Doctor of Philosophy on Microbiology, Private Practice at Halitorium, Halitosis Clinic, Adana, Turkey.
J Breath Res. 2022 Oct 13;17(1). doi: 10.1088/1752-7163/ac8faf.
Due to the fact that only a human can judge the objectionability of an odor, organoleptic examination (sniffing and scoring oral odor) was used as a reference standard of oral halitosis measurement. However, there are several problems that make the diagnostic value of organoleptic examination questionable. There is no universally accepted, precise definition, standardization or calibration in organoleptic examination, including scoring, scaling or safety protocols. Standardization, calibration, reproducibility, reliability, objectivity, specificity, accuracy and sensitivity of organoleptic measurements are doubtful. It is extremely subjective, emotional, instinctive, intuitive, speculative, hedonic and highly flexible. In addition, it is found to be repulsive, primitive and moreover even shame is experienced by patients and examiners. Non-standard protocols on pre-measurement, scoring, scaling, and training processes may cause misinterpretation or misdiagnosis since it depends on the examiner's emotional mood, gender, ethnicity, odor detection spectrum, threshold and even climatic conditions. It is not the gold standard, and not even considered standard. It is difficult to recognize, identify or focus on a particular gas among thousands in the breath. Organoleptic examination may not be necessary due to it not being a good diagnostic tool for halitosis. There may be an infection risk for sniffers or patients. Moreover, female examiners may have disadvantages in olfactory accuracy during organoleptic examination since menstruation, pregnancy and menopause may alter their odor sensation. In addition, age limits the reliability of examiners due to age-related smell loss. According to the psychophysics laws, the human nose can recognize odors logarithmically. There is no reason to think that scoring the oral malodor by sniffing the mouth of the patients obtains sufficient evidence for the diagnosis of halitosis. Portable multi-gas detectors and electronic noses, can be suggested as an alternative instead of sniffing patients. This is the first paper in the literature to criticize organoleptic examination, revalue its health risks and inconsistencies in assessment protocols.
由于只有人类才能判断气味的可接受性，因此感官检查（嗅闻和口腔气味评分）被用作口腔口臭测量的参考标准。然而，感官检查存在几个问题，使其诊断价值值得怀疑。感官检查在评分、定级或安全协议方面没有普遍接受的、精确的定义、标准化或校准。感官测量的标准化、校准、再现性、可靠性、客观性、特异性、准确性和敏感性都是值得怀疑的。它是极其主观、情绪化、本能的、直观的、推测性的、享乐的和高度灵活的。此外，它被认为是令人反感的、原始的，甚至患者和检查者都会感到羞耻。在测量前、评分、定级和培训过程中没有标准的协议，可能会导致误解或误诊，因为它取决于检查者的情绪、性别、种族、气味检测范围、阈值甚至气候条件。它不是金标准，甚至不被认为是标准。在呼吸中，很难识别、识别或关注数千种气体中的一种特定气体。由于感官检查不是口臭的良好诊断工具，因此可能没有必要进行检查。嗅探者或患者可能存在感染风险。此外，由于月经、怀孕和绝经期可能改变女性的嗅觉感知，女性检查者在感官检查中的嗅觉准确性可能存在劣势。此外，年龄限制了检查者的可靠性，因为年龄相关的嗅觉丧失。根据心理物理学定律，人类的鼻子可以对数/log 地感知气味。没有理由认为通过嗅闻患者口腔来对口腔异味进行评分可以为口臭的诊断提供充分的证据。便携式多气体探测器和电子鼻可以作为嗅闻患者的替代方法被推荐。这是文献中第一篇批评感官检查、重新评估其健康风险和评估协议不一致性的论文。
