The First Major Breakthrough in Bad Breath Treatment Since TheraBreath
Here’s the fascinating story behind the most revolutionary addition to oral care since
the introduction of OXYD-8® and TheraBreath® back in 1994, TheraBreath Aktiv-K12
In the Spring of 2003, I came across a very interesting research article in The Journal
of Clinical Microbiology, with the “mysterious” title: Diversity of Bacterial Populations
on the Tongue Dorsa of Patients with Halitosis and Healthy Patients. It was
written by three groups of scientists, one from Harvard University, the second from the
Forsyth Institute of Boston, and the remaining group from the University of Michigan.
Their study “hit me like a brick”, because over the past ten years I had heard countless
times from people, just like you, pleading for a method to reverse the negative effects
of the sulfur producing “bugs” in their mouth. In essence, they requested an “introduction
of good bacteria” into the oral cavity. (Some wanted to know if their tongue could
be reshaped or smoothed-out – others asked if they should stop kissing their offending
Unbeknownst to me, and completely across the world (and I mean across the world)
Professor John Tagg and his research team from the Department of Microbiology,
University of Otago in New Zealand, had been working diligently to identify beneficial
strains of naturally occurring bacteria, which, by their production of antibacterial protein
chains, help protect humans against infection by other destructive bacteria.
The term used for these natural antibacterial peptides is B.L.I.S., an abbreviation for
Bacteriocin Like Inhibitory Substances.
A “bacteriocin”, by definition, is a protein chain
produced by beneficial bacteria to inhibit the growth of related bacteria. They are at the
forefront of medical/dental research because they are made by non-pathogenic bacteria
that normally colonize the human body.
Loss of these harmless bacteria following use of antibiotics may allow pathogenic bacteria
to invade the human body. [This is another bit of evidence that supports my call
to end the use of antibiotics such as Tetracycline and Minocycline for acne. A large
percentage of patients at my clinics reported use of these antibiotics during their teens
and now have chronic halitosis.]
Looking at our concept of natural bacterial intervention, or “Bacteriotherapy”, (the use
of strains of beneficial bacteria to control infection by undesirable bacteria), we have
learned that certain strains of micro-organisms produce BLIS substances, acting as
natural antibiotics, harmless to humans, which control the growth of undesirable bacterial
infections. The goal is to use nature’s strengths, instead of
artificial antibiotic or questionable therapies that have lead to the fact that many
antibiotics no longer work, because of their overuse and misuse.
The Theory Behind ProBiotics: A Mutually Beneficial Relationship Between Bacteria
In humans our internal tissues are normally free of micro-organisms. However, the surface
tissues, such as the skin and mucous membranes (inside of the mouth, nasal passages,
etc), are constantly in contact with the external environment and become easily
colonized by certain micro-organisms. The mixture of organisms regularly present at
any site is referred to as the normal flora. (In the mouth it is known as the normal oral
flora or microflora). This is usually a mutually-beneficial relationship. The normal
flora utilizes the supply of nutrients provided by the host, a stable environment, a constant
temperature, as well as protection and transport. The host may obtain from the
micro-organisms some nutritional benefit, some stimulation of the development of the
lymphatic tissues, but the most important general benefit is that colonization by
the well-adapted normal flora can exclude
other harmful micro-organisms from colonizing
The top two circular areas of the photo show
the inhibition of bacterial growth coming from
BLIS producing bacteria.
As an example of the strength of these “good
guy” bacteria, the photo at the right shows
The top two circular areas of the photo show
the inhibition of bacterial growth coming from
BLIS producing bacteria, versus the five
smaller circular inhibition areas on the bottom
of the plate, using the same, but “non BLIS producing” bacteria.
Studies show a direct link between low levels of Streptococcus salivarius in the mouth
throat and tonsils and the development of halitosis. This is because in-vitro testing
has shown that Streptococcus salivarius K12 inhibits the key pathogens responsible for
halitosis. Moreover, in-vitro testing has also shown that Streptococcus salivarius K12
inhibits the key pathogens responsible for ear infections and tonsillitis and clinical trials
are underway in these indications.
These trials have shown that for the majority of sufferers of chronic bad breath tested,
use of the TheraBreath Aktiv-K12 System resulted in a significant improvement in
breath scores. The 13 subjects in one trial averaged pre-treatment breath readings
which placed many of them in the range of bad breath odor being noticeable several
feet away. Following use of TheraBreath Aktiv-K12, a week later 11 of the 13 recorded
Halimeter scored below the range associated with bad breath even when tested first
thing in the morning before any oral care. Eight of these 11 maintained good breath
levels when tested first thing in the morning a further week later. The results of this
trial were presented at the TheraBreath sponsored International Conference for Breath
Odour in London, on 22 April 2004.
The following readings represent
an additional study,
showing the significant drop
in VSC readings following the
use of TheraBreath Aktiv-K12.
(The VSC levels of eight subjects
were significantly lower when tested
at one and two weeks after commencing
treatment. Average results are
presented in the following table)
Some of my dental colleagues
are finally getting around to acknowledging the significance of the tongue in the production
of breath odor. However, simply brushing, scraping, or cleaning the tongue is
NOT enough. Here’s the proof:
A control group of three subjects were also monitored using ONLY tongue cleaning and
chlorhexidine (an oral antibiotic rinse not available in the US), and showed no improvement
in VSC levels at the seven-day point versus pre-treatment VSC levels. In other
words, just cleaning your tongue and using strong-tasting mouthwash will not work.
Other measures in the trial such as organoleptic scoring of incubated saliva (smell
test), reduction of protein activity and changes in the bacterial profiles and cultural
analysis of the oral microflora also generally correlated with the observed reduction in
VSC levels. In other words, the study proved that this was a long-term benefit to oral
The Safety of S. Salivarius K12
Streptococcus salivarius is a naturally occurring bacterium, a predominant inhabitant
of the back of the tongue and the throat area of humans. S. salivarius becomes established
in the human oral cavity within two days after birth. The levels of S. salivarius
in swab samples taken from newborn infants represent 10% of the total streptococci
isolated, increasing to 25-30 % by one month of age. However, only 2% of the population
harbors S. salivarius strains that produce BOTH Salivaricin A and Salivaricin B.
Fortunately, The California Breath Clinics are now able to provide to nearly everyone, a
reproducible method allowing colonization of these “good bugs” onto the tongue and in
the oral cavity, so that bad breath can be controlled for much longer periods of time.
In spite of Streptococcus salivarius being one of the predominant organisms in the oral
cavity of humans, a search of the literature on this bacterial species found few references
linking it to any disease. The only cases that were reported were those that were
specifically related to cases involved with infection following surgical intervention with
poor hygiene control, major tissue trauma or were opportunistic infections in immune-compromised
individuals. Where antibiotic therapy was instituted treatment was successful.
No deaths or significant long term illnesses have been reported to result from
any case of infection from S. salivarius. Furthermore, S. salivarius has no reported
virulence factors that have been described for pathogenic streptococci. A review of the
literature in respect of toxicity, carcinogenicity, reproductive and embryo fetal toxicity
raised no issues of safety.
One major reason for its history of safety is that Streptococcus salivarius is closely
related to Streptococcus thermophilus, the safe bacteria widely used in yogurt and
The idea that Streptococcus salivarius strains may provide some protection against
pathogenic bacteria was reviewed by Tagg and Dierksen (2003) and has also been the
subject of earlier reports from other groups Huskins and Kaplan (1989); Sanders and
Sanders (1982), and Fantinato, Jorge, Schimuzu (1999).
In a very recent study to compare the bacterial populations on the dorsal surface of
the tongue in healthy subjects and people with halitosis, Streptococcus salivarius was
found to be the predominant species in healthy subjects, but was typically at low levels
or absent in those subjects suffering from halitosis (Kazor et al, 2003).
In fact, sales of BLIS K12 began in New Zealand in May 2002. To date over 50,000
courses have been sold with no adverse reports related to the use of the active organism.
Additional Safety Studies:
Streptococcus salivarius is an indigenous organism of the oral cavity in humans.
It is found in the highest amounts on the dorsal surface of the tongue and the pharynx (throat).
Streptococcus salivarius was tested for mutagenicity in the Ames test and all test results were negative.
Streptococcus salivarius K12 was originally isolated from a healthy individual who
showed high relative resistance to infection by undesirable oral bacteria.
Testing of Streptococcus salivarius K12 has been carried out which showed that theorganism is
susceptible to most commonly used antibiotics for upper respiratory conditions,
and carries no known virulence factors.
In colonisation trials with the product containing
Streptococcus salivarius K12, no adverse effects were reported.
Since May of 2002, post-marketing surveillance following sales of over 70,000
courses of the active ingredient in Aktiv-K12, has only led to one report of
infection which proved not to be Streptococcus salivarius.
Streptococcus salivarius is listed in the USA as an organism considered
to pose no threat to health or the environment.
Overall, it may be concluded that administration of Streptococcus salivarius K12 to
humans in the manner proposed is safe for everyone and is unlikely to result in adverse effects of significance.
The Ingredients of Aktiv-K12 ProBiotics
More than 100 Million Cells of Beneficial Bacteria, Streptococcus Salivarius K12