Department of Preventive Dentistry, Institute of Health Biosciences, The University of Tokushima Graduate School, Kuramotocho, Japan.
Arch Oral Biol. 2010 Nov;55(11):842-7. doi: 10.1016/j.archoralbio.2010.07.014.
To investigate the relationship between salivary stress markers and mental stress states in patients complaining of oral malodour. The utility of the salivary stress markers in assessment of mental conditions of those patients was also investigated.
The study population included 74 patients, aged 20-59 years, who complained of oral malodour and were referred to the Breath Odor Clinic at Tokushima University Hospital. Patients were classified into two groups, genuine halitosis (GH) and psychosomatic halitosis (PH), according to the results of organoleptic rating measurement. All patients were subjected to examination by the Cornell Medical Index (CMI) Health Questionnaire. Resting saliva was collected and levels of salivary IgA, cortisol and chromogranin A were determined by ELISA. Twenty-three volunteers not complaining of halitosis were included as the control group. Kruskal-Wallis test and Mann-Whitney's U-test were used for statistical analysis.
A significant increase was observed in the concentrations of salivary cortisol in the PH group as compared with GH and control groups (p<0.05). Concentrations of IgA and chromogranin A in saliva were not significantly different among the three groups. In addition, higher salivary cortisol concentrations were found in CMI scale III and IV (tendency towards neurosis) than in scale I and II (normal) (p<0.05). Since salivary cortisol reflects a status of chronic stress condition, psychosomatic halitosis might be closely related to this state of chronic stress.
Determination of cortisol levels in saliva may provide useful information for evaluating the mental status of patients complaining of halitosis.
探讨口臭患者唾液应激标志物与精神应激状态的关系，并研究唾液应激标志物在评估这些患者精神状况中的作用。
研究对象为 74 名年龄在 20-59 岁之间、因口臭就诊于徳岛大学医院口气异味诊所的患者。根据嗅感测试评分结果，患者被分为真性口臭（GH）和心因性口臭（PH）两组。所有患者均接受康奈尔医学指数（CMI）健康问卷检查。采集唾液，采用 ELISA 法检测唾液 IgA、皮质醇和嗜铬粒蛋白 A 的水平。选择 23 名无口臭的志愿者作为对照组。采用 Kruskal-Wallis 检验和 Mann-Whitney U 检验进行统计学分析。
与 GH 组和对照组相比，PH 组唾液皮质醇浓度显著升高（p<0.05）。三组间唾液 IgA 和嗜铬粒蛋白 A 浓度无显著差异。此外，CMI 量表 III 和 IV（倾向于神经症）的唾液皮质醇浓度高于量表 I 和 II（正常）（p<0.05）。由于唾液皮质醇反映了慢性应激状态，因此心因性口臭可能与这种慢性应激状态密切相关。
唾液皮质醇水平的测定可能为评估口臭患者的精神状态提供有用的信息。
