Abstract
Halitosis is a highly distressing, socially unaesthetic condition, with a very high incidence amongst the adult population. It predominantly arises from excessive oral cavity volatile sulphur compound (VSC) concentrations, which have either oral or extra-oral etiologies (90–95% and 5–10% of cases, respectively). However, reports concerning age- and gender-related influences on the patterns and concentrations of these malodorous agents remain sparse; therefore, this study’s first objective was to explore the significance and impact of these potential predictor variables on the oral cavity levels of these malodorants. Moreover, because non-oral etiologies for halitosis may represent avatars of serious extra-oral diseases, the second objective was to distinguish between etiology- (source-) dependent patterns of oral cavity VSCs. Oral cavity VSC determinations were performed on 116 healthy human participants using a non-stationary gas chromatographic facility, and following a 4 h period of abstention from all non-respiratory oral activities. Participants were grouped according to ages or age bands, and gender. Statistical analyses of VSC level data acquired featured both univariate/correlation and multivariate (MV) approaches. Factorial analysis-of-variance and MV analyses revealed that the levels of all VSCs monitored were independent of both age and gender. Principal component analysis (PCA) and a range of further MV analysis techniques, together with an agglomerative hierarchal clustering strategy, demonstrated that VSC predictor variables were partitioned into two components, the first arising from orally-sourced H2S and CH3SH, the second from extra-orally-sourced (CH3)2S alone (about 55% and 30% of total variance respectively). In conclusion, oral cavity VSC concentrations appear not to be significantly influenced by age and gender. Furthermore, (CH3)2S may serve as a valuable biomarker for selected extra-oral conditions.
Highlights
National Institutes of Health (NIH), National Cancer Institute, Neuro-Oncology Branch, Abstract: Halitosis is a highly distressing, socially unaesthetic condition, with a very high incidence amongst the adult population
Principal component analysis (PCA) and a range of further MV analysis techniques, together with an agglomerative hierarchal clustering strategy, demonstrated that volatile sulphur compound (VSC) predictor variables were partitioned into two components, the first arising from orally-sourced hydrogen sulphide (H2 S) and CH3SH and (CH3) SH, the second from extra-orally-sourced (CH3 )2 S alone
A χ2 contingency test conformed that there was no significant association between age group and VSC nature regarding the numbers of participants scoring levels which were higher than the specified threshold concentrations of malodorous objectionability (TCMO) thresholds (p = 0.57)
Summary
In 2014 Aydin and Harvey-Woodworth [17] noted that such halitosis classification systems omit some aetiologies, and that such diagnoses are often derived from unreliable single halitometric and organoleptic assessments They suggested that the diagnosis of this condition should be focused more greatly on patient declarations and their social environments. VSC level determinations performed on a healthy, or perceivably healthy, population of participants of variable ages and genders, in order to provide a bank of reference data for future studies Such future investigations will be focused firstly on the roles that oral and extra-oral health conditions exert on oral cavity VSC status, and secondly on evaluating the VSC-suppressing activities of oral healthcare products and their active ingredients, properties which are required for the effective management and control of oral malodour in the human population. Of particular importance to objective (1) are determinations of the frequencies, nature and concentrations of oral cavity VSCs which are over and above their specified threshold concentration of malodorous objectionability (TCMO) values in a population of healthy or perceivably healthy participants, and whether such incidences were participant ageand/or gender-dependent
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