Clinical reliability of non-organoleptic oral malodour measurements.
OBJECTIVE
Measurement of volatile sulphur compounds (VSC) by portable sulphur monitors (Halimeter, OralChroma) is a common practice for diagnosis of oral malodour. In this study, the clinical value of these devices was examined.


METHODS
Two hundred and eighty patients with bad breath complaints attending a halitosis consultation were enrolled. Organoleptic scores were given by a trained and calibrated judge, before measurement of the VSC levels (Halimeter, OralChroma), to avoid any bias.


RESULTS
Significant correlations were found between the organoleptic assessment, the Halimeter, and the OralChroma (R=0.74 for organoleptic versus Halimeter; 0.66 for organoleptic versus OralChroma; 0.63 for Halimeterversus OralChroma). The sensitivity and specificity (with regard to the organoleptic score) to detect patients with/without oral malodour for the Halimeter were 63% and 98%, respectively, and for the OralChroma 69% and 100% when using the cutoffs suggested by the manufacturer. By lowering these values, sensitivity could be improved without a significant decrease in specificity (both devices).


CONCLUSIONS
We concluded that the measurement of the VSC levels can be used as an adjunct to the organoleptic assessment. Thresholds should be revisited in order to improve their clinical utility. These devices can prove the absence of malodour in case of pseudo-halitosis.
Vandekerckhove
Betty
B
Department of Periodontology, Catholic University of Leuven, Leuven BE-3000, Belgium.
Van den Velde
Sandra
S
De Smit
Menke
M
Dadamio
Jesica
J
Teughels
Wim
W
Van Tornout
Marie
M
Quirynen
Marc
M
D000328:Adult; D001944:Breath Tests / Q000295:instrumentation*; D002849:Chromatography, Gas / Q000295:instrumentation / Q000706:statistics & numerical data; D005260:Female; D006209:Halitosis / Q000175:diagnosis*; D006801:Humans; D006862:Hydrogen Sulfide / Q000032:analysis; D008297:Male; D009911:Oral Hygiene Index; D010512:Periodontal Index; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012903:Smell / Q000502:physiology; D013438:Sulfhydryl Compounds / Q000032:analysis; D013457:Sulfur Compounds / Q000032:analysis*; D014059:Tongue / Q000473:pathology; D055549:Volatile Organic Compounds / Q000032:analysis; D014987:Xerostomia / Q000145:classification
D013438:Sulfhydryl Compounds; D013457:Sulfur Compounds; D055549:Volatile Organic Compounds; D006862:Hydrogen Sulfide