Dear Editor, Halitosis1 is unpleasant for both the affected person and those around them. As people age, many become more troubled by halitosis, for which oral cleaning mouthwashes containing antiseptic agents are abundant on the market. Except for temporary cases caused by foods such as garlic (Allium) and beer, halitosis Figure 1 is caused by oral bacteria such as Actinomyces spp. and Bacteroides spp.,2 particularly periodontal disease, alveolar pyorrhea, and tongue coating. There are 500 species of oral bacteria, each of which has different properties; thus, it is difficult to selectively sterilize them. As a countermeasure against this problem, disinfectants1 such as chlorhexidine are highly efficacious in the dental field; however, they are not commonly used in daily life. Cetylpyridinium chloride1 is commercially available.Figure 1: Photographs of bacteria-related oral diseases that cause halitosis; examples of its clinical features of gingivitis, periodontitis, and geographic tongue; and a lucent image (arrowheads) of root tissue on an X-P view of alveolar pyorrhea in balloonsRecently, ozone nanobubble (ONB) water3 has attracted attention owing to its efficacy in treating oral bacteria-related systemic diseases. ONB water is under clinical study as an adjunct disinfectant for periodontal disease and is sold online and at some medical institutions. ONB water cannot completely overcome periodontal disease due to oxidation-resistant bacteria such as Porphyromonas gingivalis.4 ONB water cannot be used to treat alveolar pyorrhea since it may cause halitosis. Nonetheless, ONB water has a sterilizing effect that sets it apart from commercially available mouthwashes. Although the efficacy of ONB water oral rinse for halitosis is unknown, it is expected to have a bactericidal effect because halitosis treatment aims to sterilize the oral bacteria, its main cause. ONB water3 is safe because it does not damage the oral mucosa or cause antibiotic resistance. If stored in a cool place, the nano-ozone state can be maintained for 1 year, making it easier to use. Treatment diversity is important, and the safety of ONB water and the magnitude of its expected bactericidal effects are worth considering for halitosis. Oral diseases such as gingivitis and periodontal disease, especially alveolar pyorrhea, are particularly difficult to treat, and ultraviolet light therapy is being considered for gingivitis.5 ONB water has been used as a novel therapy for halitosis. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Yasuhiro Horiuchi (Sun,) studied this question.