A new portable monitor for measuring odorous compounds in oral, exhaled and nasal air

ORGANOLEPTIC AND HALITOMETRIC ASSESSMENTS DO NOT CORRELATE WELL IN INTRA-ORAL HALITOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

BACKGROUND

The gold standard method for diagnosing oral halitosis is the subjective organoleptic measurement. Device-supported methods are also widespread worldwide. The challenges and safety concerns around performing organoleptic measurements during pandemics and the diversity of measuring device alternatives raised our clinical question: which halitometer is the most suitable for diagnosing halitosis?

METHODS

This systematic review was registered in PROSPERO (ID CRD42022320024). The search was performed on March 23, 2022 in the following electronic databases: MEDLINE, Embase, Scopus, Web of Science, and CENTRAL. Adult populations with or without halitosis were included, and patients with systemic diseases were excluded. Organoleptic (subjective) measurement and the device-supported (objective) methods were compared; the primary outcome was the correlation coefficient, and the secondary was the specificity and sensitivity of the devices. QUADAS-2 and QUADAS-C were used to evaluate the risk of bias in the studies. Random-effects meta analyses were performed on the outcomes, and the secondary outcomes were plotted on a common ROC plot.

RESULTS

A total of 1231 records were found in the 5 databases. After the selection process, 76 articles were eligible for the systematic review, and 14,635 patients were involved in the qualitative analysis. The pooled Spearman's correlation coefficient (c.c.) for sulfide monitors was 0.65; 95% CIs: [0.53-0.74]; I2 = 95%, P < .01. The pooled Spearman's c.c. for portable gas chromatographs was 0.69; 95% CIs: [0.63-0.74]; I2 = 12%, P < .01. The pooled Spearman's c.c. for gas chromatographs was 0.76; 95% CIs: [0.67-0.83]; I2 = 0%, P < .01.

DISCUSSION

None of the most commonly used halitometers proved to be significantly superior to the others. Halimeter and OralChroma measurements did not correlate well with the organoleptic level of oral halitosis in adults. Therefore, better halitometers need to be developed as an alternative to organoleptic measurements.

Piezoelectric Gas Sensors with Polycomposite Coatings in Biomedical Application

When developing methods for diagnosing pathologies and diseases in humans and animals using electronic noses, one of the important trends is the miniaturization of devices, while maintaining significant information for diagnostic purposes. A combination of several sorbents that have unique sorption features of volatile organic compounds (VOCs) on one transducer is a possible option for the miniaturization of sensors for gas analysis. This paper considers the principles of creating polycomposite coatings on the electrodes of piezoelectric quartz resonators, including the choice of sorbents for the formation of sensitive layers, determining the mass and geometry of the formation of sensitive layers in a polycomposite coating, as well as an algorithm for processing the output data of sensors to obtain maximum information about the qualitative and quantitative composition of the gas phase. A comparative analysis of the efficiency and kinetics of VOC vapor sorption by sensors with polycomposite coatings and a set of sensors with relevant single coatings has been carried out. Regression equations have been obtained to predict the molar-specific sensitivity of the microbalance of VOC vapors by a sensor with a polycomposite coating of three sorbents with an error of 5-15% based on the results of the microbalance of VOC vapors on single coatings. A method for creating "visual prints" of sensor signals with polycomposite coatings is shown, with results comparable to those from an array of sensors. The parameters A_ij∑ are proposed for obtaining information on the qualitative composition of the gas phase when processing the output data of sensors with polycomposite coatings. A biochemical study of exhaled breath condensate (EBC) samples, a microbiological investigation of calf tracheal washes, and a clinical examination were conducted to assess the presence of bovine respiratory disease (BRD). An analysis of the gas phase over EBC samples with an array of sensors with polycomposite coatings was also carried out. The "visual prints" of the responses of sensors with polycomposite coatings and the results of the identification of VOCs in the gas phase over EBC samples were compared to the results of bacteriological studies of tracheal washes of the studied calves. A connection was found between the parameters A_ij∑ of a group of sensors with polycomposite coatings and the biochemical parameters of biosamples. The adequacy of replacing an array of piezoelectric sensors with single coatings by the sensors with polycomposite coatings is shown.

Knowledge and perception of parents regarding halitosis in their children in Saudi Arabia

Objective

To evaluate parents’ knowledge about halitosis, and to compare parents’ perception of halitosis in their children to the presence of halitosis clinically.

Methods

Children between 3 and 8 years attended to Dental University Hospital, King Saud University, were screened. Children satisfying inclusion criteria and their parents agreed to participate were included. Questionnaires regarding parents’ knowledge and perception about halitosis in their children were filled by attending parents. Then, the assessment of halitosis in the participating children carried out by portable gas chromatograph device (OralChroma^TM).

Results

A total of 67 children (44 girls and 23 boys) were included in this study with a mean age of 5.3 years (SD = 1.7). The majority of the questionnaires (n = 44, 65.7%) were filled by accompanying fathers. One in two (52.2%) parents obtained high knowledge score about halitosis. Parents’ knowledge was significantly associated with the mean age of the children (P = 0.02). Thirty-nine (58.2%) parents perceived halitosis in their children. Gender, child’s age, parents’ education level, or family income were not associated with parents’ perception of halitosis. Halitosis was detected clinically in 58 children (86.6%). Thirty-eight (57%) of parents’ perception of halitosis was in consistency with OralChroma^TM readings; however, there was no significant association between parents’ perception and the OralChroma^TM score.

Conclusion

Half of the parents had good knowledge about halitosis and 6 in 10 parents perceived halitosis in their children which is quite less than the presence of halitosis detected clinically. Moreover, parents’ perception was not associated with the OralChroma^TM score.

Role of the oral microbiome, metabolic pathways, and novel diagnostic tools in intra-oral halitosis: a comprehensive update

Halitosis or oral malodor is one of the most common reasons for the patients' visit to the dental clinic, ranking behind only dental caries and periodontitis. In the present times, where social and professional communications are becoming unavoidable, halitosis has become a concern of growing importance. Oral malodor mostly develops due to the putrefaction of substrates by the indigenous bacterial populations. Although culture-based studies have provided adequate information on halitosis, the high throughput omics technologies have amplified the resolution at which oral microbial community can be examined and has led to the detection of a broader range of taxa associated with intra-oral halitosis (IOH). These microorganisms are regulated by the interactions of their ecological processes. Thus to develop effective treatment strategies, it is important to understand the microbial basis of halitosis. In the current review, we provide an update on IOH in context to the role of the oral microbiome, metabolic pathways involved, and novel diagnostic tools, including breathomics. Understanding oral microbiota associated with halitosis from a broader ecological perspective can provide novel insights into one's oral and systemic health. Such information can pave the way for the emergence of diagnostic tools that can revolutionize the early detection of halitosis and various associated medical conditions.

Prevalence of halitosis in elderly living in nursing homes

OBJECTIVES

Halitosis is a concern for many people, but has sparsely been studied in elderly living in nursing homes. The aim of this investigation was to study the prevalence of halitosis in this particular group and factors that could be associated with this condition.

METHOD AND MATERIALS

One hundred and twenty-four residents at three different nursing homes were included in the study. The level of halitosis was assessed using an organoleptic method based on a 6-graded scale. Oral status, including registrations of plaque, gingivitis and assessment of hyposalivation, was performed by two investigators who both examined all patients. Medical history, that is medication, neurological conditions, diabetes, cardiovascular disease, chronic obstructive pulmonary disease (COPD)/asthma, dementia and mental illness, was obtained from the patient files. Registrations of the use of oral hygiene aids, ADL (Activity of Daily Life) and the frequency of contact with dental services were included in the clinical examination.

RESULTS

Halitosis occurred in over 50% of residents living in nursing homes and was found to be associated with the presence of hyposalivation, periodontal disease, calculus, fixed prosthodontics and dementia.

CONCLUSION

Halitosis was a common finding in the elderly living in Swedish nursing homes.

A new measurement protocol to differentiate sources of halitosis

OBJECTIVE

Three sources of halitosis exist, potentially in any combination: mouth, nasal cavity or alveolar breath. There has been no universally accepted protocol which differentiates and quantifies each odour source separately. In this study a new gas measurement protocol is described and tested to determine whether each odour source can be separately detected without contamination.

MATERIALS AND METHODS

Ninety healthy volunteers were divided into three groups. Hydrogen sulphide (H2S), volatile organic compounds (VOCs) and hydrogen (H2) were artificially generated in the mouth, nose and pulmonary alveoli, respectively. VOC, ammonia (NH3), sulphur dioxide (SO2), H2S and H2 gas readings from mouth, nose and alveolar air were measured and compared. Measurements were taken before and during gas generation.

RESULTS

Contamination of nasal air (2.8%) and alveolar air (5.0%) by oral H2S; alveolar air (2.06%) and oral air (4%) by nasal organic gas; nasal air (18.43%) and oral air (9.42%) by alveolar H2 was calculated.

CONCLUSION

The results demonstrated that artificially generated oral H2S nasal VOC and alveolar H2 can be individually quantified. This gas measurement protocol can be used diagnostically or to gauge response to therapy in any medical or dental setting.

Usefulness of a new malodour-compound detection portable device in oral malodour diagnosis

A new device (BB Checker) able to detect malodour compounds has recently been made available. This retrospective analysis aimed at evaluating the usefulness of this device as adjunct tool for the diagnosis of oral malodour. Data from 100 consecutive volunteers with bad breath complaints attending their first consultation at a halitosis clinic were analysed. In addition to the standard protocol (organoleptic ratings from mouth and nose air, and from tongue coating when present; OralChroma and Halimeter measurements from mouth air; and intra-oral examinations), oral, exhaled and nasal air samples were examined with the BB Checker. We could not establish a correlation between the BB Checker values and the organoleptic scores, or the sulfur-compound levels determined by the OralChroma or the Halimeter (R < 0.3, p > 0.05). The overall sensitivity and specificity of the new device did not exceed the 50%. The correlations between the organoleptic scores and the OralChroma and the Halimeter measurements were good and in line with previous reports (R between 0.56 and 0.73). Our results do not favour the use of the BB Checker as adjunct tool in the diagnosis of oral malodour.