Impact case study database

Figure 1: Summary of the research and its impact. UWE’s Malodour Research environment (see Section 2) includes: 1. Clinical Trial capability; 2. VOC detection using gold standard SIFT-MS; 3. flat-bed in vitro biofilm model and 4. qualified organoleptic breath assessment. (i-v) Impacts resulted from the research (details are provided below).

(i) Development and launch of a novel oral care technology In collaboration with Philips Research Laboratories, Saad developed superior halitosis products ( R5, G8). A Senior Scientist at Phillips stated that Saad’s research showed ‘a direct relationship between bacterial numbers and strength of odour’, critical in determining ‘to what extent tongue bacteria count had to be reduced in order to achieve sustained clean breath’ ( S1). Philips invested in feasibility studies, prototype development and clinical studies with UWE, allowing Philips ‘ to further iterate the technology’ and to devise various technologies including ‘customised bristles under sonic motion to remove bacteria from deep within the tongue structure’ ( S1). The assistance from UWE meant that ‘ TongueCare+ was developed and launched in record 3 years from initial idea to market launch’ ( S1). ‘ TongueCare+ was initially launched in 2016 in Europe and USA before global rollout [and at the time] … first year sales were projected to exceed 25M Euros’. ‘ TongueCare+ is currently retailed by major global retailers such as Amazon, Walmart and Boots’ ( S1). Further impacts were ‘ the creation of a new sub-category of breath odour for Philips Oral Health Care’ and enabling ‘new marketing strategies and technology functions’ ( S1).

**(ii) Development of a reformulated oral care product with new evidence-based claims Colgate-Palmolive reformulated their best-selling toothpaste, Colgate Total®, which ‘ represents approximately $1bn of annual revenue for the company’ ( S2, S3). This included replacing the active ingredient triclosan (where regulatory scrutiny risked business and reputation) with Dual Zinc plus Arginine ( S3) as antimicrobial and odour-neutralising agents ( R6, G9). Saad’s research provided the ‘evidence-based claims for the product’ ( S2). Additionally, for such an established product, Saad’s research allowed Colgate-Palmolive to make new claims namely ‘ the Dual Zinc plus Arginine dentrifice in Colgate-Total® can provide short-term (twelve hours) and long-term (one month) improvements in breath quality from a single use’ ( R6, S2). UWE’s Malodour Research environment (figure 1) allowed Colgate-Palmolive ‘ to capture and analyse new dimensions in oral malodour’ such as previously uncharacterised volatile compounds. The reformulated toothpaste was ‘re-launched in January 2019’ ( S2, S3).

**(iii) Repurposing an existing device for the healthcare market resulting in time and cost savings ** Saad tested a prototype electronic nose NeOse^TM Pro invented by the technology company Aryballe and funded by CEMAG Care. NeOse^TM Pro, the bio-optic smell sensor, was targeted at detecting environmental fumes, such as smoke. Saad’s research showed that the core technology in NeOse^TM Pro conformed to both the SIFT-MS and the organoleptic score providing ‘a sound underpinning validation of the NeOse^TM Pro in the field of halitosis’ ( S4). ‘ Saad made recommendations to improve the early prototypes … to reliably test VOC compounds’ and ‘directed the development of key accessories’ ( S5). The core technology was given a new casing including a newly developed mouthpiece for collecting VOCs. Consequently, Aryballe filed a patent application in France with Saad as a named inventor in 2020 ( S6). The Chief Scientific Officer of CEMAG stated that Saad’s work demonstrated ‘the first published use for the technology in the field of healthcare’ that can be used ‘ to measure the full spectrum of compounds in halitosis’ ( S4). Saad’s work quickly resulted in proof-of-concept data and ‘ led to a saving of around one year in the pipeline of this technology’ ( S4). Subsequently, Saad and Varadi set up new collaborations between Colgate-Palmolive and CEMAG-Aryballe ( G9, G10) providing credibility and validation for the device ( S5) and ‘accelerating the route to market in this field’ with consequent cost savings ( S5).

(iv) Improving patient diagnosis, classification and treatmentSaad’s research ( R1, R5, R6, G1) underpinned UWE’s ‘Odour Judge Assessment’ continuous professional development (CPD) programme. Twelve participants (dentists, physicians, hygienists, microbiologists, maxillofacial surgeons) attended each of the six programmes (2004-2013) from the USA, Netherlands, France, Italy, Germany, Sweden, Norway, Iceland, Poland, Hungary and UK. A participant periodontologist and Associate Professor at the Dental Faculty of Strasbourg, is now ‘ able to differentiate [between] the different gases’ leading to discrimination ‘ between physical … and psychiatric conditions’ and ‘coming to a definitive diagnosis’ in a halitosis clinic providing a service for patients across France ( S7). Another participant, dentist and Associate Professor of Medical Technologies at the University of Cagliari, stated that he can now ‘ assess oral malodour prior to dental implantation’ to prevent implant failure ( S8). He now offers in his referral clinic a service for patients with ‘delusional halitosis’ with appropriate interventions ( S8). Additionally, he included a new topic on ‘ microflora of the tongue and oral malodour’ in the dental curriculum at his University ( S8). One dentist involved in Saad’s clinical trials, used Saad’s research to recommend interventions and oral care products to patients that were ‘ successful in alleviating malodour’ and ‘educating patients about tongue cleaning has made a huge difference’ in his practice and has been shared with six partner clinics in London ( S9). He also highlighted that the knowledge he gained from Saad’s research is ‘ improving the quality of life for our patients’ ( S9).