title: The levels of volatile sulfur compounds in mouth air from patients with chronic periodontitis.
abstract: OBJECTIVE
  Volatile sulfur compounds may be the main source of oral malodor. The aim of this study was to clarify the relationship between periodontal parameters and volatile sulfur compounds and to evaluate the improvement of several halitosis-related outcomes by tongue scraping, nonsurgical periodontal treatment (including oral hygiene instruction) and oral hygiene instruction/chlorhexidine + cetyl pyridinium gargling.
  
  
  METHODS
  Seventy-two chronic periodontitis patients with heavy tongue coating were assessed for oral malodor and periodontal status. Oral malodor was evaluated by measuring the levels of volatile sulfur compounds using OralChroma and the organoleptic test score. Thirty participants were selected for the subsequent experiments: tongue scraping; nonsurgical periodontal treatment; and oral hygiene instruction/chlorhexidine + cetyl pyridinium gargling. Twenty-five participants completed all experimental stages.
  
  
  RESULTS
  Significant correlations were observed between the organoleptic test score and hydrogen sulfide (H2S), methyl mercapton (CH3SH), tongue coating score and volatile sulfur compounds, which was also significantly correlated with bleeding on probing percentage and tongue coating score. Tongue scraping significantly reduced the levels of volatile sulfur compounds. Further reduction of volatile sulfur compounds after nonsurgical periodontal treatment and oral hygiene instruction/chlorhexidine + cetyl pyridinium gargling were noted compared with baseline.
  
  
  CONCLUSIONS
  Volatile sulfur compounds, with H2S and CH3SH as the main components, in mouth air are the prominent elements of malodor. Volatile sulfur compounds were decreased by more than 50% after tongue scraping. Nonsurgical periodontal treatment and oral hygiene instruction/chlorhexidine + cetyl pyridinium gargling maintained a significantly lower level of malodor compared with baseline.
authors.affiliation: Graduate Institute of Dental Sciences, College of Dental Medicine and Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. chchts@kmu.edu.tw
authors.forename: C-C
authors.initials: CC
authors.lastname: Tsai
authors.forename: H-H
authors.initials: HH
authors.lastname: Chou
authors.forename: T-L
authors.initials: TL
authors.lastname: Wu
authors.forename: Y-H
authors.initials: YH
authors.lastname: Yang
authors.forename: K-Y
authors.initials: KY
authors.lastname: Ho
authors.forename: Y-M
authors.initials: YM
authors.lastname: Wu
authors.forename: Y-P
authors.initials: YP
authors.lastname: Ho
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D001944:Breath Tests; D002594:Cetylpyridinium / Q000627:therapeutic use; D002710:Chlorhexidine / Q000627:therapeutic use; D012534:Dental Scaling; D005260:Female; D006209:Halitosis / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use; D009910:Oral Hygiene; D010518:Periodontitis / Q000150:complications* / Q000628:therapy*; D018709:Statistics, Nonparametric; D013457:Sulfur Compounds / Q000032:analysis*; D014059:Tongue / Q000737:chemistry
chemical_list: D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D013457:Sulfur Compounds; D002594:Cetylpyridinium; D002710:Chlorhexidine