Relationship between oral malodor and clinical parameters

Objectives: Oral malodor is caused by several factors, however, the pathological factors are still unclear. The purpose of this study was to investigate which clinical parameters were most related with oral malodor. Methods: The subjects were 199 patients with the mean age of 45.2 years (male: female, 53: 146) who visited the Fresh Breath Clinic at Tokyo Medical and Dental University Dental Hospital, between 2003 and 2004. Clinical evaluation included a questionnaire regarding patient's history of halitosis and symptoms, oral examination (pocket-depth and DMFT), organoleptic test (OLT) and volatile sulfur compounds (VSC) measurement with a gas chromatography at baseline. Data were analyzed using the SPSS version 10. We used logistic regression analyses to determine which variables demonstrated significant independent effects on oral malodor. Results: In the correlation analysis between malodor and oral health measurements, OLT score was significantly correlated with total VSC level (r=0.44), tongue-coating scores (area: r=0.23, thickness: r=0.35) and pocket-depth (r=0.20). Gender, smoking habit, tongue self-cleaning, and some other parameters had significant associations with malodor by bivariate analyses. Forty-eight patients classified with oral pathologic halitosis were defined as over 3 OLT score (mean total VSC: 19.0ng/10ml, pocket-depth: 4.2mm). The independent effects of variables associated with malodor were analyzed by multivariate logistic regression. Significant variables in the logistic regression model were dental clinic consultation, tongue self-cleaning, self-perception of oral malodor, nutrition balance, tongue-coating thickness scores, and diabetic patient. Odds ratios were 2.5, 2.5, 2.6, 2.8, 4.3, and 17.4, respectively. Conclusions: These results suggest that clinical parameters most related with oral malodor may be not only oral health condition especially tongue-coating thickness but also general health such as nutrition balance and diabetes.