tri-, polyand heterosaccharides. [EU] Carcinogenic: Producing carcinoma. [EU] Carcinoma: Cancer that begins in the skin or in tissues that line or cover internal organs. [NIH]

Case report: A detailed report of the diagnosis, treatment, and follow-up of an individual patient. Case reports also contain some demographic information about the patient (for example, age, gender, ethnic origin). [NIH] Case series: A group or series of case reports involving patients who were given similar treatment. Reports of case series usually contain detailed information about the individual patients. This includes demographic information (for example, age, gender, ethnic origin) and information on diagnosis, treatment, response to treatment, and follow-up after treatment. [NIH] Cathode: An electrode, usually an incandescent filament of tungsten, which emits electrons in an X-ray tube. [NIH] Cations: Postively charged atoms, radicals or groups of atoms which travel to the cathode or negative pole during electrolysis. [NIH] Caudal: Denoting a position more toward the cauda, or tail, than some specified point of reference; same as inferior, in human anatomy. [EU] Cecum: The beginning of the large intestine. The cecum is connected to the lower part of the small intestine, called the ileum. [NIH] Celiac Disease: A disease characterized by intestinal malabsorption and precipitated by gluten-containing foods. The intestinal mucosa shows loss of villous structure. [NIH] Cell: The individual unit that makes up all of the tissues of the body. All living things are made up of one or more cells. [NIH] Cell Division: The fission of a cell. [NIH] Cell Survival: The span of viability of a cell characterized by the capacity to perform certain functions such as metabolism, growth, reproduction, some form of responsiveness, and adaptability. [NIH] Cellobiose: A disaccharide consisting of two glucose units in beta (1-4) glycosidic linkage. Obtained from the partial hydrolysis of cellulose. [NIH]

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Cellulose: A polysaccharide with glucose units linked as in cellobiose. It is the chief constituent of plant fibers, cotton being the purest natural form of the substance. As a raw material, it forms the basis for many derivatives used in chromatography, ion exchange materials, explosives manufacturing, and pharmaceutical preparations. [NIH] Cerebral: Of or pertaining of the cerebrum or the brain. [EU] Cerebral Palsy: Refers to a motor disability caused by a brain dysfunction. [NIH] Cervical: Relating to the neck, or to the neck of any organ or structure. Cervical lymph nodes are located in the neck; cervical cancer refers to cancer of the uterine cervix, which is the lower, narrow end (the "neck") of the uterus. [NIH] Cervix: The lower, narrow end of the uterus that forms a canal between the uterus and vagina. [NIH] Cetylpyridinium: Cationic bactericidal surfactant used as a topical antiseptic for skin, wounds, mucous membranes, instruments, etc.; and also as a component in mouthwash and lozenges. [NIH] Character: In current usage, approximately equivalent to personality. The sum of the relatively fixed personality traits and habitual modes of response of an individual. [NIH] Cheilitis: Inflammation of the lips. It is of various etiologies and degrees of pathology. [NIH] Chlorhexidine: Disinfectant and topical anti-infective agent used also as mouthwash to prevent oral plaque. [NIH] Chlorine: A greenish-yellow, diatomic gas that is a member of the halogen family of elements. It has the atomic symbol Cl, atomic number 17, and atomic weight 70.906. It is a powerful irritant that can cause fatal pulmonary edema. Chlorine is used in manufacturing, as a reagent in synthetic chemistry, for water purification, and in the production of chlorinated lime, which is used in fabric bleaching. [NIH] Chlorophyll: Porphyrin derivatives containing magnesium that act to convert light energy in photosynthetic organisms. [NIH] Cholinergic: Resembling acetylcholine in pharmacological action; stimulated by or releasing acetylcholine or a related compound. [EU] Chorda Tympani Nerve: A branch of the facial (7th cranial) nerve which passes through the middle ear and continues through the petrotympanic fissure. The chorda tympani nerve carries taste sensation from the anterior two-thirds of the tongue and conveys parasympathetic efferents to the salivary glands. [NIH] Chromosome: Part of a cell that contains genetic information. Except for sperm and eggs, all human cells contain 46 chromosomes. [NIH] Chronic: A disease or condition that persists or progresses over a long period of time. [NIH] Chronic Fatigue Syndrome: Fatigue caused by the combined effects of different types of prolonged fatigue. [NIH] Cimetidine: A histamine congener, it competitively inhibits histamine binding to H2 receptors. Cimetidine has a range of pharmacological actions. It inhibits gastric acid secretion, as well as pepsin and gastrin output. It also blocks the activity of cytochrome P450. [NIH] Clinical study: A research study in which patients receive treatment in a clinic or other medical facility. Reports of clinical studies can contain results for single patients (case reports) or many patients (case series or clinical trials). [NIH] Clinical trial: A research study that tests how well new medical treatments or other interventions work in people. Each study is designed to test new methods of screening,

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prevention, diagnosis, or treatment of a disease. [NIH] Cloning: The production of a number of genetically identical individuals; in genetic engineering, a process for the efficient replication of a great number of identical DNA molecules. [NIH] Cochlear: Of or pertaining to the cochlea. [EU] Cochlear Diseases: Diseases of the cochlea, the part of the inner ear that is concerned with hearing. [NIH] Cofactor: A substance, microorganism or environmental factor that activates or enhances the action of another entity such as a disease-causing agent. [NIH] Colitis: Inflammation of the colon. [NIH] Colloidal: Of the nature of a colloid. [EU] Complement: A term originally used to refer to the heat-labile factor in serum that causes immune cytolysis, the lysis of antibody-coated cells, and now referring to the entire functionally related system comprising at least 20 distinct serum proteins that is the effector not only of immune cytolysis but also of other biologic functions. Complement activation occurs by two different sequences, the classic and alternative pathways. The proteins of the classic pathway are termed 'components of complement' and are designated by the symbols C1 through C9. C1 is a calcium-dependent complex of three distinct proteins C1q, C1r and C1s. The proteins of the alternative pathway (collectively referred to as the properdin system) and complement regulatory proteins are known by semisystematic or trivial names. Fragments resulting from proteolytic cleavage of complement proteins are designated with lower-case letter suffixes, e.g., C3a. Inactivated fragments may be designated with the suffix 'i', e.g. C3bi. Activated components or complexes with biological activity are designated by a bar over the symbol e.g. C1 or C4b,2a. The classic pathway is activated by the binding of C1 to classic pathway activators, primarily antigen-antibody complexes containing IgM, IgG1, IgG3; C1q binds to a single IgM molecule or two adjacent IgG molecules. The alternative pathway can be activated by IgA immune complexes and also by nonimmunologic materials including bacterial endotoxins, microbial polysaccharides, and cell walls. Activation of the classic pathway triggers an enzymatic cascade involving C1, C4, C2 and C3; activation of the alternative pathway triggers a cascade involving C3 and factors B, D and P. Both result in the cleavage of C5 and the formation of the membrane attack complex. Complement activation also results in the formation of many biologically active complement fragments that act as anaphylatoxins, opsonins, or chemotactic factors. [EU] Complementary and alternative medicine: CAM. Forms of treatment that are used in addition to (complementary) or instead of (alternative) standard treatments. These practices are not considered standard medical approaches. CAM includes dietary supplements, megadose vitamins, herbal preparations, special teas, massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Complementary medicine: Practices not generally recognized by the medical community as standard or conventional medical approaches and used to enhance or complement the standard treatments. Complementary medicine includes the taking of dietary supplements, megadose vitamins, and herbal preparations; the drinking of special teas; and practices such as massage therapy, magnet therapy, spiritual healing, and meditation. [NIH] Computational Biology: A field of biology concerned with the development of techniques for the collection and manipulation of biological data, and the use of such data to make biological discoveries or predictions. This field encompasses all computational methods and theories applicable to molecular biology and areas of computer-based techniques for solving biological problems including manipulation of models and datasets. [NIH]

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Confusion: A mental state characterized by bewilderment, emotional disturbance, lack of clear thinking, and perceptual disorientation. [NIH] Congestion: Excessive or abnormal accumulation of blood in a part. [EU] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue: Tissue that supports and binds other tissues. It consists of connective tissue cells embedded in a large amount of extracellular matrix. [NIH] Connective Tissue Cells: A group of cells that includes fibroblasts, cartilage cells, adipocytes, smooth muscle cells, and bone cells. [NIH] Constipation: Infrequent or difficult evacuation of feces. [NIH] Consumption: Pulmonary tuberculosis. [NIH] Contamination: The soiling or pollution by inferior material, as by the introduction of organisms into a wound, or sewage into a stream. [EU] Contraindications: Any factor or sign that it is unwise to pursue a certain kind of action or treatment, e. g. giving a general anesthetic to a person with pneumonia. [NIH] Controlled study: An experiment or clinical trial that includes a comparison (control) group. [NIH]

Corneum: The superficial layer of the epidermis containing keratinized cells. [NIH] Coronary: Encircling in the manner of a crown; a term applied to vessels; nerves, ligaments, etc. The term usually denotes the arteries that supply the heart muscle and, by extension, a pathologic involvement of them. [EU] Coronary Thrombosis: Presence of a thrombus in a coronary artery, often causing a myocardial infarction. [NIH] Craniocerebral Trauma: Traumatic injuries involving the cranium and intracranial structures (i.e., brain; cranial nerves; meninges; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage. [NIH] Crowns: A prosthetic restoration that reproduces the entire surface anatomy of the visible natural crown of a tooth. It may be partial (covering three or more surfaces of a tooth) or complete (covering all surfaces). It is made of gold or other metal, porcelain, or resin. [NIH] Curative: Tending to overcome disease and promote recovery. [EU] Cysteine: A thiol-containing non-essential amino acid that is oxidized to form cystine. [NIH] Cystine: A covalently linked dimeric nonessential amino acid formed by the oxidation of cysteine. Two molecules of cysteine are joined together by a disulfide bridge to form cystine. [NIH]

Cytochrome: Any electron transfer hemoprotein having a mode of action in which the transfer of a single electron is effected by a reversible valence change of the central iron atom of the heme prosthetic group between the +2 and +3 oxidation states; classified as cytochromes a in which the heme contains a formyl side chain, cytochromes b, which contain protoheme or a closely similar heme that is not covalently bound to the protein, cytochromes c in which protoheme or other heme is covalently bound to the protein, and cytochromes d in which the iron-tetrapyrrole has fewer conjugated double bonds than the hemes have. Well-known cytochromes have been numbered consecutively within groups and are designated by subscripts (beginning with no subscript), e.g. cytochromes c, c1, C2, . New cytochromes are named according to the wavelength in nanometres of the absorption maximum of the a-band of the iron (II) form in pyridine, e.g., c-555. [EU]

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Databases, Bibliographic: Extensive collections, reputedly complete, of references and citations to books, articles, publications, etc., generally on a single subject or specialized subject area. Databases can operate through automated files, libraries, or computer disks. The concept should be differentiated from factual databases which is used for collections of data and facts apart from bibliographic references to them. [NIH] Dehydration: The condition that results from excessive loss of body water. [NIH] Dental Abutments: Natural teeth or teeth roots used as anchorage for a fixed or removable denture or other prosthesis (such as an implant) serving the same purpose. [NIH] Dental Care: The total of dental diagnostic, preventive, and restorative services provided to meet the needs of a patient (from Illustrated Dictionary of Dentistry, 1982). [NIH] Dental Caries: Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. The three most prominent theories used to explain the etiology of the disase are that acids produced by bacteria lead to decalcification; that micro-organisms destroy the enamel protein; or that keratolytic micro-organisms produce chelates that lead to decalcification. [NIH]

Dental Hygienists: Persons trained in an accredited school or dental college and licensed by the state in which they reside to provide dental prophylaxis under the direction of a licensed dentist. [NIH] Dental Plaque: A film that attaches to teeth, often causing dental caries and gingivitis. It is composed of mucins, secreted from salivary glands, and microorganisms. [NIH] Dentifrices: Any preparations used for cleansing teeth; they usually contain an abrasive, detergent, binder and flavoring agent and may exist in the form of liquid, paste or powder; may also contain medicaments and caries preventives. [NIH] Dentists: Individuals licensed to practice dentistry. [NIH] Dentures: An appliance used as an artificial or prosthetic replacement for missing teeth and adjacent tissues. It does not include crowns, dental abutments, nor artificial teeth. [NIH] Dermal: Pertaining to or coming from the skin. [NIH] Dermatitis: Any inflammation of the skin. [NIH] Dermatitis Herpetiformis: Rare, chronic, papulo-vesicular disease characterized by an intensely pruritic eruption consisting of various combinations of symmetrical, erythematous, papular, vesicular, or bullous lesions. The disease is strongly associated with the presence of HLA-B8 and HLA-DR3 antigens. A variety of different autoantibodies has been detected in small numbers in patients with dermatitis herpetiformis. [NIH] Detergents: Purifying or cleansing agents, usually salts of long-chain aliphatic bases or acids, that exert cleansing (oil-dissolving) and antimicrobial effects through a surface action that depends on possessing both hydrophilic and hydrophobic properties. [NIH] Deuterium: Deuterium. The stable isotope of hydrogen. It has one neutron and one proton in the nucleus. [NIH] Diabetic Ketoacidosis: Complication of diabetes resulting from severe insulin deficiency coupled with an absolute or relative increase in glucagon concentration. The metabolic acidosis is caused by the breakdown of adipose stores and resulting increased levels of free fatty acids. Glucagon accelerates the oxidation of the free fatty acids producing excess ketone bodies (ketosis). [NIH] Diagnostic procedure: A method used to identify a disease. [NIH]

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Diaper Rash: A type of irritant dermatitis localized to the area in contact with a diaper and occurring most often as a reaction to prolonged contact with urine, feces, or retained soap or detergent. [NIH] Diarrhea: Passage of excessively liquid or excessively frequent stools. [NIH] Digestion: The process of breakdown of food for metabolism and use by the body. [NIH] Digestive tract: The organs through which food passes when food is eaten. These organs are the mouth, esophagus, stomach, small and large intestines, and rectum. [NIH] Dimethyl: A volatile metabolite of the amino acid methionine. [NIH] Direct: 1. Straight; in a straight line. 2. Performed immediately and without the intervention of subsidiary means. [EU] Dissociation: 1. The act of separating or state of being separated. 2. The separation of a molecule into two or more fragments (atoms, molecules, ions, or free radicals) produced by the absorption of light or thermal energy or by solvation. 3. In psychology, a defense mechanism in which a group of mental processes are segregated from the rest of a person's mental activity in order to avoid emotional distress, as in the dissociative disorders (q.v.), or in which an idea or object is segregated from its emotional significance; in the first sense it is roughly equivalent to splitting, in the second, to isolation. 4. A defect of mental integration in which one or more groups of mental processes become separated off from normal consciousness and, thus separated, function as a unitary whole. [EU] Disulphides: A covalent bridge formed by the oxidation of two cysteine residues to a cystine residue. The-S-S-bond is very strong and its presence confers additional stability. [NIH]

Diuretic: A drug that increases the production of urine. [NIH] Dorsal: 1. Pertaining to the back or to any dorsum. 2. Denoting a position more toward the back surface than some other object of reference; same as posterior in human anatomy; superior in the anatomy of quadrupeds. [EU] Dorsum: A plate of bone which forms the posterior boundary of the sella turcica. [NIH] Dosage Forms: Completed forms of the pharmaceutical preparation in which prescribed doses of medication are included. They are designed to resist action by gastric fluids, prevent vomiting and nausea, reduce or alleviate the undesirable taste and smells associated with oral administration, achieve a high concentration of drug at target site, or produce a delayed or long-acting drug effect. They include capsules, liniments, ointments, pharmaceutical solutions, powders, tablets, etc. [NIH] Drug Interactions: The action of a drug that may affect the activity, metabolism, or toxicity of another drug. [NIH] Duct: A tube through which body fluids pass. [NIH] Duodenal Ulcer: An ulcer in the lining of the first part of the small intestine (duodenum). [NIH]

Duodenum: The first part of the small intestine. [NIH] Dysphagia: Difficulty in swallowing. [EU] Edema: Excessive amount of watery fluid accumulated in the intercellular spaces, most commonly present in subcutaneous tissue. [NIH] Effector: It is often an enzyme that converts an inactive precursor molecule into an active second messenger. [NIH] Efficacy: The extent to which a specific intervention, procedure, regimen, or service produces a beneficial result under ideal conditions. Ideally, the determination of efficacy is

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based on the results of a randomized control trial. [NIH] Electrolysis: Destruction by passage of a galvanic electric current, as in disintegration of a chemical compound in solution. [NIH] Electrolyte: A substance that dissociates into ions when fused or in solution, and thus becomes capable of conducting electricity; an ionic solute. [EU] Electrons: Stable elementary particles having the smallest known negative charge, present in all elements; also called negatrons. Positively charged electrons are called positrons. The numbers, energies and arrangement of electrons around atomic nuclei determine the chemical identities of elements. Beams of electrons are called cathode rays or beta rays, the latter being a high-energy biproduct of nuclear decay. [NIH] Emollient: Softening or soothing; called also malactic. [EU] Enamel: A very hard whitish substance which covers the dentine of the anatomical crown of a tooth. [NIH] Endodontics: A dental specialty concerned with the maintenance of the dental pulp in a state of health and the treatment of the pulp cavity (pulp chamber and pulp canal). [NIH] Enteric bacteria: Single-celled microorganisms that lack chlorophyll. Some bacteria are capable of causing human, animal, or plant diseases; others are essential in pollution control because they break down organic matter in the air and in the water. [NIH] Enteritis: Inflammation of the intestine, applied chiefly to inflammation of the small intestine; see also enterocolitis. [EU] Environmental Health: The science of controlling or modifying those conditions, influences, or forces surrounding man which relate to promoting, establishing, and maintaining health. [NIH]

Enzymatic: Phase where enzyme cuts the precursor protein. [NIH] Enzyme: A protein that speeds up chemical reactions in the body. [NIH] Eosinophilia: Abnormal increase in eosinophils in the blood, tissues or organs. [NIH] Epidermal: Pertaining to or resembling epidermis. Called also epidermic or epidermoid. [EU] Epidermis: Nonvascular layer of the skin. It is made up, from within outward, of five layers: 1) basal layer (stratum basale epidermidis); 2) spinous layer (stratum spinosum epidermidis); 3) granular layer (stratum granulosum epidermidis); 4) clear layer (stratum lucidum epidermidis); and 5) horny layer (stratum corneum epidermidis). [NIH] Epigastric: Having to do with the upper middle area of the abdomen. [NIH] Epithelial: Refers to the cells that line the internal and external surfaces of the body. [NIH] Epithelial Cells: Cells that line the inner and outer surfaces of the body. [NIH] Epithelium: One or more layers of epithelial cells, supported by the basal lamina, which covers the inner or outer surfaces of the body. [NIH] Erythema: Redness of the skin produced by congestion of the capillaries. This condition may result from a variety of causes. [NIH] Erythema Multiforme: A skin and mucous membrane disease characterized by an eruption of macules, papules, nodules, vesicles, and/or bullae with characteristic "bull's-eye" lesions usually occurring on the dorsal aspect of the hands and forearms. [NIH] Esophageal: Having to do with the esophagus, the muscular tube through which food passes from the throat to the stomach. [NIH] Esophagitis: Inflammation, acute or chronic, of the esophagus caused by bacteria, chemicals, or trauma. [NIH]

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Esophagus: The muscular tube through which food passes from the throat to the stomach. [NIH]

Ether: One of a class of organic compounds in which any two organic radicals are attached directly to a single oxygen atom. [NIH] Evacuation: An emptying, as of the bowels. [EU] Excipients: Usually inert substances added to a prescription in order to provide suitable consistency to the dosage form; a binder, matrix, base or diluent in pills, tablets, creams, salves, etc. [NIH] Exfoliation: A falling off in scales or layers. [EU] Exocrine: Secreting outwardly, via a duct. [EU] Exogenous: Developed or originating outside the organism, as exogenous disease. [EU] Extracellular: Outside a cell or cells. [EU] Extracellular Matrix: A meshwork-like substance found within the extracellular space and in association with the basement membrane of the cell surface. It promotes cellular proliferation and provides a supporting structure to which cells or cell lysates in culture dishes adhere. [NIH] Facial: Of or pertaining to the face. [EU] Facial Nerve: The 7th cranial nerve. The facial nerve has two parts, the larger motor root which may be called the facial nerve proper, and the smaller intermediate or sensory root. Together they provide efferent innervation to the muscles of facial expression and to the lacrimal and salivary glands, and convey afferent information for taste from the anterior two-thirds of the tongue and for touch from the external ear. [NIH] Familial polyposis: An inherited condition in which numerous polyps (tissue masses) develop on the inside walls of the colon and rectum. It increases the risk for colon cancer. [NIH]

Family Planning: Programs or services designed to assist the family in controlling reproduction by either improving or diminishing fertility. [NIH] Fasciitis: Inflammation of the fascia. There are three major types: 1) Eosinophilic fasciitis, an inflammatory reaction with eosinophilia, producing hard thickened skin with an orangepeel configuration suggestive of scleroderma and considered by some a variant of scleroderma; 2) Necrotizing fasciitis, a serious fulminating infection (usually by a beta hemolytic Streptococcus) causing extensive necrosis of superficial fascia; 3) Nodular/Pseudosarcomatous/Proliferative fasciitis, characterized by a rapid growth of fibroblasts with mononuclear inflammatory cells and proliferating capillaries in soft tissue, often the forearm; it is not malignant but is sometimes mistaken for fibrosarcoma. [NIH] Fat: Total lipids including phospholipids. [NIH] Fatigue: The state of weariness following a period of exertion, mental or physical, characterized by a decreased capacity for work and reduced efficiency to respond to stimuli. [NIH]

Fatty acids: A major component of fats that are used by the body for energy and tissue development. [NIH] Feces: The excrement discharged from the intestines, consisting of bacteria, cells exfoliated from the intestines, secretions, chiefly of the liver, and a small amount of food residue. [EU] Fibroblasts: Connective tissue cells which secrete an extracellular matrix rich in collagen and other macromolecules. [NIH] Fibroma: A benign tumor of fibrous or fully developed connective tissue. [NIH]

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Fibrosarcoma: A type of soft tissue sarcoma that begins in fibrous tissue, which holds bones, muscles, and other organs in place. [NIH] Filler: An inactive substance used to make a product bigger or easier to handle. For example, fillers are often used to make pills or capsules because the amount of active drug is too small to be handled conveniently. [NIH] Flame Ionization: Pyrolysis of organic compounds at the temperature of a hydrogen-air flame to produce ionic intermediates which can be collected and the resulting ion current measured by gas chromatography. [NIH] Flatus: Gas passed through the rectum. [NIH] Flavoring Agents: Substances added to foods and medicine to improve the quality of taste. [NIH]

Forearm: The part between the elbow and the wrist. [NIH] Fungi: A kingdom of eukaryotic, heterotrophic organisms that live as saprobes or parasites, including mushrooms, yeasts, smuts, molds, etc. They reproduce either sexually or asexually, and have life cycles that range from simple to complex. Filamentous fungi refer to those that grow as multicelluar colonies (mushrooms and molds). [NIH] Fungistatic: Inhibiting the growth of fungi. [EU] Gallbladder: The pear-shaped organ that sits below the liver. Bile is concentrated and stored in the gallbladder. [NIH] Gas: Air that comes from normal breakdown of food. The gases are passed out of the body through the rectum (flatus) or the mouth (burp). [NIH] Gastric: Having to do with the stomach. [NIH] Gastric Acid: Hydrochloric acid present in gastric juice. [NIH] Gastric Juices: Liquids produced in the stomach to help break down food and kill bacteria. [NIH]

Gastric Mucosa: Surface epithelium in the stomach that invaginates into the lamina propria, forming gastric pits. Tubular glands, characteristic of each region of the stomach (cardiac, gastric, and pyloric), empty into the gastric pits. The gastric mucosa is made up of several different kinds of cells. [NIH] Gastric Outlet Obstruction: The hindering of output from the stomach to the small intestine. The source varies: peptic ulcer, foreign bodies, aging, neoplasms, etc. [NIH] Gastrin: A hormone released after eating. Gastrin causes the stomach to produce more acid. [NIH]

Gastritis: Inflammation of the stomach. [EU] Gastrointestinal: Refers to the stomach and intestines. [NIH] Gastrointestinal tract: The stomach and intestines. [NIH] Gelatin: A product formed from skin, white connective tissue, or bone collagen. It is used as a protein food adjuvant, plasma substitute, hemostatic, suspending agent in pharmaceutical preparations, and in the manufacturing of capsules and suppositories. [NIH] Gels: Colloids with a solid continuous phase and liquid as the dispersed phase; gels may be unstable when, due to temperature or other cause, the solid phase liquifies; the resulting colloid is called a sol. [NIH] Gene: The functional and physical unit of heredity passed from parent to offspring. Genes are pieces of DNA, and most genes contain the information for making a specific protein. [NIH]

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General practitioner: A medical practitioner who does not specialize in a particular branch of medicine or limit his practice to a specific class of diseases. [NIH] Gingival Hyperplasia: A pathological increase in the depth of the gingival crevice surrounding a tooth at the gum margin. [NIH] Gland: An organ that produces and releases one or more substances for use in the body. Some glands produce fluids that affect tissues or organs. Others produce hormones or participate in blood production. [NIH] Glossitis: Inflammation of the tongue. [NIH] Glossopharyngeal Nerve: The 9th cranial nerve. The glossopharyngeal nerve is a mixed motor and sensory nerve; it conveys somatic and autonomic efferents as well as general, special, and visceral afferents. Among the connections are motor fibers to the stylopharyngeus muscle, parasympathetic fibers to the parotid glands, general and taste afferents from the posterior third of the tongue, the nasopharynx, and the palate, and afferents from baroreceptors and chemoreceptors of the carotid sinus. [NIH] Glucose: D-Glucose. A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. [NIH] Glucuronic Acid: Derivatives of uronic acid found throughout the plant and animal kingdoms. They detoxify drugs and toxins by conjugating with them to form glucuronides in the liver which are more water-soluble metabolites that can be easily eliminated from the body. [NIH] Glucuronides: Glycosides of glucuronic acid formed by the reaction of uridine diphosphate glucuronic acid with certain endogenous and exogenous substances. Their formation is important for the detoxification of drugs, steroid excretion and bilirubin metabolism to a more water-soluble compound that can be eliminated in the urine and bile. [NIH] Gluten: The protein of wheat and other grains which gives to the dough its tough elastic character. [EU] Glycine: A non-essential amino acid. It is found primarily in gelatin and silk fibroin and used therapeutically as a nutrient. It is also a fast inhibitory neurotransmitter. [NIH] Governing Board: The group in which legal authority is vested for the control of healthrelated institutions and organizations. [NIH] Graft: Healthy skin, bone, or other tissue taken from one part of the body and used to replace diseased or injured tissue removed from another part of the body. [NIH] Granuloma: A relatively small nodular inflammatory lesion containing grouped mononuclear phagocytes, caused by infectious and noninfectious agents. [NIH] Grasses: A large family, Gramineae, of narrow-leaved herbaceous monocots. Many grasses produce highly allergenic pollens and are hosts to cattle parasites and toxic fungi. [NIH] Growth: The progressive development of a living being or part of an organism from its earliest stage to maturity. [NIH] Growth factors: Substances made by the body that function to regulate cell division and cell survival. Some growth factors are also produced in the laboratory and used in biological therapy. [NIH] Hair follicles: Shafts or openings on the surface of the skin through which hair grows. [NIH] Halitosis: An offensive, foul breath odor resulting from a variety of causes such as poor oral hygiene, dental or oral infections, or the ingestion of certain foods. [NIH] Handicap: A handicap occurs as a result of disability, but disability does not always

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constitute a handicap. A handicap may be said to exist when a disability causes a substantial and continuing reduction in a person's capacity to function socially and vocationally. [NIH] Haptens: Small antigenic determinants capable of eliciting an immune response only when coupled to a carrier. Haptens bind to antibodies but by themselves cannot elicit an antibody response. [NIH] Hemodialysis: The use of a machine to clean wastes from the blood after the kidneys have failed. The blood travels through tubes to a dialyzer, which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body. [NIH] Hemolytic: A disease that affects the blood and blood vessels. It destroys red blood cells, cells that cause the blood to clot, and the lining of blood vessels. HUS is often caused by the Escherichia coli bacterium in contaminated food. People with HUS may develop acute renal failure. [NIH] Hemorrhage: Bleeding or escape of blood from a vessel. [NIH] Hepatic: Refers to the liver. [NIH] Herbicides: Pesticides used to destroy unwanted vegetation, especially various types of weeds, grasses, and woody plants. [NIH] Heterogeneity: The property of one or more samples or populations which implies that they are not identical in respect of some or all of their parameters, e. g. heterogeneity of variance. [NIH]

Histamine: 1H-Imidazole-4-ethanamine. A depressor amine derived by enzymatic decarboxylation of histidine. It is a powerful stimulant of gastric secretion, a constrictor of bronchial smooth muscle, a vasodilator, and also a centrally acting neurotransmitter. [NIH] Histology: The study of tissues and cells under a microscope. [NIH] Homeostasis: The processes whereby the internal environment of an organism tends to remain balanced and stable. [NIH] Hormones: Chemical substances having a specific regulatory effect on the activity of a certain organ or organs. The term was originally applied to substances secreted by various endocrine glands and transported in the bloodstream to the target organs. It is sometimes extended to include those substances that are not produced by the endocrine glands but that have similar effects. [NIH] Horny layer: The superficial layer of the epidermis containing keratinized cells. [NIH] Host: Any animal that receives a transplanted graft. [NIH] Hydrocephalus: Excessive accumulation of cerebrospinal fluid within the cranium which may be associated with dilation of cerebral ventricles, intracranial hypertension; headache; lethargy; urinary incontinence; and ataxia (and in infants macrocephaly). This condition may be caused by obstruction of cerebrospinal fluid pathways due to neurologic abnormalities, intracranial hemorrhages; central nervous system infections; brain neoplasms; craniocerebral trauma; and other conditions. Impaired resorption of cerebrospinal fluid from the arachnoid villi results in a communicating form of hydrocephalus. Hydrocephalus ex-vacuo refers to ventricular dilation that occurs as a result of brain substance loss from cerebral infarction and other conditions. [NIH] Hydrogen: The first chemical element in the periodic table. It has the atomic symbol H, atomic number 1, and atomic weight 1. It exists, under normal conditions, as a colorless, odorless, tasteless, diatomic gas. Hydrogen ions are protons. Besides the common H1 isotope, hydrogen exists as the stable isotope deuterium and the unstable, radioactive isotope tritium. [NIH] Hydrogen Peroxide: A strong oxidizing agent used in aqueous solution as a ripening agent,

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bleach, and topical anti-infective. It is relatively unstable and solutions deteriorate over time unless stabilized by the addition of acetanilide or similar organic materials. [NIH] Hydrophilic: Readily absorbing moisture; hygroscopic; having strongly polar groups that readily interact with water. [EU] Hydrophobic: Not readily absorbing water, or being adversely affected by water, as a hydrophobic colloid. [EU] Hygienic: Pertaining to hygiene, or conducive to health. [EU] Hyperlipidaemia: A general term for elevated concentrations of any or all of the lipids in the plasma, including hyperlipoproteinaemia, hypercholesterolaemia, etc. [EU] Hyperpigmentation: Excessive pigmentation of the skin, usually as a result of increased melanization of the epidermis rather than as a result of an increased number of melanocytes. Etiology is varied and the condition may arise from exposure to light, chemicals or other substances, or from a primary metabolic imbalance. [NIH] Hyperplasia: An increase in the number of cells in a tissue or organ, not due to tumor formation. It differs from hypertrophy, which is an increase in bulk without an increase in the number of cells. [NIH] Hypertrophy: General increase in bulk of a part or organ, not due to tumor formation, nor to an increase in the number of cells. [NIH] Hypnotic: A drug that acts to induce sleep. [EU] Id: The part of the personality structure which harbors the unconscious instinctive desires and strivings of the individual. [NIH] Ileitis: Inflammation of the ileum. [EU] Ileum: The lower end of the small intestine. [NIH] Imidazole: C3H4N2. The ring is present in polybenzimidazoles. [NIH] Immune function: Production and action of cells that fight disease or infection. [NIH] Immune response: The activity of the immune system against foreign substances (antigens). [NIH]

Immunology: The study of the body's immune system. [NIH] Impaction: The trapping of an object in a body passage. Examples are stones in the bile duct or hardened stool in the colon. [NIH] Impairment: In the context of health experience, an impairment is any loss or abnormality of psychological, physiological, or anatomical structure or function. [NIH] In vitro: In the laboratory (outside the body). The opposite of in vivo (in the body). [NIH] In vivo: In the body. The opposite of in vitro (outside the body or in the laboratory). [NIH] Indicative: That indicates; that points out more or less exactly; that reveals fairly clearly. [EU] Infarction: A pathological process consisting of a sudden insufficient blood supply to an area, which results in necrosis of that area. It is usually caused by a thrombus, an embolus, or a vascular torsion. [NIH] Infection: 1. Invasion and multiplication of microorganisms in body tissues, which may be clinically unapparent or result in local cellular injury due to competitive metabolism, toxins, intracellular replication, or antigen-antibody response. The infection may remain localized, subclinical, and temporary if the body's defensive mechanisms are effective. A local infection may persist and spread by extension to become an acute, subacute, or chronic clinical infection or disease state. A local infection may also become systemic when the microorganisms gain access to the lymphatic or vascular system. 2. An infectious disease.

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[EU]

Inflammation: A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function. [NIH] Ingestion: Taking into the body by mouth [NIH] Initiation: Mutation induced by a chemical reactive substance causing cell changes; being a step in a carcinogenic process. [NIH] Inorganic: Pertaining to substances not of organic origin. [EU] Insecticides: Pesticides designed to control insects that are harmful to man. The insects may be directly harmful, as those acting as disease vectors, or indirectly harmful, as destroyers of crops, food products, or textile fabrics. [NIH] Insulin: A protein hormone secreted by beta cells of the pancreas. Insulin plays a major role in the regulation of glucose metabolism, generally promoting the cellular utilization of glucose. It is also an important regulator of protein and lipid metabolism. Insulin is used as a drug to control insulin-dependent diabetes mellitus. [NIH] Intestinal: Having to do with the intestines. [NIH] Intestine: A long, tube-shaped organ in the abdomen that completes the process of digestion. There is both a large intestine and a small intestine. Also called the bowel. [NIH] Intracellular: Inside a cell. [NIH] Intracranial Hypertension: Increased pressure within the cranial vault. This may result from several conditions, including hydrocephalus; brain edema; intracranial masses; severe systemic hypertension; pseudotumor cerebri; and other disorders. [NIH] Intrinsic: Situated entirely within or pertaining exclusively to a part. [EU] Ions: An atom or group of atoms that have a positive or negative electric charge due to a gain (negative charge) or loss (positive charge) of one or more electrons. Atoms with a positive charge are known as cations; those with a negative charge are anions. [NIH] Irritable Bowel Syndrome: A disorder that comes and goes. Nerves that control the muscles in the GI tract are too active. The GI tract becomes sensitive to food, stool, gas, and stress. Causes abdominal pain, bloating, and constipation or diarrhea. Also called spastic colon or mucous colitis. [NIH] Isosorbide: 1,4:3,6-Dianhydro D-glucitol. Chemically inert osmotic diuretic used mainly to treat hydrocephalus; also used in glaucoma. [NIH] Isosorbide Dinitrate: A vasodilator used in the treatment of angina. Its actions are similar to nitroglycerin but with a slower onset of action. [NIH] Kb: A measure of the length of DNA fragments, 1 Kb = 1000 base pairs. The largest DNA fragments are up to 50 kilobases long. [NIH] Keratolytic: An agent that promotes keratolysis. [EU] Ketone Bodies: Chemicals that the body makes when there is not enough insulin in the blood and it must break down fat for its energy. Ketone bodies can poison and even kill body cells. When the body does not have the help of insulin, the ketones build up in the blood and then "spill" over into the urine so that the body can get rid of them. The body can also rid itself of one type of ketone, called acetone, through the lungs. This gives the breath a fruity odor. Ketones that build up in the body for a long time lead to serious illness and coma. [NIH] Ketosis: A condition of having ketone bodies build up in body tissues and fluids. The signs of ketosis are nausea, vomiting, and stomach pain. Ketosis can lead to ketoacidosis. [NIH]

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Large Intestine: The part of the intestine that goes from the cecum to the rectum. The large intestine absorbs water from stool and changes it from a liquid to a solid form. The large intestine is 5 feet long and includes the appendix, cecum, colon, and rectum. Also called colon. [NIH] Larynx: An irregularly shaped, musculocartilaginous tubular structure, lined with mucous membrane, located at the top of the trachea and below the root of the tongue and the hyoid bone. It is the essential sphincter guarding the entrance into the trachea and functioning secondarily as the organ of voice. [NIH] Laxative: An agent that acts to promote evacuation of the bowel; a cathartic or purgative. [EU]

Lesion: An area of abnormal tissue change. [NIH] Lethal: Deadly, fatal. [EU] Leukemia: Cancer of blood-forming tissue. [NIH] Leukoplakia: A white patch that may develop on mucous membranes such as the cheek, gums, or tongue and may become cancerous. [NIH] Library Services: Services offered to the library user. They include reference and circulation. [NIH]

Linkage: The tendency of two or more genes in the same chromosome to remain together from one generation to the next more frequently than expected according to the law of independent assortment. [NIH] Lip: Either of the two fleshy, full-blooded margins of the mouth. [NIH] Lipid: Fat. [NIH] Lipoma: A benign tumor composed of fat cells. [NIH] Liquor: 1. A liquid, especially an aqueous solution containing a medicinal substance. 2. A general term used in anatomical nomenclature for certain fluids of the body. [EU] Liver: A large, glandular organ located in the upper abdomen. The liver cleanses the blood and aids in digestion by secreting bile. [NIH] Localized: Cancer which has not metastasized yet. [NIH] Lymph: The almost colorless fluid that travels through the lymphatic system and carries cells that help fight infection and disease. [NIH] Lymph node: A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Also known as a lymph gland. Lymph nodes are spread out along lymphatic vessels and contain many lymphocytes, which filter the lymphatic fluid (lymph). [NIH]

Lymphatic: The tissues and organs, including the bone marrow, spleen, thymus, and lymph nodes, that produce and store cells that fight infection and disease. [NIH] Lymphatic system: The tissues and organs that produce, store, and carry white blood cells that fight infection and other diseases. This system includes the bone marrow, spleen, thymus, lymph nodes and a network of thin tubes that carry lymph and white blood cells. These tubes branch, like blood vessels, into all the tissues of the body. [NIH] Malabsorption: Impaired intestinal absorption of nutrients. [EU] Malignant: Cancerous; a growth with a tendency to invade and destroy nearby tissue and spread to other parts of the body. [NIH] Mebendazole: A nematocide in humans and animals. It acts by interfering with the carbohydrate metabolism and associated energy production of the parasite. [NIH]

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Mediate: Indirect; accomplished by the aid of an intervening medium. [EU] Medicament: A medicinal substance or agent. [EU] MEDLINE: An online database of MEDLARS, the computerized bibliographic Medical Literature Analysis and Retrieval System of the National Library of Medicine. [NIH] Melanocytes: Epidermal dendritic pigment cells which control long-term morphological color changes by alteration in their number or in the amount of pigment they produce and store in the pigment containing organelles called melanosomes. Melanophores are larger cells which do not exist in mammals. [NIH] Membrane: A very thin layer of tissue that covers a surface. [NIH] Memory: Complex mental function having four distinct phases: (1) memorizing or learning, (2) retention, (3) recall, and (4) recognition. Clinically, it is usually subdivided into immediate, recent, and remote memory. [NIH] Mental Health: The state wherein the person is well adjusted. [NIH] Menthol: An alcohol produced from mint oils or prepared synthetically. [NIH] Meta-Analysis: A quantitative method of combining the results of independent studies (usually drawn from the published literature) and synthesizing summaries and conclusions which may be used to evaluate therapeutic effectiveness, plan new studies, etc., with application chiefly in the areas of research and medicine. [NIH] Metabolite: Any substance produced by metabolism or by a metabolic process. [EU] Methionine: A sulfur containing essential amino acid that is important in many body functions. It is a chelating agent for heavy metals. [NIH] Methyl salicylate: Non-steroidal anti-inflammatory drugs. [NIH] MI: Myocardial infarction. Gross necrosis of the myocardium as a result of interruption of the blood supply to the area; it is almost always caused by atherosclerosis of the coronary arteries, upon which coronary thrombosis is usually superimposed. [NIH] Microbiological: Pertaining to microbiology : the science that deals with microorganisms, including algae, bacteria, fungi, protozoa and viruses. [EU] Microbiological Techniques: Techniques used in microbiology. [NIH] Microbiology: The study of microorganisms such as fungi, bacteria, algae, archaea, and viruses. [NIH] Micro-organism: An organism which cannot be observed with the naked eye; e. g. unicellular animals, lower algae, lower fungi, bacteria. [NIH] Migration: The systematic movement of genes between populations of the same species, geographic race, or variety. [NIH] Milk Thistle: The plant Silybum marianum in the family Asteraceae containing the bioflavonoid complex silymarin. For centuries this has been used traditionally to treat liver disease. [NIH] Mineral Oil: A mixture of liquid hydrocarbons obtained from petroleum. It is used as laxative, lubricant, ointment base, and emollient. [NIH] Mineralization: The action of mineralizing; the state of being mineralized. [EU] Molecular: Of, pertaining to, or composed of molecules : a very small mass of matter. [EU] Molecule: A chemical made up of two or more atoms. The atoms in a molecule can be the same (an oxygen molecule has two oxygen atoms) or different (a water molecule has two hydrogen atoms and one oxygen atom). Biological molecules, such as proteins and DNA, can be made up of many thousands of atoms. [NIH]

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Monitor: An apparatus which automatically records such physiological signs as respiration, pulse, and blood pressure in an anesthetized patient or one undergoing surgical or other procedures. [NIH] Mononuclear: A cell with one nucleus. [NIH] Mucins: A secretion containing mucopolysaccharides and protein that is the chief constituent of mucus. [NIH] Mucociliary: Pertaining to or affecting the mucus membrane and hairs (including eyelashes, nose hair, .): mucociliary clearing: the clearance of mucus by ciliary movement ( particularly in the respiratory system). [EU] Mucosa: A mucous membrane, or tunica mucosa. [EU] Mucus: The viscous secretion of mucous membranes. It contains mucin, white blood cells, water, inorganic salts, and exfoliated cells. [NIH] Myocardium: The muscle tissue of the heart composed of striated, involuntary muscle known as cardiac muscle. [NIH] Nausea: An unpleasant sensation in the stomach usually accompanied by the urge to vomit. Common causes are early pregnancy, sea and motion sickness, emotional stress, intense pain, food poisoning, and various enteroviruses. [NIH] Necrolysis: Separation or exfoliation of tissue due to necrosis. [EU] Necrosis: A pathological process caused by the progressive degradative action of enzymes that is generally associated with severe cellular trauma. It is characterized by mitochondrial swelling, nuclear flocculation, uncontrolled cell lysis, and ultimately cell death. [NIH] Need: A state of tension or dissatisfaction felt by an individual that impels him to action toward a goal he believes will satisfy the impulse. [NIH] Nematocide: A chemical used to kill nematodes. [NIH] Neoplasm: A new growth of benign or malignant tissue. [NIH] Nerve: A cordlike structure of nervous tissue that connects parts of the nervous system with other tissues of the body and conveys nervous impulses to, or away from, these tissues. [NIH] Neurofibroma: A fibrous tumor, usually benign, arising from the nerve sheath or the endoneurium. [NIH] Neurons: The basic cellular units of nervous tissue. Each neuron consists of a body, an axon, and dendrites. Their purpose is to receive, conduct, and transmit impulses in the nervous system. [NIH] Neurosis: Functional derangement due to disorders of the nervous system which does not affect the psychic personality of the patient. [NIH] Nicotine: Nicotine is highly toxic alkaloid. It is the prototypical agonist at nicotinic cholinergic receptors where it dramatically stimulates neurons and ultimately blocks synaptic transmission. Nicotine is also important medically because of its presence in tobacco smoke. [NIH] Nitroglycerin: A highly volatile organic nitrate that acts as a dilator of arterial and venous smooth muscle and is used in the treatment of angina. It provides relief through improvement of the balance between myocardial oxygen supply and demand. Although total coronary blood flow is not increased, there is redistribution of blood flow in the heart when partial occlusion of coronary circulation is effected. [NIH] Ocular: 1. Of, pertaining to, or affecting the eye. 2. Eyepiece. [EU] Odour: A volatile emanation that is perceived by the sense of smell. [EU]

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Ointments: Semisolid preparations used topically for protective emollient effects or as a vehicle for local administration of medications. Ointment bases are various mixtures of fats, waxes, animal and plant oils and solid and liquid hydrocarbons. [NIH] Oral Health: The optimal state of the mouth and normal functioning of the organs of the mouth without evidence of disease. [NIH] Oral Hygiene: The practice of personal hygiene of the mouth. It includes the maintenance of oral cleanliness, tissue tone, and general preservation of oral health. [NIH] Organoleptic: Of, relating to, or involving the employment of the sense organs; used especially of subjective testing (as of flavor, odor, appearance) of food and drug products. [NIH]

Orofacial: Of or relating to the mouth and face. [EU] Oropharynx: Oral part of the pharynx. [NIH] Orthodontics: A dental specialty concerned with the prevention and correction of dental and oral anomalies (malocclusion). [NIH] Osmotic: Pertaining to or of the nature of osmosis (= the passage of pure solvent from a solution of lesser to one of greater solute concentration when the two solutions are separated by a membrane which selectively prevents the passage of solute molecules, but is permeable to the solvent). [EU] Oxidation: The act of oxidizing or state of being oxidized. Chemically it consists in the increase of positive charges on an atom or the loss of negative charges. Most biological oxidations are accomplished by the removal of a pair of hydrogen atoms (dehydrogenation) from a molecule. Such oxidations must be accompanied by reduction of an acceptor molecule. Univalent o. indicates loss of one electron; divalent o., the loss of two electrons. [EU]

Palate: The structure that forms the roof of the mouth. It consists of the anterior hard palate and the posterior soft palate. [NIH] Palliative: 1. Affording relief, but not cure. 2. An alleviating medicine. [EU] Pancreas: A mixed exocrine and endocrine gland situated transversely across the posterior abdominal wall in the epigastric and hypochondriac regions. The endocrine portion is comprised of the Islets of Langerhans, while the exocrine portion is a compound acinar gland that secretes digestive enzymes. [NIH] Pancreatic: Having to do with the pancreas. [NIH] Pancreatitis: Acute or chronic inflammation of the pancreas, which may be asymptomatic or symptomatic, and which is due to autodigestion of a pancreatic tissue by its own enzymes. It is caused most often by alcoholism or biliary tract disease; less commonly it may be associated with hyperlipaemia, hyperparathyroidism, abdominal trauma (accidental or operative injury), vasculitis, or uraemia. [EU] Papilla: A small nipple-shaped elevation. [NIH] Papilloma: A benign epithelial neoplasm which may arise from the skin, mucous membranes or glandular ducts. [NIH] Paralysis: Loss of ability to move all or part of the body. [NIH] Paranasal Sinuses: Air-filled extensions of the respiratory part of the nasal cavity into the frontal, ethmoid, sphenoid, and maxillary cranial bones. They vary in size and form in different individuals and are lined by the ciliated mucous membranes of the nasal cavity. [NIH]

Parasite: An animal or a plant that lives on or in an organism of another species and gets at

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least some of its nutrition from that other organism. [NIH] Parotid: The space that contains the parotid gland, the facial nerve, the external carotid artery, and the retromandibular vein. [NIH] Patch: A piece of material used to cover or protect a wound, an injured part, etc.: a patch over the eye. [NIH] Pathogenesis: The cellular events and reactions that occur in the development of disease. [NIH]

Pathologic: 1. Indicative of or caused by a morbid condition. 2. Pertaining to pathology (= branch of medicine that treats the essential nature of the disease, especially the structural and functional changes in tissues and organs of the body caused by the disease). [EU] Patient Education: The teaching or training of patients concerning their own health needs. [NIH]

Pelvic: Pertaining to the pelvis. [EU] Pemphigus: Group of chronic blistering diseases characterized histologically by acantholysis and blister formation within the epidermis. [NIH] Pepsin: An enzyme made in the stomach that breaks down proteins. [NIH] Pepsin A: Formed from pig pepsinogen by cleavage of one peptide bond. The enzyme is a single polypeptide chain and is inhibited by methyl 2-diaazoacetamidohexanoate. It cleaves peptides preferentially at the carbonyl linkages of phenylalanine or leucine and acts as the principal digestive enzyme of gastric juice. [NIH] Peptic: Pertaining to pepsin or to digestion; related to the action of gastric juices. [EU] Peptic Ulcer: Ulcer that occurs in those portions of the alimentary tract which come into contact with gastric juice containing pepsin and acid. It occurs when the amount of acid and pepsin is sufficient to overcome the gastric mucosal barrier. [NIH] Peptide: Any compound consisting of two or more amino acids, the building blocks of proteins. Peptides are combined to make proteins. [NIH] Perception: The ability quickly and accurately to recognize similarities and differences among presented objects, whether these be pairs of words, pairs of number series, or multiple sets of these or other symbols such as geometric figures. [NIH] Periodontal disease: Disease involving the supporting structures of the teeth (as the gums and periodontal membranes). [NIH] Periodontal Pocket: An abnormal extension of a gingival sulcus accompanied by the apical migration of the epithelial attachment and bone resorption. [NIH] Periodontics: A dental specialty concerned with the histology, physiology, and pathology of the tissues that support, attach, and surround the teeth, and of the treatment and prevention of disease affecting these tissues. [NIH] Periodontitis: Inflammation of the periodontal membrane; also called periodontitis simplex. [NIH]

Pesticides: Chemicals used to destroy pests of any sort. The concept includes fungicides (industrial fungicides), insecticides, rodenticides, etc. [NIH] Petroleum: Naturally occurring complex liquid hydrocarbons which, after distillation, yield combustible fuels, petrochemicals, and lubricants. [NIH] Pharmaceutical Preparations: Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. [NIH]

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Pharmaceutical Solutions: Homogeneous liquid preparations that contain one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents. For reasons of their ingredients, method of preparation, or use, they do not fall into another group of products. [NIH] Pharmacologic: Pertaining to pharmacology or to the properties and reactions of drugs. [EU] Pharynx: The hollow tube about 5 inches long that starts behind the nose and ends at the top of the trachea (windpipe) and esophagus (the tube that goes to the stomach). [NIH] Phobia: A persistent, irrational, intense fear of a specific object, activity, or situation (the phobic stimulus), fear that is recognized as being excessive or unreasonable by the individual himself. When a phobia is a significant source of distress or interferes with social functioning, it is considered a mental disorder; phobic disorder (or neurosis). In DSM III phobic disorders are subclassified as agoraphobia, social phobias, and simple phobias. Used as a word termination denoting irrational fear of or aversion to the subject indicated by the stem to which it is affixed. [EU] Phobic Disorders: Anxiety disorders in which the essential feature is persistent and irrational fear of a specific object, activity, or situation that the individual feels compelled to avoid. The individual recognizes the fear as excessive or unreasonable. [NIH] Phosphorus: A non-metallic element that is found in the blood, muscles, nevers, bones, and teeth, and is a component of adenosine triphosphate (ATP; the primary energy source for the body's cells.) [NIH] Physiologic: Having to do with the functions of the body. When used in the phrase "physiologic age," it refers to an age assigned by general health, as opposed to calendar age. [NIH]

Physiology: The science that deals with the life processes and functions of organismus, their cells, tissues, and organs. [NIH] Pigment: A substance that gives color to tissue. Pigments are responsible for the color of skin, eyes, and hair. [NIH] Pigmentation: Coloration or discoloration of a part by a pigment. [NIH] Plant Diseases: Diseases of plants. [NIH] Plants: Multicellular, eukaryotic life forms of the kingdom Plantae. They are characterized by a mainly photosynthetic mode of nutrition; essentially unlimited growth at localized regions of cell divisions (meristems); cellulose within cells providing rigidity; the absence of organs of locomotion; absense of nervous and sensory systems; and an alteration of haploid and diploid generations. [NIH] Plaque: A clear zone in a bacterial culture grown on an agar plate caused by localized destruction of bacterial cells by a bacteriophage. The concentration of infective virus in a fluid can be estimated by applying the fluid to a culture and counting the number of. [NIH] Plasma: The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma. [NIH] Polymers: Compounds formed by the joining of smaller, usually repeating, units linked by covalent bonds. These compounds often form large macromolecules (e.g., polypeptides, proteins, plastics). [NIH] Polyposis: The development of numerous polyps (growths that protrude from a mucous membrane). [NIH] Polysaccharide: A type of carbohydrate. It contains sugar molecules that are linked together chemically. [NIH]

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Posterior: Situated in back of, or in the back part of, or affecting the back or dorsal surface of the body. In lower animals, it refers to the caudal end of the body. [EU] Practice Guidelines: Directions or principles presenting current or future rules of policy for the health care practitioner to assist him in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery. [NIH] Precursor: Something that precedes. In biological processes, a substance from which another, usually more active or mature substance is formed. In clinical medicine, a sign or symptom that heralds another. [EU] Progression: Increase in the size of a tumor or spread of cancer in the body. [NIH] Progressive: Advancing; going forward; going from bad to worse; increasing in scope or severity. [EU] Prone: Having the front portion of the body downwards. [NIH] Prophylaxis: An attempt to prevent disease. [NIH] Proportional: Being in proportion : corresponding in size, degree, or intensity, having the same or a constant ratio; of, relating to, or used in determining proportions. [EU] Protein S: The vitamin K-dependent cofactor of activated protein C. Together with protein C, it inhibits the action of factors VIIIa and Va. A deficiency in protein S can lead to recurrent venous and arterial thrombosis. [NIH] Proteins: Polymers of amino acids linked by peptide bonds. The specific sequence of amino acids determines the shape and function of the protein. [NIH] Protocol: The detailed plan for a clinical trial that states the trial's rationale, purpose, drug or vaccine dosages, length of study, routes of administration, who may participate, and other aspects of trial design. [NIH] Protons: Stable elementary particles having the smallest known positive charge, found in the nuclei of all elements. The proton mass is less than that of a neutron. A proton is the nucleus of the light hydrogen atom, i.e., the hydrogen ion. [NIH] Protozoa: A subkingdom consisting of unicellular organisms that are the simplest in the animal kingdom. Most are free living. They range in size from submicroscopic to macroscopic. Protozoa are divided into seven phyla: Sarcomastigophora, Labyrinthomorpha, Apicomplexa, Microspora, Ascetospora, Myxozoa, and Ciliophora. [NIH] Pruritic: Pertaining to or characterized by pruritus. [EU] Psychiatric: Pertaining to or within the purview of psychiatry. [EU] Psychiatry: The medical science that deals with the origin, diagnosis, prevention, and treatment of mental disorders. [NIH] Psychic: Pertaining to the psyche or to the mind; mental. [EU] Psychogenic: Produced or caused by psychic or mental factors rather than organic factors. [EU]

Psychopathology: The study of significant causes and processes in the development of mental illness. [NIH] Psychosomatic: Pertaining to the mind-body relationship; having bodily symptoms of psychic, emotional, or mental origin; called also psychophysiologic. [EU] Public Opinion: The attitude of a significant portion of a population toward any given

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proposition, based upon a measurable amount of factual evidence, and involving some degree of reflection, analysis, and reasoning. [NIH] Public Policy: A course or method of action selected, usually by a government, from among alternatives to guide and determine present and future decisions. [NIH] Publishing: "The business or profession of the commercial production and issuance of literature" (Webster's 3d). It includes the publisher, publication processes, editing and editors. Production may be by conventional printing methods or by electronic publishing. [NIH]

Pulmonary: Relating to the lungs. [NIH] Pulmonary Edema: An accumulation of an excessive amount of watery fluid in the lungs, may be caused by acute exposure to dangerous concentrations of irritant gasses. [NIH] Pulse: The rhythmical expansion and contraction of an artery produced by waves of pressure caused by the ejection of blood from the left ventricle of the heart as it contracts. [NIH]

Purpura: Purplish or brownish red discoloration, easily visible through the epidermis, caused by hemorrhage into the tissues. [NIH] Putrefaction: The process of decomposition of animal and vegetable matter by living organisms. [NIH] Pyogenic: Producing pus; pyopoietic (= liquid inflammation product made up of cells and a thin fluid called liquor puris). [EU] Quaternary: 1. Fourth in order. 2. Containing four elements or groups. [EU] Radioactive: Giving off radiation. [NIH] Randomized: Describes an experiment or clinical trial in which animal or human subjects are assigned by chance to separate groups that compare different treatments. [NIH] Ranitidine: A non-imidazole blocker of those histamine receptors that mediate gastric secretion (H2 receptors). It is used to treat gastrointestinal ulcers. [NIH] Reagent: A substance employed to produce a chemical reaction so as to detect, measure, produce, etc., other substances. [EU] Receptor: A molecule inside or on the surface of a cell that binds to a specific substance and causes a specific physiologic effect in the cell. [NIH] Rectum: The last 8 to 10 inches of the large intestine. [NIH] Refer: To send or direct for treatment, aid, information, de decision. [NIH] Reference Values: The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality. [NIH] Reflux: The term used when liquid backs up into the esophagus from the stomach. [NIH] Regeneration: The natural renewal of a structure, as of a lost tissue or part. [EU] Regimen: A treatment plan that specifies the dosage, the schedule, and the duration of treatment. [NIH] Regional enteritis: Inflammation of the intestines, but usually only of the small intestine. Also called Crohn's disease. [NIH] Regurgitation: A backward flowing, as the casting up of undigested food, or the backward flowing of blood into the heart, or between the chambers of the heart when a valve is incompetent. [EU] Reliability: Used technically, in a statistical sense, of consistency of a test with itself, i. e. the

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extent to which we can assume that it will yield the same result if repeated a second time. [NIH]

Resorption: The loss of substance through physiologic or pathologic means, such as loss of dentin and cementum of a tooth, or of the alveolar process of the mandible or maxilla. [EU] Respiration: The act of breathing with the lungs, consisting of inspiration, or the taking into the lungs of the ambient air, and of expiration, or the expelling of the modified air which contains more carbon dioxide than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration (= oxygen consumption) or cell respiration (= cell respiration). [NIH] Risk factor: A habit, trait, condition, or genetic alteration that increases a person's chance of developing a disease. [NIH] Rod: A reception for vision, located in the retina. [NIH] Rodenticides: Substances used to destroy or inhibit the action of rats, mice, or other rodents. [NIH]

Root Caries: Dental caries involving the tooth root, cementum, or cervical area of the tooth. [NIH]

Salicylate: Non-steroidal anti-inflammatory drugs. [NIH] Saliva: The clear, viscous fluid secreted by the salivary glands and mucous glands of the mouth. It contains mucins, water, organic salts, and ptylin. [NIH] Salivary: The duct that convey saliva to the mouth. [NIH] Salivary glands: Glands in the mouth that produce saliva. [NIH] Salivation: 1. The secretion of saliva. 2. Ptyalism (= excessive flow of saliva). [EU] Scleroderma: A chronic disorder marked by hardening and thickening of the skin. Scleroderma can be localized or it can affect the entire body (systemic). [NIH] Screening: Checking for disease when there are no symptoms. [NIH] Sebaceous: Gland that secretes sebum. [NIH] Secretion: 1. The process of elaborating a specific product as a result of the activity of a gland; this activity may range from separating a specific substance of the blood to the elaboration of a new chemical substance. 2. Any substance produced by secretion. [EU] Sensor: A device designed to respond to physical stimuli such as temperature, light, magnetism or movement and transmit resulting impulses for interpretation, recording, movement, or operating control. [NIH] Side effect: A consequence other than the one(s) for which an agent or measure is used, as the adverse effects produced by a drug, especially on a tissue or organ system other than the one sought to be benefited by its administration. [EU] Silymarin: A mixture of flavonoids extracted from seeds of the milk thistle, Silybum marianum. It consists primarily of three isomers: silicristin, silidianin, and silybin, its major component. Silymarin displays antioxidant and membrane stabilizing activity. It protects various tissues and organs against chemical injury, and shows potential as an antihepatoxic agent. [NIH] Sinusitis: An inflammatory process of the mucous membranes of the paranasal sinuses that occurs in three stages: acute, subacute, and chronic. Sinusitis results from any condition causing ostial obstruction or from pathophysiologic changes in the mucociliary transport mechanism. [NIH] Small intestine: The part of the digestive tract that is located between the stomach and the large intestine. [NIH]

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Soaps: Sodium or potassium salts of long chain fatty acids. These detergent substances are obtained by boiling natural oils or fats with caustic alkali. Sodium soaps are harder and are used as topical anti-infectives and vehicles in pills and liniments; potassium soaps are soft, used as vehicles for ointments and also as topical antimicrobials. [NIH] Sodium: An element that is a member of the alkali group of metals. It has the atomic symbol Na, atomic number 11, and atomic weight 23. With a valence of 1, it has a strong affinity for oxygen and other nonmetallic elements. Sodium provides the chief cation of the extracellular body fluids. Its salts are the most widely used in medicine. (From Dorland, 27th ed) Physiologically the sodium ion plays a major role in blood pressure regulation, maintenance of fluid volume, and electrolyte balance. [NIH] Sodium Fluoride: A source of inorganic fluoride which is used topically to prevent dental caries. [NIH] Soft tissue: Refers to muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. [NIH] Spastic: 1. Of the nature of or characterized by spasms. 2. Hypertonic, so that the muscles are stiff and the movements awkward. 3. A person exhibiting spasticity, such as occurs in spastic paralysis or in cerebral palsy. [EU] Spasticity: A state of hypertonicity, or increase over the normal tone of a muscle, with heightened deep tendon reflexes. [EU] Specialist: In medicine, one who concentrates on 1 special branch of medical science. [NIH] Species: A taxonomic category subordinate to a genus (or subgenus) and superior to a subspecies or variety, composed of individuals possessing common characters distinguishing them from other categories of individuals of the same taxonomic level. In taxonomic nomenclature, species are designated by the genus name followed by a Latin or Latinized adjective or noun. [EU] Specificity: Degree of selectivity shown by an antibody with respect to the number and types of antigens with which the antibody combines, as well as with respect to the rates and the extents of these reactions. [NIH] Sphincter: A ringlike band of muscle fibres that constricts a passage or closes a natural orifice; called also musculus sphincter. [EU] Spinous: Like a spine or thorn in shape; having spines. [NIH] Spleen: An organ that is part of the lymphatic system. The spleen produces lymphocytes, filters the blood, stores blood cells, and destroys old blood cells. It is located on the left side of the abdomen near the stomach. [NIH] Splenectomy: An operation to remove the spleen. [NIH] Stimulus: That which can elicit or evoke action (response) in a muscle, nerve, gland or other excitable issue, or cause an augmenting action upon any function or metabolic process. [NIH] Stomach: An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum. [NIH] Stomatitis: Inflammation of the oral mucosa, due to local or systemic factors which may involve the buccal and labial mucosa, palate, tongue, floor of the mouth, and the gingivae. [EU]

Stool: The waste matter discharged in a bowel movement; feces. [NIH] Stress: Forcibly exerted influence; pressure. Any condition or situation that causes strain or tension. Stress may be either physical or psychologic, or both. [NIH] Subacute: Somewhat acute; between acute and chronic. [EU]

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Subclinical: Without clinical manifestations; said of the early stage(s) of an infection or other disease or abnormality before symptoms and signs become apparent or detectable by clinical examination or laboratory tests, or of a very mild form of an infection or other disease or abnormality. [EU] Subcutaneous: Beneath the skin. [NIH] Substance P: An eleven-amino acid neurotransmitter that appears in both the central and peripheral nervous systems. It is involved in transmission of pain, causes rapid contractions of the gastrointestinal smooth muscle, and modulates inflammatory and immune responses. [NIH]

Substrate: A substance upon which an enzyme acts. [EU] Substrate Specificity: A characteristic feature of enzyme activity in relation to the kind of substrate on which the enzyme or catalytic molecule reacts. [NIH] Suction: The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. [NIH] Sulfides: Chemical groups containing the covalent sulfur bonds -S-. The sulfur atom can be bound to inorganic or organic moieties. [NIH] Sulfur: An element that is a member of the chalcogen family. It has an atomic symbol S, atomic number 16, and atomic weight 32.066. It is found in the amino acids cysteine and methionine. [NIH] Sulfur Compounds: Inorganic or organic compounds that contain sulfur as an integral part of the molecule. [NIH] Surfactant: A fat-containing protein in the respiratory passages which reduces the surface tension of pulmonary fluids and contributes to the elastic properties of pulmonary tissue. [NIH]

Symptomatic: Having to do with symptoms, which are signs of a condition or disease. [NIH] Synaptic: Pertaining to or affecting a synapse (= site of functional apposition between neurons, at which an impulse is transmitted from one neuron to another by electrical or chemical means); pertaining to synapsis (= pairing off in point-for-point association of homologous chromosomes from the male and female pronuclei during the early prophase of meiosis). [EU] Synaptic Transmission: The communication from a neuron to a target (neuron, muscle, or secretory cell) across a synapse. In chemical synaptic transmission, the presynaptic neuron releases a neurotransmitter that diffuses across the synaptic cleft and binds to specific synaptic receptors. These activated receptors modulate ion channels and/or secondmessenger systems to influence the postsynaptic cell. Electrical transmission is less common in the nervous system, and, as in other tissues, is mediated by gap junctions. [NIH] Systemic: Affecting the entire body. [NIH] Systemic disease: Disease that affects the whole body. [NIH] Tartar: A mass of calcium and magnesium salts deposited around the teeth and upon artificial dentures. [NIH] Taste Buds: Small sensory organs which contain gustatory receptor cells, basal cells, and supporting cells. Taste buds in humans are found in the epithelia of the tongue, palate, and pharynx. They are innervated by the chorda tympani nerve (a branch of the facial nerve) and the glossopharyngeal nerve. [NIH] Tea Tree Oil: Essential oil extracted from Melaleuca alternifolia (tea tree). It is used as a topical antimicrobial due to the presence of terpineol. [NIH]

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Therapeutics: The branch of medicine which is concerned with the treatment of diseases, palliative or curative. [NIH] Thorax: A part of the trunk between the neck and the abdomen; the chest. [NIH] Thrombosis: The formation or presence of a blood clot inside a blood vessel. [NIH] Tin: A trace element that is required in bone formation. It has the atomic symbol Sn, atomic number 50, and atomic weight 118.71. [NIH] Tinnitus: Sounds that are perceived in the absence of any external noise source which may take the form of buzzing, ringing, clicking, pulsations, and other noises. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. [NIH] Tissue: A group or layer of cells that are alike in type and work together to perform a specific function. [NIH] Tooth Loss: The failure to retain teeth as a result of disease or injury. [NIH] Topical: On the surface of the body. [NIH] Toxic: Having to do with poison or something harmful to the body. Toxic substances usually cause unwanted side effects. [NIH] Toxicity: The quality of being poisonous, especially the degree of virulence of a toxic microbe or of a poison. [EU] Toxicology: The science concerned with the detection, chemical composition, and pharmacologic action of toxic substances or poisons and the treatment and prevention of toxic manifestations. [NIH] Toxins: Specific, characterizable, poisonous chemicals, often proteins, with specific biological properties, including immunogenicity, produced by microbes, higher plants, or animals. [NIH] Trace element: Substance or element essential to plant or animal life, but present in extremely small amounts. [NIH] Trachea: The cartilaginous and membranous tube descending from the larynx and branching into the right and left main bronchi. [NIH] Transfection: The uptake of naked or purified DNA into cells, usually eukaryotic. It is analogous to bacterial transformation. [NIH] Transplantation: Transference of a tissue or organ, alive or dead, within an individual, between individuals of the same species, or between individuals of different species. [NIH] Trauma: Any injury, wound, or shock, must frequently physical or structural shock, producing a disturbance. [NIH] Triclosan: A diphenyl ether derivative used in cosmetics and toilet soaps as an antiseptic. It has some bacteriostatic and fungistatic action. [NIH] Triglyceride: A lipid carried through the blood stream to tissues. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. Triglycerides are obtained primarily from fat in foods. [NIH] Tuberculosis: Any of the infectious diseases of man and other animals caused by species of Mycobacterium. [NIH] Ulcer: A localized necrotic lesion of the skin or a mucous surface. [NIH]

124 Halitosis

Ulcerative colitis: Chronic inflammation of the colon that produces ulcers in its lining. This condition is marked by abdominal pain, cramps, and loose discharges of pus, blood, and mucus from the bowel. [NIH] Unconscious: Experience which was once conscious, but was subsequently rejected, as the "personal unconscious". [NIH] Uraemia: 1. An excess in the blood of urea, creatinine, and other nitrogenous end products of protein and amino acids metabolism; more correctly referred to as azotemia. 2. In current usage the entire constellation of signs and symptoms of chronic renal failure, including nausea, vomiting anorexia, a metallic taste in the mouth, a uraemic odour of the breath, pruritus, uraemic frost on the skin, neuromuscular disorders, pain and twitching in the muscles, hypertension, edema, mental confusion, and acid-base and electrolyte imbalances. [EU]

Urea: A compound (CO(NH2)2), formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. [NIH] Uremia: The illness associated with the buildup of urea in the blood because the kidneys are not working effectively. Symptoms include nausea, vomiting, loss of appetite, weakness, and mental confusion. [NIH] Urine: Fluid containing water and waste products. Urine is made by the kidneys, stored in the bladder, and leaves the body through the urethra. [NIH] Urticaria: A vascular reaction of the skin characterized by erythema and wheal formation due to localized increase of vascular permeability. The causative mechanism may be allergy, infection, or stress. [NIH] Uterus: The small, hollow, pear-shaped organ in a woman's pelvis. This is the organ in which a fetus develops. Also called the womb. [NIH] Vaccine: A substance or group of substances meant to cause the immune system to respond to a tumor or to microorganisms, such as bacteria or viruses. [NIH] Vascular: Pertaining to blood vessels or indicative of a copious blood supply. [EU] Vasculitis: Inflammation of a blood vessel. [NIH] Vasodilator: An agent that widens blood vessels. [NIH] Vein: Vessel-carrying blood from various parts of the body to the heart. [NIH] Venous: Of or pertaining to the veins. [EU] Vesicular: 1. Composed of or relating to small, saclike bodies. 2. Pertaining to or made up of vesicles on the skin. [EU] Vestibulocochlear Nerve: The 8th cranial nerve. The vestibulocochlear nerve has a cochlear part (cochlear nerve) which is concerned with hearing and a vestibular part (vestibular nerve) which mediates the sense of balance and head position. The fibers of the cochlear nerve originate from neurons of the spiral ganglion and project to the cochlear nuclei (cochlear nucleus). The fibers of the vestibular nerve arise from neurons of Scarpa's ganglion and project to the vestibular nuclei. [NIH] Vestibulocochlear Nerve Diseases: Diseases of the vestibular and/or cochlear (acoustic) nerves, which join to form the vestibulocochlear nerve. Vestibular neuritis, cochlear neuritis, and acoustic neuromas are relatively common conditions that affect these nerves. Clinical manifestations vary with which nerve is primarily affected, and include hearing loss, vertigo, and tinnitus. [NIH] Veterinary Medicine: The medical science concerned with the prevention, diagnosis, and

Dictionary 125

treatment of diseases in animals. [NIH] Villi: The tiny, fingerlike projections on the surface of the small intestine. Villi help absorb nutrients. [NIH] Villous: Of a surface, covered with villi. [NIH] Virulence: The degree of pathogenicity within a group or species of microorganisms or viruses as indicated by case fatality rates and/or the ability of the organism to invade the tissues of the host. [NIH] Virus: Submicroscopic organism that causes infectious disease. In cancer therapy, some viruses may be made into vaccines that help the body build an immune response to, and kill, tumor cells. [NIH] Viscosity: A physical property of fluids that determines the internal resistance to shear forces. [EU] Vitro: Descriptive of an event or enzyme reaction under experimental investigation occurring outside a living organism. Parts of an organism or microorganism are used together with artificial substrates and/or conditions. [NIH] Vulgaris: An affection of the skin, especially of the face, the back and the chest, due to chronic inflammation of the sebaceous glands and the hair follicles. [NIH] Windpipe: A rigid tube, 10 cm long, extending from the cricoid cartilage to the upper border of the fifth thoracic vertebra. [NIH] Wound Healing: Restoration of integrity to traumatized tissue. [NIH] Xerostomia: Decreased salivary flow. [NIH]

127

INDEX A Abdomen, 92, 95, 98, 105, 111, 112, 121, 123 Abdominal, 50, 95, 111, 115, 124 Abdominal Pain, 50, 95, 111, 124 Abrasion, 76, 95 Acantholysis, 95, 116 Acidosis, 95, 103 Adverse Effect, 38, 95, 120 Aerobic, 50, 95 Affinity, 53, 95, 121 Agar, 95, 117 Agonist, 95, 114 Agoraphobia, 95, 117 Algorithms, 58, 95, 98 Alimentary, 52, 95, 116 Alkaline, 95, 96, 99 Alkaloid, 96, 114 Alternative medicine, 68, 96 Amino Acids, 40, 44, 96, 116, 118, 122, 124 Ammonia, 18, 92, 96, 124 Ammonium Compounds, 53, 96 Anaerobic, 40, 41, 44, 45, 48, 50, 51, 52, 96 Analytes, 57, 96 Anatomical, 96, 105, 110, 112 Anesthesia, 37, 96 Angina, 96, 111, 114 Anions, 96, 111 Anomalies, 96, 115 Antibacterial, 38, 47, 52, 53, 96 Antibiotic, 63, 64, 96 Antibody, 95, 96, 101, 109, 110, 121 Antigen, 95, 96, 101, 110 Anti-infective, 97, 100, 110, 121 Anti-inflammatory, 97, 113, 120 Anti-Inflammatory Agents, 97 Antimicrobial, 27, 36, 45, 64, 97, 103, 122 Antioxidant, 49, 97, 120 Antiseptic, 97, 100, 123 Anus, 97, 98 Aphthous Stomatitis, 64, 97 Aqueous, 40, 44, 97, 109, 112 Arterial, 97, 114, 118 Arteries, 97, 98, 102, 113 Aspirin, 49, 65, 97 Asymptomatic, 97, 115 Autoantibodies, 97, 103 Autodigestion, 97, 115

Autoimmune disease, 50, 97 B Bacterial Infections, 56, 97 Bactericidal, 42, 97, 100 Bactericide, 42, 97 Bacteriophage, 97, 117 Bacteriostatic, 97, 123 Bacterium, 46, 97, 109 Basal cells, 97, 122 Base, 49, 53, 97, 106, 111, 113, 124 Benign, 98, 106, 112, 114, 115 Benign tumor, 98, 106, 112 Bile, 98, 107, 108, 110, 112 Biliary, 98, 115 Biliary Tract, 98, 115 Biochemical, 7, 98 Biological therapy, 98, 108 Biotechnology, 7, 8, 68, 75, 98 Bismuth, 45, 49, 56, 98 Blister, 98, 116 Bloating, 50, 98, 111 Blood Coagulation, 98, 99 Blood pressure, 98, 114, 121 Body Fluids, 98, 104, 121 Body Image, 4, 98 Bowel, 50, 65, 98, 111, 112, 121, 124 Bowel Movement, 65, 98, 121 Branch, 89, 98, 100, 108, 112, 116, 121, 122, 123 Breakdown, 98, 103, 104, 107 Breeding, 40, 98 Buccal, 42, 55, 62, 98, 121 Bullous, 98, 103 C Calcium, 36, 40, 41, 42, 43, 53, 99, 101, 122 Calcium Carbonate, 42, 99 Calcium Hydroxide, 36, 40, 41, 99 Capsules, 47, 99, 104, 107 Carbohydrate, 99, 112, 117 Carcinogenic, 99, 111 Carcinoma, 63, 64, 99 Case report, 19, 24, 29, 99, 100 Case series, 99, 100 Cathode, 99, 105 Cations, 53, 99, 111 Caudal, 99, 118 Cecum, 99, 112 Celiac Disease, 64, 99

128 Halitosis

Cell, 7, 36, 63, 95, 97, 98, 99, 100, 101, 106, 108, 111, 114, 117, 119, 120, 122 Cell Division, 97, 99, 108, 117 Cell Survival, 99, 108 Cellobiose, 99, 100 Cellulose, 42, 99, 100, 117 Cerebral, 100, 109, 121 Cerebral Palsy, 100, 121 Cervical, 63, 64, 100, 120 Cervix, 100 Cetylpyridinium, 10, 20, 47, 100 Character, 100, 108 Cheilitis, 65, 100 Chlorhexidine, 10, 20, 27, 46, 47, 65, 69, 100 Chlorine, 41, 44, 65, 69, 100 Chlorophyll, 32, 47, 100, 105 Cholinergic, 100, 114 Chorda Tympani Nerve, 100, 122 Chromosome, 100, 112 Chronic Fatigue Syndrome, 50, 100 Cimetidine, 46, 100 Clinical study, 29, 100 Clinical trial, 7, 75, 100, 102, 118, 119 Cloning, 98, 101 Cochlear, 101, 123, 124 Cochlear Diseases, 101, 123 Cofactor, 101, 118 Colitis, 63, 64, 101, 111 Colloidal, 49, 101 Complement, 101 Complementary and alternative medicine, 27, 33, 101 Complementary medicine, 27, 101 Computational Biology, 75, 101 Confusion, 102, 124 Congestion, 31, 102, 105 Connective Tissue, 53, 102, 106, 107, 112 Connective Tissue Cells, 102 Constipation, 50, 102, 111 Consumption, 38, 55, 102, 120 Contamination, 50, 102 Contraindications, ii, 102 Controlled study, 10, 20, 102 Corneum, 38, 102, 105 Coronary, 102, 113, 114 Coronary Thrombosis, 102, 113 Craniocerebral Trauma, 102, 109, 123 Crowns, 102, 103 Curative, 102, 123 Cysteine, 7, 102, 104, 122 Cystine, 102, 104

Cytochrome, 100, 102 D Databases, Bibliographic, 75, 103 Dehydration, 5, 103 Dental Abutments, 103 Dental Care, 6, 38, 64, 80, 103 Dental Caries, 38, 42, 76, 103, 121 Dental Hygienists, 4, 81, 82, 103 Dental Plaque, 38, 42, 43, 45, 46, 51, 57, 103 Dentifrices, 38, 42, 43, 103 Dentists, 61, 81, 103 Dentures, 5, 6, 38, 103, 122 Dermal, 45, 56, 103 Dermatitis, 63, 64, 103, 104 Dermatitis Herpetiformis, 63, 64, 103 Detergents, 38, 103 Deuterium, 103, 109 Diabetic Ketoacidosis, 47, 103 Diagnostic procedure, 35, 68, 103 Diaper Rash, 45, 104 Diarrhea, 50, 104, 111 Digestion, 50, 52, 56, 95, 98, 104, 111, 112, 116, 121 Digestive tract, 104, 120 Dimethyl, 44, 104 Direct, iii, 24, 58, 63, 104, 119 Dissociation, 95, 104 Disulphides, 55, 104 Diuretic, 104, 111 Dorsal, 55, 104, 105, 118 Dorsum, 104 Dosage Forms, 45, 56, 104 Drug Interactions, 104 Duct, 104, 106, 110, 120 Duodenal Ulcer, 46, 104 Duodenum, 98, 104, 121 Dysphagia, 31, 63, 64, 104 E Edema, 38, 104, 111, 124 Effector, 7, 101, 104 Efficacy, 38, 104 Electrolysis, 96, 99, 105 Electrolyte, 105, 121, 124 Electrons, 97, 99, 105, 111, 115 Emollient, 105, 113, 115 Enamel, 103, 105 Endodontics, 5, 10, 18, 19, 43, 105 Enteric bacteria, 50, 105 Enteritis, 105 Environmental Health, 74, 76, 105 Enzymatic, 7, 37, 47, 99, 101, 103, 105, 109

Index 129

Enzyme, 7, 104, 105, 116, 122, 125 Eosinophilia, 105, 106 Epidermal, 65, 105, 113 Epidermis, 38, 95, 97, 98, 102, 105, 109, 110, 116, 119 Epigastric, 105, 115 Epithelial, 45, 105, 115, 116 Epithelial Cells, 45, 105 Epithelium, 53, 105, 107 Erythema, 65, 105, 124 Erythema Multiforme, 65, 105 Esophageal, 63, 64, 105 Esophagitis, 63, 64, 105 Esophagus, 76, 104, 105, 106, 117, 119, 121 Ether, 106, 123 Evacuation, 102, 106, 112 Excipients, 47, 106 Exfoliation, 106, 114 Exocrine, 106, 115 Exogenous, 43, 106, 108 Extracellular, 102, 106, 121 Extracellular Matrix, 102, 106 F Facial, 63, 100, 106, 116, 122 Facial Nerve, 106, 116, 122 Familial polyposis, 63, 64, 106 Family Planning, 75, 106 Fasciitis, 64, 106 Fat, 106, 111, 112, 121, 122, 123 Fatigue, 100, 106 Fatty acids, 103, 106, 121 Feces, 102, 104, 106, 121 Fibroblasts, 102, 106 Fibroma, 19, 62, 106 Fibrosarcoma, 106, 107 Filler, 54, 107 Flame Ionization, 39, 107 Flatus, 107 Flavoring Agents, 49, 107 Forearm, 98, 106, 107 Fungi, 107, 108, 113 Fungistatic, 107, 123 G Gallbladder, 95, 98, 107 Gas, 3, 5, 6, 10, 39, 50, 58, 96, 100, 107, 109, 111, 122 Gastric, 13, 46, 57, 97, 100, 104, 107, 109, 116, 119 Gastric Acid, 46, 57, 100, 107 Gastric Juices, 107, 116 Gastric Mucosa, 107, 116 Gastric Outlet Obstruction, 13, 107

Gastrin, 100, 107 Gastritis, 46, 57, 107 Gastrointestinal, 13, 47, 49, 56, 63, 64, 65, 107, 119, 122 Gastrointestinal tract, 47, 107 Gelatin, 107, 108 Gels, 38, 107 Gene, 98, 107 General practitioner, 5, 108 Gingival Hyperplasia, 65, 108 Gland, 63, 64, 108, 112, 115, 116, 120, 121 Glossitis, 5, 63, 108 Glossopharyngeal Nerve, 108, 122 Glucose, 99, 100, 108, 111 Glucuronic Acid, 49, 108 Glucuronides, 108 Gluten, 64, 99, 108 Glycine, 51, 108 Governing Board, 108, 118 Graft, 108, 109 Granuloma, 63, 108 Grasses, 108, 109 Growth, 45, 51, 52, 96, 97, 98, 99, 106, 107, 108, 112, 114, 117 Growth factors, 45, 108 H Hair follicles, 108, 125 Handicap, 5, 108 Haptens, 95, 109 Hemodialysis, 99, 109 Hemolytic, 106, 109 Hemorrhage, 102, 109, 119 Hepatic, 5, 47, 65, 109 Herbicides, 58, 109 Heterogeneity, 95, 109 Histamine, 100, 109, 119 Histology, 109, 116 Homeostasis, 7, 109 Hormones, 108, 109 Horny layer, 105, 109 Host, 7, 97, 109, 125 Hydrocephalus, 109, 111 Hydrogen, 7, 39, 44, 47, 53, 55, 56, 65, 95, 97, 99, 103, 107, 109, 113, 115, 118 Hydrogen Peroxide, 65, 109 Hydrophilic, 103, 110 Hydrophobic, 38, 103, 110 Hygienic, 51, 110 Hyperlipidaemia, 28, 110 Hyperpigmentation, 64, 110 Hyperplasia, 62, 110 Hypertrophy, 110

130 Halitosis

Hypnotic, 30, 110 I Id, 25, 30, 82, 88, 90, 110 Ileitis, 64, 110 Ileum, 99, 110 Imidazole, 109, 110, 119 Immune function, 7, 110 Immune response, 96, 97, 109, 110, 122, 125 Immunology, 24, 95, 110 Impaction, 5, 110 Impairment, 38, 110 In vitro, 47, 110 In vivo, 110 Indicative, 57, 62, 110, 116, 124 Infarction, 102, 109, 110, 113 Infection, 13, 36, 46, 57, 63, 64, 67, 68, 98, 106, 110, 112, 122, 124 Inflammation, 53, 97, 100, 101, 103, 105, 106, 107, 108, 110, 111, 115, 116, 119, 121, 124, 125 Ingestion, 28, 40, 108, 111 Initiation, 53, 111 Inorganic, 96, 111, 114, 121, 122 Insecticides, 111, 116 Insulin, 103, 111 Intestinal, 50, 99, 111, 112 Intestine, 50, 98, 105, 111, 112 Intracellular, 110, 111 Intracranial Hypertension, 109, 111, 123 Intrinsic, 47, 95, 111 Ions, 47, 97, 104, 105, 109, 111 Irritable Bowel Syndrome, 50, 63, 64, 111 Isosorbide, 17, 111 Isosorbide Dinitrate, 17, 111 K Kb, 74, 111 Keratolytic, 103, 111 Ketone Bodies, 103, 111 Ketosis, 65, 103, 111 L Large Intestine, 64, 99, 104, 111, 112, 119, 120 Larynx, 76, 112, 123 Laxative, 95, 112, 113 Lesion, 108, 112, 123 Lethal, 97, 112 Leukemia, 65, 112 Leukoplakia, 76, 112 Library Services, 88, 112 Linkage, 52, 99, 112 Lip, 63, 112

Lipid, 111, 112, 123 Lipoma, 63, 112 Liquor, 112, 119 Liver, 5, 50, 65, 95, 98, 106, 107, 108, 109, 112, 113, 124 Localized, 103, 104, 110, 112, 117, 120, 123, 124 Lymph, 63, 64, 100, 112 Lymph node, 63, 64, 100, 112 Lymphatic, 110, 112, 121 Lymphatic system, 112, 121 M Malabsorption, 99, 112 Malignant, 106, 112, 114 Mebendazole, 9, 112 Mediate, 113, 119 Medicament, 54, 113 MEDLINE, 75, 113 Melanocytes, 110, 113 Membrane, 28, 95, 97, 101, 105, 106, 112, 113, 114, 115, 116, 117, 120 Memory, 50, 113 Mental Health, iv, 4, 6, 74, 77, 113 Menthol, 47, 52, 113 Meta-Analysis, 28, 113 Metabolite, 104, 113 Methionine, 104, 113, 122 Methyl salicylate, 52, 113 MI, 40, 93, 113 Microbiological, 5, 43, 113 Microbiological Techniques, 5, 113 Microbiology, 12, 18, 24, 46, 52, 57, 113 Micro-organism, 103, 113 Migration, 113, 116 Milk Thistle, 113, 120 Mineral Oil, 38, 113 Mineralization, 99, 113 Molecular, 7, 44, 75, 77, 96, 98, 101, 113 Molecule, 96, 97, 101, 104, 113, 115, 119, 122 Monitor, 11, 14, 69, 114 Mononuclear, 106, 108, 114 Mucins, 103, 114, 120 Mucociliary, 114, 120 Mucosa, 64, 65, 99, 107, 114, 121 Mucus, 114, 124 Myocardium, 113, 114 N Nausea, 104, 111, 114, 124 Necrolysis, 65, 114 Necrosis, 106, 110, 113, 114 Need, 3, 4, 17, 55, 61, 62, 69, 76, 83, 95, 114

Index 131

Nematocide, 112, 114 Neoplasm, 114, 115 Nerve, 96, 100, 106, 108, 114, 121, 124 Neurofibroma, 63, 114 Neurons, 114, 122, 124 Neurosis, 114, 117 Nicotine, 49, 76, 81, 114 Nitroglycerin, 111, 114 O Ocular, 56, 114 Odour, 47, 51, 53, 114, 124 Ointments, 104, 115, 121 Oral Health, 14, 43, 47, 63, 64, 82, 115 Oral Hygiene, 5, 36, 37, 38, 42, 43, 44, 46, 47, 53, 57, 62, 64, 65, 82, 108, 115 Organoleptic, 6, 11, 39, 65, 115 Orofacial, 18, 62, 115 Oropharynx, 47, 115 Orthodontics, 43, 115 Osmotic, 111, 115 Oxidation, 97, 102, 103, 104, 115 P Palate, 108, 115, 121, 122 Palliative, 115, 123 Pancreas, 64, 95, 111, 115 Pancreatic, 63, 64, 115 Pancreatitis, 63, 64, 115 Papilla, 40, 115 Papilloma, 63, 115 Paralysis, 115, 121 Paranasal Sinuses, 115, 120 Parasite, 112, 115 Parotid, 5, 108, 116 Patch, 112, 116 Pathogenesis, 61, 65, 116 Pathologic, 4, 5, 95, 102, 116, 120 Patient Education, 5, 6, 80, 86, 88, 93, 116 Pelvic, 50, 116 Pemphigus, 65, 95, 116 Pepsin, 100, 116 Pepsin A, 100, 116 Peptic, 46, 49, 57, 63, 64, 107, 116 Peptic Ulcer, 46, 49, 57, 63, 64, 107, 116 Peptide, 116, 118 Perception, 4, 29, 116 Periodontal disease, 5, 6, 7, 37, 38, 40, 45, 47, 50, 53, 57, 62, 116 Periodontal Pocket, 45, 53, 116 Periodontics, 7, 43, 116 Periodontitis, 7, 29, 51, 52, 65, 116 Pesticides, 58, 109, 111, 116 Petroleum, 113, 116

Pharmaceutical Preparations, 100, 107, 116 Pharmaceutical Solutions, 104, 117 Pharmacologic, 96, 117, 123 Pharynx, 76, 115, 117, 122 Phobia, 17, 117 Phobic Disorders, 117 Phosphorus, 99, 117 Physiologic, 4, 95, 117, 119, 120 Physiology, 28, 116, 117 Pigment, 113, 117 Pigmentation, 63, 110, 117 Plant Diseases, 105, 117 Plants, 96, 98, 108, 109, 117, 123 Plaque, 29, 36, 38, 42, 43, 45, 47, 51, 53, 54, 65, 100, 117 Plasma, 107, 110, 117 Polymers, 36, 117, 118 Polyposis, 117 Polysaccharide, 96, 100, 117 Posterior, 40, 55, 104, 108, 115, 118 Practice Guidelines, 77, 118 Precursor, 104, 105, 118 Progression, 7, 53, 118 Progressive, 108, 114, 118 Prone, 40, 118 Prophylaxis, 4, 103, 118 Proportional, 52, 118 Protein S, 55, 98, 118 Proteins, 44, 53, 96, 101, 113, 116, 117, 118, 123 Protocol, 4, 9, 62, 118 Protons, 109, 118 Protozoa, 113, 118 Pruritic, 103, 118 Psychiatric, 5, 118 Psychiatry, 118 Psychic, 114, 118 Psychogenic, 62, 118 Psychopathology, 4, 118 Psychosomatic, 5, 10, 118 Public Opinion, 51, 118 Public Policy, 75, 119 Publishing, 4, 6, 8, 64, 69, 119 Pulmonary, 5, 98, 100, 102, 119, 122 Pulmonary Edema, 100, 119 Pulse, 114, 119 Purpura, 65, 119 Putrefaction, 5, 119 Pyogenic, 63, 119 Q Quaternary, 47, 53, 119

132 Halitosis

R Radioactive, 109, 119 Randomized, 9, 105, 119 Ranitidine, 46, 119 Reagent, 58, 100, 119 Receptor, 46, 96, 119, 122 Rectum, 97, 98, 104, 106, 107, 112, 119 Refer, 1, 61, 98, 101, 107, 119 Reference Values, 48, 119 Reflux, 31, 63, 64, 119 Regeneration, 45, 119 Regimen, 44, 104, 119 Regional enteritis, 64, 119 Regurgitation, 64, 119 Reliability, 69, 119 Resorption, 109, 116, 120 Respiration, 114, 120 Risk factor, 76, 120 Rod, 97, 120 Rodenticides, 116, 120 Root Caries, 64, 120 S Salicylate, 52, 120 Saliva, 20, 36, 40, 45, 55, 120 Salivary, 6, 55, 63, 64, 65, 100, 103, 106, 120, 125 Salivary glands, 100, 103, 106, 120 Salivation, 64, 120 Scleroderma, 106, 120 Screening, 50, 100, 120 Sebaceous, 120, 125 Secretion, 46, 100, 109, 114, 119, 120 Sensor, 39, 58, 120 Side effect, 49, 65, 95, 98, 120, 123 Silymarin, 49, 113, 120 Sinusitis, 31, 80, 120 Small intestine, 50, 63, 64, 99, 104, 105, 107, 110, 111, 119, 120, 125 Soaps, 121, 123 Sodium, 42, 43, 44, 53, 121 Sodium Fluoride, 42, 121 Soft tissue, 106, 107, 121 Spastic, 64, 111, 121 Spasticity, 121 Specialist, 81, 83, 121 Species, 113, 115, 121, 123, 125 Specificity, 95, 121 Sphincter, 112, 121 Spinous, 105, 121 Spleen, 112, 121 Splenectomy, 16, 121 Stimulus, 117, 121

Stomach, 38, 41, 46, 57, 63, 64, 95, 97, 104, 105, 106, 107, 111, 114, 116, 117, 119, 120, 121 Stomatitis, 5, 65, 121 Stool, 110, 111, 112, 121 Stress, 5, 46, 57, 111, 114, 121, 124 Subacute, 110, 120, 121 Subclinical, 110, 122 Subcutaneous, 104, 122 Substance P, 113, 120, 122 Substrate, 7, 122 Substrate Specificity, 7, 122 Suction, 45, 122 Sulfides, 40, 53, 122 Sulfur, 3, 5, 6, 7, 20, 24, 27, 40, 41, 44, 49, 53, 113, 122 Sulfur Compounds, 3, 5, 6, 7, 20, 41, 44, 53, 122 Surfactant, 100, 122 Symptomatic, 115, 122 Synaptic, 114, 122 Synaptic Transmission, 114, 122 Systemic, 4, 5, 6, 17, 47, 81, 98, 110, 111, 120, 121, 122 Systemic disease, 5, 17, 47, 81, 122 T Tartar, 36, 37, 122 Taste Buds, 81, 122 Tea Tree Oil, 27, 122 Therapeutics, 123 Thorax, 95, 123 Thrombosis, 118, 123 Tin, 53, 123 Tinnitus, 50, 123, 124 Tooth Loss, 64, 123 Topical, 45, 56, 65, 100, 110, 121, 122, 123 Toxic, iv, 65, 108, 114, 123 Toxicity, 104, 123 Toxicology, 76, 123 Toxins, 36, 96, 108, 110, 123 Trace element, 123 Trachea, 112, 117, 123 Transfection, 98, 123 Transplantation, 64, 123 Trauma, 105, 114, 115, 123 Triclosan, 24, 29, 30, 42, 43, 65, 123 Triglyceride, 42, 123 Tuberculosis, 102, 123 U Ulcer, 46, 57, 67, 104, 116, 123 Ulcerative colitis, 63, 64, 124 Unconscious, 110, 124

Index 133

Uraemia, 115, 124 Urea, 124 Uremia, 65, 124 Urine, 104, 108, 111, 124 Urticaria, 65, 124 Uterus, 100, 124 V Vaccine, 118, 124 Vascular, 110, 124 Vasculitis, 115, 124 Vasodilator, 109, 111, 124 Vein, 116, 124 Venous, 114, 118, 124 Vesicular, 103, 124 Vestibulocochlear Nerve, 123, 124

Vestibulocochlear Nerve Diseases, 123, 124 Veterinary Medicine, 75, 124 Villi, 55, 109, 125 Villous, 99, 125 Virulence, 7, 123, 125 Virus, 97, 117, 125 Viscosity, 42, 125 Vitro, 125 Vulgaris, 32, 95, 125 W Windpipe, 117, 125 Wound Healing, 45, 125 X Xerostomia, 6, 54, 63, 64, 65, 80, 81, 125

134 Halitosis

Index 135

136 Halitosis

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