Evaluation of halitosis in patients with chronic obstructive pulmonary disease, chronic renal failure, and peptic ulcer: A comparative study

Abstract

Background: Oral breath can be used as a chairside investigation method in the detection of volatile sulfur compounds (VSCs), which can serve as a potential biomarker in the early detection of underlying systemic diseases. Aim: The primary aim was to study the hydrogen sulfide levels in oral breath of patients with chronic obstructive pulmonary disease (COPD), chronic renal failure (CRF), and peptic ulcer disease. Materials and Methods: The study included 100 patients divided into four groups with 25 patients in each group of CRF, COPD, peptic ulcer, and control. The oral breath sample collected from each participant was passed through a sensor in the hydrogen sulfide detector (Tanita, Japan), which registers the level of sulfides. The maximum level attained was determined in parts per billion sulfide equivalents using direct readings from the monitor's digital display. The values obtained were statistically analyzed using statistical tests: Shapiro–Wilk test, analysis of variance, and post hoc analysis. Results: The mean values for the age and hydrogen sulfide scores were as follows: control group (35.16 ± 14.12 and 0.44 ± 1.00), CRF (49.16 ± 13.93 and 2.32 ± 0.98), COPD (48.16 ± 15.58 and 2.40 ± 0.95), and the peptic ulcer (42.36 ± 15.44 and 1.68 ± 1.02). The post hoc analysis for intergroup comparison of mean values reveals that statistically significant (P = 0.001*) differences exist between the control group and the CRF group, the control group and the COPD group, and the control group and the peptic ulcer group. Conclusion: The CRF group had slightly higher hydrogen sulfide measurements among the four groups, indicating the release of more VSCs.