Tonzetich J
J Periodontol. 1977 Jan;48(1):13-20. doi: 10.1902/jop.1977.48.1.13.
Organoleptic studies indicate that the oral cavity is usually the principal source of physiologic malodor associated with the early morning halitosis. In all individuals, regardless of the age or health status of the oral tissues, the most intense oral malodor is exhibited after prolonged periods of reduced saliva flow and abstinence from food and liquid. This results from normal metabolic activity in the oral cavity and is accentuated in cases with periodontal involvement. Physiologic oral malodor is transient in duration as it can be controlled to varying degrees in most individuals by oral hygiene measures, such as tooth brushing, dental prophylaxis, tongue scraping and rinsing with antiseptic mouth washes. Experimental evidence strongly suggests that putrefaction of sulphur-containing proteinaceous substrates by predominantly gram-negative oral microorganisms is the primary cause of oral malodor. Optimum putrefactive activity occurs in low carbohydrate environment, physiological pH, and anaerobic conditions. Salivary sediment containing the exfoliated epithelial cells is the primary source of substrate which exists in a disulphide state. Proteolysis and reduction of disulphide bonds precedes the formation of odor. The odor intensity of putrescent saliva and plaque head-space vapor has been correlated with the concentration of volatile sulphur compounds consisting of hydrogen sulphide, methyl mercaptan, dimethyl sulphide and dimethyl disulphide. Except for dimethyl disulphide, the same sulphur-containing compounds have been found in mouth air of all tested individuals. Hydrogen sulphide and methyl mercaptan emanate an offensive putrid odor and account for approxiamtely 90% of the total sulphur content of mouth air. In half of the population tested, methyl mercaptan and hydrogen sulphide content of early morning mouth air is sufficiently high to account for the oral malodor. Brushing studies indicate that both plaque and tongue are important sources of malodor with most of the odor emanating from the dorso-posterior surface of the tongue. None of the gas chromatographic or mass spectrometric analyses have detected the presence of amines, indole, or skatole in the head-space, mouth air, or breath vapor samples.
感官研究表明，口腔通常是与清晨口臭相关的生理性口臭的主要来源。在所有个体中，无论口腔组织的年龄或健康状况如何，在长时间唾液分泌减少以及禁食和禁液后，口腔异味最为强烈。这是由口腔中的正常代谢活动引起的，在牙周受累的情况下会更加明显。生理性口腔异味持续时间短暂，因为在大多数个体中，通过口腔卫生措施，如刷牙、牙齿预防、刮舌和用抗菌漱口水漱口，可以在不同程度上加以控制。实验证据有力地表明，主要由革兰氏阴性口腔微生物对含硫蛋白质底物的腐败作用是口腔异味的主要原因。最佳腐败活性发生在低碳水化合物环境、生理pH值和厌氧条件下。含有脱落上皮细胞的唾液沉淀物是底物的主要来源，底物以二硫键状态存在。在气味形成之前会发生蛋白质水解和二硫键还原。腐败唾液和牙菌斑顶空蒸汽的气味强度与由硫化氢、甲硫醇、二甲基硫醚和二甲基二硫醚组成的挥发性硫化物的浓度相关。除了二甲基二硫醚外，在所有测试个体的口腔空气中都发现了相同的含硫化合物。硫化氢和甲硫醇散发出难闻的腐臭味，约占口腔空气总硫含量的90%。在一半的测试人群中，清晨口腔空气中甲硫醇和硫化氢的含量高到足以导致口腔异味。刷牙研究表明，牙菌斑和舌头都是异味的重要来源，大部分异味来自舌背后部表面。在顶空、口腔空气或呼气蒸汽样本中，气相色谱或质谱分析均未检测到胺、吲哚或粪臭素的存在。
