口臭を訴える患者の口内気体中揮発性硫化物と症状との関係

Abstract

This study was undertaken to learn what kind of components in mouth air are the main source of halitosis and what kind of symptoms or clinical examination have a relation to halitosis.In 26 patients complaining of bad breath, we examined the subjective or objective consciousness of their bad breath, the evaluation of halitosis by olfactory panel, the analysis of volatile sulfur compounds in mouth air by gas chromatography, some oral conditions (decayed teeth, pus discharge from gingival pockets, gingival bleeding, food impaction, tongue coating, PI, DI, CI and OHI), olfactometry, and questionnaire findings (Y-G and C.M.I.). The interrelationships between these data were investigated statistically.The results obtained were as follows:1. Three kinds of volatile sulfur compounds, i. e., hydrogen sulfide (H2S), methyl mercaptan (CH3SH) and dimethyl sulfide ( (CH3) 2S), were detected from the mouth air, and significant positive correlations between the evaluation of halitosis and the concentration of these three volatile sulfur compounds were found. CH3SH was always detected in the patients with halitosis and a highly significant correlation (r=0.743) with the evaluation of halitosis by olfactory panel was obtained (Fig. 5). It therefore seemed that CH3SH is a main source of halitosis.2. Significant positive correlations between the score of tongue coating and the evaluation of halitosis, and the concentration of CH3SH were found (Fig. 6, 7).3. The mean concentration of (CH3) 2S in mouth air in the patients with gingival bleeding was statistically less than that in the patients without bleeding (Table 6).4. Complaints of patients about bad breath were divided into three types, i. e., self-awareness, indication by others or presumption from the attitude of other persons, and investigated in relation to the diagnosis of halitosis by olfactory panel. No relation was found between them (Table 3, 4).5. A relatively high concentration of (CH3) 2S was detected in the patients whose threshold value of iso-valeric acid was increased (Fig. 8).6. There was no relation between the area of C.M.I. and the presence or absence of halitosis (Table 9).7. From Y-G personality inventory, no relation between the types of personality and presence or absence of halitosis was found (Table 11). But some complaints of their bad breath still remained after objective halitosis disappeared. Further study is needed to clarify the relation between the personality of the patients and halitosis.