Relationship between volatile sulfur compounds, BANA-hydrolyzing bacteria and gingival health in patients with and without complaints of oral malodor.

The aim of this study was to obtain measurements of oral malodor, as measured by volatile sulfur compounds (VSC), in periodontally healthy individuals without any complaints of bad breath, and to compare the results with data obtained from patients with complaints of oral malodor. The quality of the mouth air was assessed organoleptically and a portable sulfide monitor was used to measure the concentration of VSC in mouth air. The gingival health of 35 individuals (21 M, 14 F; ages 18-57 years) without any malodor complaints was evaluated according to the Papillary Bleeding Score (PBS). Pocket depths and Bleeding upon Probing (BOP) were also recorded in 20 patients (11 females and 9 males ranging in age from 14 to 71 years) who complained of oral malodor. Scrapings of the dorsal surface of the tongue and each of 6 plaque samples per patient were evaluated for the presence of BANA-positive species, such as T. denticola, P. gingivalis, and B. forsythus. The organoleptic ratings and VSC values were significantly higher in the complaint group (p < 0.05). Subjects in the complaint group had a significantly higher percentage of bleeding sites (p < 0.005) and had significantly more plaques that tested positive for the presence of BANA-hydrolyzing species (p < 0.05). Tongue scrapings of subjects with a high organoleptic score consistently yielded a positive BANA reaction suggesting that the dorsal surface of the tongue is an important niche for BANA-positive, VSC-producing bacteria. This study suggests that the primary sources of VSC production are BANA-hydrolyzing bacteria in the plaque and on the dorsal surface of the tongue.