Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
Department of Oral Medicine, Seoul National University Dental Hospital, 101, Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
J Breath Res. 2022 Jun 23;16(3). doi: 10.1088/1752-7163/ac788d.
Halitosis is an unpleasant odor discharged through the oral cavity with a prevalence as high as 30%-50% of the general population. Conventional diagnostic methods have been focused on mouth air analysis measuring the amount of sulfur compounds which does not directly reflect the cause of halitosis. Also, the possible role of halitosis as an indicator of general health status has been steadily suggested and inflammation has been constantly associated with aversive body odor. Therefore, this study aimed to search for inter-relationships between hematologic indicators, clinical characteristics, and halitosis measurement that can predict the presence of pathologic halitosis and its intensity. Furthermore, the tentative relationship between halitosis and the presence of systemic inflammation was investigated. A total of 125 patients were divided into 103 patients in the genuine halitosis group (value ⩾80 ppb) and 22 patients in the pseudo halitosis group (value <80 ppb) based on portable sulfide monitor measurements. Clinical examination and hematological indices including inflammatory prognostic factors and halitosis measurements including organoleptic testing, portable sulfide monitor, and gas chromatography were evaluated. The genuine halitosis group showed a significantly higher white blood cell (WBC) count (< 0.01) compared to the pseudo halitosis group. Erythrocyte sedimentation rate (ESR,= 0.341,< 0.05) values and duration of halitosis (= 0.353,< 0.05) showed a significant association with halitosis intensity and neutrophil to lymphocyte ratio (NLR) values (= 3.859,< 0.05) were significantly related to genuine halitosis diagnosis. A new WBC cut-off value of 5575lshowed near to fair discriminative power in predicting genuine halitosis (area under the curve 0.661,< 0.05). The results of this study showing an increased WBC count in genuine halitosis and its strong association with hematologic indices of subclinical inflammation including ESR and NLR suggest inflammatory hematologic markers as potential diagnostic tools in the diagnosis of genuine halitosis.
口臭是一种通过口腔散发的令人不愉快的气味，其患病率高达普通人群的 30%-50%。传统的诊断方法一直集中在测量口腔空气中硫化合物的含量，而这些含量并不能直接反映口臭的原因。此外，口臭作为一般健康状况的指标的可能性也在稳步提出，炎症一直与令人不快的体臭有关。因此，本研究旨在寻找血液学指标、临床特征和口臭测量之间的相互关系，这些关系可以预测病理性口臭及其严重程度的存在。此外，还研究了口臭与全身炎症之间的暂定关系。根据便携式硫化物监测仪的测量结果，共有 125 名患者被分为 103 名真性口臭组（值 ⩾80 ppb）和 22 名假性口臭组（值 <80 ppb）。进行了临床检查和血液学指标评估，包括炎症预后因素和口臭测量，包括嗅觉测试、便携式硫化物监测仪和气相色谱法。真性口臭组的白细胞（WBC）计数明显高于假性口臭组（< 0.01）。红细胞沉降率（ESR，= 0.341，< 0.05）值和口臭持续时间（= 0.353，< 0.05）与口臭严重程度呈显著相关性，中性粒细胞与淋巴细胞比值（NLR）值（= 3.859，< 0.05）与真性口臭诊断显著相关。WBC 的新临界值为 5575l，对真性口臭的预测具有接近中等的区分能力（曲线下面积 0.661，< 0.05）。本研究结果表明，真性口臭患者的白细胞计数增加，与 ESR 和 NLR 等亚临床炎症的血液学指标密切相关，提示炎症性血液学标志物可能成为真性口臭诊断的潜在诊断工具。
