Departamento de Clínica, Patologia e Cirurgia, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Surg Obes Relat Dis. 2013 Mar-Apr;9(2):315-21. doi: 10.1016/j.soard.2011.10.020. Epub 2011 Nov 25.
Patients undergoing bariatric surgery often complain of bad breath. However, the relationship between bariatric surgery and halitosis is relatively unknown. The purpose of the present study was to evaluate and compare the occurrence of halitosis among patients before and after a specific type of bariatric surgery, Roux-en-Y gastric bypass, and its relationship with the tongue coating index, plaque index, and salivary flow rate.
A total of 62 patients with good oral health and in treatment for obesity at the walk-in clinic of Santa Casa Hospital, Belo Horizonte, Brazil, were selected. Of this sample, 31 were bariatric surgery candidates (control group) and 31 had already undergone Roux-en-Y gastric bypass surgery (case group). After completing a questionnaire, all patients underwent an oral clinical examination. Halitosis was measured using an organoleptic scale and a portable sulfide monitor.
The Spearman correlation demonstrated a strong positive relation between the organoleptic rates and the concentration of volatile sulfur compounds determined using the sulfide monitor (rs = .58; P = .0001). No difference was found in the prevalence of halitosis between the 2 groups (P = .48). Only the salivary flow rate was significantly reduced in the control group compared with the case group (P = .02). In the case group, the concentration of volatile sulfur compounds correlated negatively with the salivary flow rate (P = .04) and positively with the tongue coating index (P = .005). The tongue coating index was significantly increased in those patients who did not brush the tongue (P < .04) and who had had episodes of vomiting (P = .02).
These data suggest that no significant association exists between halitosis and Roux-en-Y gastric bypass. However, they do highlight the possible effect of this surgery on the oral cavity.
接受减重手术的患者常抱怨口臭。然而，减重手术与口臭之间的关系尚不清楚。本研究旨在评估和比较特定类型减重手术后（Roux-en-Y 胃旁路术）患者口臭的发生情况及其与舌苔指数、菌斑指数和唾液流率的关系。
本研究共选择巴西贝洛奥里藏特圣家医院门诊就诊、口腔健康状况良好且正在接受肥胖治疗的 62 名患者。该样本中，31 名为减重手术候选者（对照组），31 名已行 Roux-en-Y 胃旁路术（病例组）。所有患者完成问卷调查后，均接受口腔临床检查。使用嗅觉量表和便携式硫化物监测仪测量口臭。
Spearman 相关分析显示，嗅觉评分与硫化物监测仪测定的挥发性硫化合物浓度之间存在强正相关关系（rs =.58；P =.0001）。两组间口臭的患病率无差异（P =.48）。与病例组相比，对照组的唾液流率显著降低（P =.02）。在病例组中，挥发性硫化合物浓度与唾液流率呈负相关（P =.04），与舌苔指数呈正相关（P =.005）。未刷舌患者（P <.04）和有呕吐发作患者（P =.02）的舌苔指数显著增加。
这些数据表明，Roux-en-Y 胃旁路术与口臭之间无显著相关性。然而，它们确实突出了该手术对口腔的可能影响。
