Clinical Evaluation of Volatile Sulfur Compound Detectors

Objectives: Halitosis is one of the major concerns in the general population. Volatile sulfur compounds (VSC) are the major causes of breath malodor. Measuring VSC concentration in mouth air is an efficient procedure to diagnose halitosis. Halimeter^TM, a voltametric sensor, is widely utilized and an improved procedure has been lately developed. Recently, two new products for detecting halitosis were also developed. The objectives of this study were to assess the sensitivity and selectivity of these three procedures and to compare the data with those from a gas chromatography(GC), the gold standard of measuring VSC. Methods: The three main VSC observed in human breath were hydrogen sulfide, methyl mercaptan, and dimethyl sulfide. The levels of oral VSC in healthy individuals (n=126) are evaluated by three procedures: OralChroma^TM( a portable gas chromatography,Takasago,Japan), Breathtron^TM equipped with a semiconductor sensor and a filter for removing contaminants(Yoshida,Japan), and Halimeter^TM(Interscan, USA). Results: In hydrogen sulfide measurements, adequate correlations were found between OralChroma^TM vs. GC and Breathtron^TM vs. GC, y=2.25x (R=0.80) and y=2.13x(R=0.90) respectively. OralChroma^TM was found to be completely specific to detect hydrogen sulfide. The incidence of misdiagnosis of oral malodor was higher (24%) in Breathtron^TM than in OralChromaTM(13%). Halimeter¢Edemonstrated also a good correlation with GC in hydrogen sulfide measurements. However, an improved procedure by Furne et al (2002), which is the plateau phage measurement, demonstrated no correlation between the results from HalimeterTM and GC. Conclusion: Either detector demonstrated good correlation with GC readings. However, OralChroma^TM demonstrated higher specificity and accuracy in detecting VSC.