New Adjunct Test for Oral Malodour: Clinical Utility

Introduction: Until now, the application of biogenic amines as clinical markers of oral malodour has been limited because of the complexity of the techniques for their detection. Objectives: The aim of this study was to evaluate the utility, as an adjunct test in the oral malodour diagnosis, of a simple colorimetric method able to detect amines in saliva. Methods: Non stimulated saliva samples were collected from 100 volunteers with different degrees of oral malodour at a multidisciplinary consultation for bad breath. The colour developed by the saliva in contact with the new test was checked employing a 10-point colour scale developed ad hoc. The test results were correlated with the organoleptic score (OLS) and the volatile sulphur compounds (VSC) and compared with other salivary colour test (BANA test, beta-Galactosidase and Ninhydrin method). The difference between the results of the new test in patients with and without oral malodour was assessed. The sensitivity (Se), specificity (Sp), and positive (PPV) and negative predicted value (NPV) of the new test was calculated. A linear regression model was used to check whether the test improves the relation between the OLS and VSC measurements. Results: The test results correlated with the OLS (r= 0.5488; p < 0.0001) and the VSC (p= 0.5221; p <0.0001). The colour scores of patients without halitosis were significantly different from the colour scores of patients with halitosis (Mann-Whitney U-test, p < 0.0001). The Se, Sp and PPV, NPV of the new test were 75%, 77.1%, 78% and 74% respectively. The p-value for the addition of a variable to the model was 0.0001. Conclusions: The amines in saliva detected by this test explain part of the OLS variability that VSC doesn't. Our results support the “fit for purpose” of the test as adjunct tool for the diagnosis of oral malodour.