P32 Saliva incubation as replacement for intra‐oral malodour evaluation

Abstract

Background Breath odor is scored by different techniques, each with its own shortcomings. Organoleptic ratings are uncomfortable for the patient, subjective, influenced by external parameters including food and cosmetics, and lack of international calibration. An intra‐oral VSC rating (Halimeter) or gas chromatography can overcome the embarrassing situation for the patient, but not every clinician has this equipment. This project evaluated the reliability of saliva incubation as an indirect, in vitro, test for bad breath.Methods In a double‐blind, randomized, long‐term, parallel study 45 moderate periodontitis patients that received a ‘one‐stage, full‐mouth’ disinfection, oral hygiene instruction (including tongue scraping) and antiseptics. The intra‐oral VSC ratings (at baseline, and at 3 and 6 months) were compared to in vitro VSC recordings of the headspace air from saliva (0.5 ml, 37°C, 1 and 2 h, anaerobic chamber). The latter recordings were further correlated to the number of CFU in the saliva. At the same time the headspace also received an organoleptic rating.Results Even though the VSC values remained within a narrow range (90% observation 10–200), a strong correlation was found between the intra‐oral VSC ratings and the 1 h (r = 0.48, P < 0.0001) and 2 h (r = 0.43, P < 0.0001) VSC production of saliva. The VSC values of incubated saliva correlated strongly (r = 0.71) with the CFU for anaerobic species in the saliva. The VSC values and organoleptic ratings of the incubated saliva also correlated strongly (r = 0.64 after 1 h and 0.73 after 2 h incubation).Conclusions Saliva incubation can be used as an indirect way to score bad breath. Due to its simplicity it can be useful in longitudinal studies as alternative for direct organoleptic recordings.