Assessment of oral malodor: a comparison of the organoleptic method with sulfide monitoring

Abstract

Aim: The purpose of the present study was to measure the oral malodor of volunteers by means of a subjective organoleptic method and a sulfide monitor as well as to evaluate the diagnostic value of the Halimeter in the diagnosis of halitosis.

Methods and materials: Sulfide monitoring and organoleptic oral malodor assessment methods were performed on 77 volunteers (51 females, 26 males) selected from academic staff, students, clerks, and patients of the Shaheed Beheshti University of Medical Sciences and Health Services, Dental School. The organoleptic method of assessment and sulphide monitoring were conducted by three calibrated judges. The Kendall's tau-b correlation analysis was used to calculate correlation coefficients between the sulfide monitor and organoleptic scores.

Results: The Kendall's correlation coefficient between sulfide monitoring and organoleptic scores was 0.493 (p<0.001). Sensitivity and specificity were assessed to be 61.1% and 87.8% respectively. The positive predictive value (PPV) and the negative predictive value (NPV) were 81.5% and 72%, respectively. The intra-class correlation coefficient for the three episodes of monitoring was calculated as 97%.

Conclusion: Use of a sulfide montoring device in conjunction with the organoleptic method is an effective strategy for diagnosing oral malodor.

Clinical relevance: Because of its small size and simplicity of handling the Halimeter sulfide monitor is convenient to use. This method of evaluation of patients for oral malodor is capable of differentiating normal patients (such as with Pseudohalitosis and halitophobia) from the others and for halitosis screening along with other techniques such as the organoleptic method. However, when used alone, it may lead to a misdiagnosis of some cases in terms of intensity.