The Efficacy of Photodynamic Therapy in the Treatment of Halitosis: A Systematic Review

Main Article Content

Muhammad Bintang Raja Faleqy
Ma'rifatu Qolbi
Maria Felicia Louise Setiabudi
Zahara Meilawaty
Amandia Dewi Permana Shita

Abstract

Introduction: Halitosis is a condition of bad breath that can affect the quality of life of sufferers. The main cause of halitosis is the accumulation of bacteria on the dorsum of the tongue that produce volatile sulfur compounds (VSCs). Conventional methods such as the mouthwash and tongue scraping often do not provide long-lasting results and can trigger bacterial resistance.


Objective: This literature review provides information on the efficacy of photodynamic therapy in the treatment of halitosis patients.


Methods: A literature search was conducted in PubMed, Scopus, Cochrane and ScienceDirect databases with inclusion criteria according to the PICOS framework in the period 2020-2024.


Review: Photodynamic therapy (PDT) is an alternative treatment that uses a combination of photosensitizers and light to produce reactive oxygen species that damage bacterial cell membranes. PDT has been widely used in various medical fields, including in the treatment of cancer, infections, and is now being developed for the treatment of halitosis.


Discussion: This study revealed that PDT is able to reduce the concentration of microorganisms that cause halitosis on the dorsum of the tongue significantly compared to conventional methods. However, there are several limitations such as uneven penetration of photosensitizers and the possibility of bacterial recolonization in a short time after therapy.


Conclusion: PDT is an effective method to reduce bacteria that cause halitosis with a low risk of microbial resistance. However, limitations related to bacterial penetration and recolonization indicate that this therapy needs to be done repeatedly for more sustainable results.

Article Details

How to Cite
Muhammad Bintang Raja Faleqy, Ma’rifatu Qolbi, Setiabudi, M. F. L., Zahara Meilawaty, & Amandia Dewi Permana Shita. (2025). The Efficacy of Photodynamic Therapy in the Treatment of Halitosis: A Systematic Review. International Journal of Medical Science and Clinical Research Studies, 5(3), 499–505. https://doi.org/10.47191/ijmscrs/v5-i03-17
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References

I. Li, Z., Li, J., Fu, R., Liu, J. A., Wen, X., & Zhang, L. (2023). Halitosis: etiology, prevention, and the role of microbiota. Clinical oral investigations, 27(11), 6383-6393.

II. Izidoro, C., Botelho, J., Machado, V., Reis, A. M., Proença, L., Alves, R. C., & Mendes, J. J. (2022). Revisiting standard and novel therapeutic approaches in halitosis: a review. International Journal Of Environmental Research And Public Health, 19(18), 11303.

III. Erawati, S., Idamawati, I., & Wijaya, H. (2023). Relationship Between Halitosis Level and Oral Hygiene in High School Students. Jurnal Penelitian Pendidikan IPA, 9 (SpecialIssue), 1083-1088.

IV. Mogilnicka, I., Bogucki, P., & Ufnal, M. (2020). Microbiota and malodor—etiology and management. International journal of molecular sciences, 21(8), 2886.

V. Hampelska, K., Jaworska, M. M., Babalska, Z. Ł., & Karpiński, T. M. (2020). The role of oral microbiota in intra-oral halitosis. Journal of clinical medicine, 9(8), 2484.

VI. He, M., Lu, H., Cao, J., Zhang, Y., Wong, M. C. M., Fan, J., & Ye, W. (2020). Psychological characteristics of Chinese patients with genuine halitosis. Oral diseases, 26(7), 1576-1585.

VII. Briceag, R., Caraiane, A., Raftu, G., Horhat, R. M., Bogdan, I., Fericean, R. M., ... & Talpos, S. (2023). Emotional and social impact of halitosis on adolescents and young adults: A systematic review. Medicina, 59(3), 564.

VIII. Okoh, M., & Caleb, O. (2021). Knowledge, attitude and practice towards halitosis among clinical students of the University of Benin. Ibom Medical Journal, 14(1), 79-86.

IX. Silva, M. F., Nascimento, G. G., Leite, F. R., Horta, B. L., & Demarco, F. F. (2020). Periodontitis and self‐reported halitosis among young adults from the 1982 Pelotas Birth Cohort. Oral Diseases, 26(4), 843-846.

X. Khalaf, A. K., & Al-Sudani, S. F. (2024). Exploring the potential link between oral cancer infections and extra-oral factors in the context of cancer-related halitosis. Onkologia i Radioterapia, 18(7).

XI. Oki, A. S., & Salsabila, A. R. (2024). Halitosis occurrence due to systemic disease and medication. World Journal of Advanced Research and Reviews, 22(2), 827-831.

XII. Aninda, R., Purwaningsih, E., & Ulfa, S. F. (2022). Pengetahuan Masyarakat Tentang Halitosis dengan Menggunakan Media Instagram di Kelurahan Arjuna Bandung. Indonesian Journal of Health and Medical. 2(4), 2774-5244.

XIII. Renvert, S., Noack, M. J., Lequart, C., Roldán, S., & Laine, M. L. (2020). The underestimated problem of intra-oral halitosis in dental practice: An expert consensus review. Clinical, Cosmetic and Investigational Dentistry, 12, 251-262.

XIV. Conceicao, M., & Giudice, F. (2021). A Chemical-mechanical tongue cleaning method: An Approach to control halitosis and to remove the invisible tongue biofilm, a possible cause of persistent taste disorder. J Dent Oral Sci, 3(2), 1-8.

XV. Dudzik, A., Sozkes, S., Michalak, E., & Olszewska-Czyz, I. (2021). Efficacy of a Zinc Lactate Mouthwash and Tongue Scraping in the Reduction of Intra-Oral Halitosis: A Single-blind, Controlled, Crossover Clinical Trial-A Pilot Study. Journal of clinical medicine, 10(23), 5532. https://doi.org/10.3390/jcm10235532.

XVI. Sudhakaran, S., Tom, J. J., Shyam, A., Mohan, S., Ali, S., & Raj, M. (2021). Effect of Chlorhexidine and Probiotics on Halitosis. Journal of pharmacy & bioallied sciences, 13(Suppl 1), S807–S811.

XVII. Alves, F., Stringasci, M. D., Requena, M. B., Blanco, K. C., Dias, L. D., Corrêa, T. Q., & Bagnato, V. S. (2022, May). Randomized and controlled clinical studies on antibacterial photodynamic therapy: An overview. In Photonics, 9(5): p.340

XVIII. Jao, Y., Ding, S. J., & Chen, C. C. (2023). Antimicrobial photodynamic therapy for the treatment of oral infections: A systematic review. Journal of Dental Sciences, 18(4):1453-1466.

XIX. Wang, N., Hao, S., Zhang, J., & Yang, J. (2022). Clinical efficacy of photodynamic therapy on halitosis: a systematic review and meta-analysis. Lasers in Medical Science, 38(1), 29.

XX. Niculescu, A. G., & Grumezescu, A. M. (2021). Photodynamic therapy—an up-to-date review. Applied Sciences, 11(8), 3626.

XXI. Algorri, J. F., Ochoa, M., Roldan-Varona, P., Rodriguez-Cobo, L., & López-Higuera, J. M. (2021). Light technology for efficient and effective photodynamic therapy: A critical review. Cancers, 13(14), 3484.

XXII. da Mota, A. C. C., Gonçalves, M. L. L., Horliana, A. C. R. T., Deana, A. M., de Souza Cavalcante, L. A., Gomes, A. O., et al. (2022). Effect of antimicrobial photodynamic therapy with red LED and methylene blue on the reduction of halitosis: controlled microbiological clinical trial. Lasers in medical science, 37(2), 877–886.

https://doi.org/10.1007/s10103-021-03325-x.

XXIII. Motta, P. B., Motta, L. J., Costa da Mota, A. C., Leal Gonçalves, M. L., Silva, T., Momolli, M., et al (2021). Comparative study between photodynamic therapy with urucum + LED and probiotics in halitosis reduction-protocol for a controlled clinical trial. PloS one, 16(5), e0247096. https://doi.org/10.1371/journal.pone.0247096.

XXIV. Klausen, M., Ucuncu, M., & Bradley, M. (2020). Design of photosensitizing agents for targeted antimicrobial photodynamic therapy. Molecules, 25(22), 5239.

XXV. Dey, A., Khan, M. A. S., Eva, F. N., Islam, T., & Hawlader, M. D. H. (2024). Self-perceived halitosis and associated factors among university students in Dhaka, Bangladesh. BMC oral health, 24(1), 909

XXVI. Huang, Z., & Cheng, Y. (2024). Oral microbiota transplantation for intra-oral halitosis: a feasibility analysis based on an oral microbiota colonization trial in Wistar rats. BMC microbiology, 24(1), 170. https://doi.org/10.1186/s12866-024-03322-4.

XXVII. Alzahrani, H. G., AlSarhan, M. A., Aldohayan, A., Bamehriz, F., & Alzoman, H. A. (2024). Effect of sleeve gastrectomy on the levels of oral volatile sulfur compounds and halitosis-related bacteria. The Saudi dental journal, 36(6), 940–946. https://doi.org/10.1016/j.sdentj.2024.04.005.

XXVIII. Rosner, O., Livne, S., Bsharat, M., Dviker, S., Jeffet, U., Matalon, S., & Sterer, N. (2024). Lavandula angustifolia Essential Oil Inhibits the Ability of Fusobacterium nucleatum to Produce Volatile Sulfide Compounds, a Key Component in Oral Malodor. Molecules, 29(13), 2982.

XXIX. Alshahrani, A.A.; Alhaizaey, A.; Kamran, M.A.; Alshahrani, I. (2020). Efficacy of antimicrobial photodynamic therapy against halitosis in adolescent patients undergoing orthodontic treatment. Photodiagn. Photodyn. Ther; 32: 102019

XXX. Labban, N.; Assery, M.K.; Al-Kattan, R.; Al-Shibani, N.; Alfouzan, A.F.; Al Taweel, S.M. (2020). Antimicrobial capacity of photodynamic therapy on oral health-related quality of life and halitosis among elderly patients wearing removal dentures. Photodiagn. Photodyn.Ther; 32: 102059.

XXXI. Maruyama T., Ekuni D., Yokoi A, Nagasaki J., Sawada N., Morita M. (2024). Effect of Antimicrobial Photodynamic Therapy on the Tongue Dorsum on Reducing Halitosis and the Duration of the Effect: A Randomized Clinical Trial. Healthcare; 12(980): 2-9

XXXII. Romero, S.S.; do Vale, K.L.; Remolina, V.G.; Silva, T.G.; Schalch, T.O.; Ramalho, K.M.; Negreiros, R.M.; Ando, E.S.; Mayer, M.P.A.;Mesquita Ferrari, R.A.; et al. (2021). Oral hygiene associated with antimicrobial photodynamic therapy or lingual scraper in the reduction of halitosis after 90 days follow up: A randomized, controlled, single-blinded trial. Photodiagn. Photodyn. Ther. 33: 102057