Relationship between Volatile Sulfur Compounds and the Oral Environment in Patients Complaining of Oral Malodor

Abstract

 The purpose of this study was to investigate the relationship between volatile sulfur compounds (VSC) and accumulation of tongue coating and periodontal conditions in patients complaining of oral malodor.

 The participants enrolled in this study were 156 outpatients of the Clinic for Breath Odor in Tokushima University Hospital. The data regarding sex, age, daily oral cleaning habits and smoking habits were obtained from electronic medical records in addition to the results of the gas chromatography (H₂S, CH₃SH, total VSC). The accumulation of tongue coating in subjects was quantified using the Winkle Tongue Coating Index (WTCI). The relationship between halitosis and the oral environment was statistically analyzed using the data from 37 participants who had been assessed for periodontal conditions and the status of oral hygiene.

 All VSC detected in the group with a tongue cleaning habit were significantly lower than those in the group without a tongue cleaning habit. A significant positive correlation was also observed between all VSC detected and WTCI and O’Leary PCR. Furthermore, a significant positive correlation was observed between Periodontal Epithelial Surface Area (PESA) and CH₃SH in patients diagnosed with genuine halitosis. The concentrations of VSC detected were determined by logarithm conversion and used as dependent variables for the multiple regression analysis. As a result, only WTCI was significantly correlated to all VSC values, and the partial correlation coefficient of H₂S, CH₃SH and total VSC were 0.519 (p<0.01), 0.479 (p<0.05) and 0.531 (p<0.01), respectively.

 These results indicated that the accumulation of tongue coating contributes to the production of VSC. Therefore, prevention of oral malodor to reduce the accumulation of tongue coating is needed.