Aim: The aim of this study was to evaluate the effects of non-surgical periodontal therapy on intra-oral halitosis 3months after therapy. Material and methods: Sixty-eight adults with intra-oral halitosis were included in a case series. Intra-oral halitosis was evaluated at baseline, and at 3months after treatment using the organoleptic scores (OLS), Halimeter (R), and a gas chromatograph. Results: Significant reductions for OLS (p<0.01), total sum of volatile sulphur compounds (T-VSC) (p<0.01) and methyl mercaptan (MM) (p<0.05) values were found after treatment. Hydrogen sulphide (H2S) levels were not significantly reduced. The numbers of probing pockets 4mm, 5mm and 6mm were significantly reduced as a result of therapy (p<0.001). Bleeding on probing (BOP) and plaque indices were also significantly reduced (p<0.001). For the 34 individuals with successful periodontal treatment (BOP<20% and a 50% reduction of total pocket depth) reductions in OLS (p<0.01) and T-VSC scores (p<0.01) were found. Eleven individuals were considered effectively treated for intra-oral halitosis presenting with a T-VSC value <160ppb, a H2S value <112ppb and a MM value <26ppb. Conclusion: Non-surgical periodontal therapy resulted in reduction of OLS, MM and T-VSC values 3months after therapy. Few individuals were considered as effectively treated for intra-oral halitosis.
Intra-oral halitosis (bad breath) is reported to affect 15-83 % of the adult population. Having intra-oral halitosis is a social and psycho-logical handicap, and may cause people in the person’s social circle to increase the physical distance or to turn their faces in another direction to avoid the unpleasant smell from the exhaled air. Such behaviours may affect the individual’s self-confidence resulting in insecurity in social and intimate relations. The oral health-related quality of life status has also been reported to be lower in individuals with halitosis. Approximately 90% of what is considered as bad breath is the result of the degradation of organic substrates (proteins) by an- aerobic bacteria of the oral cavity. Intra-oral halitosis can be assessed using both subjective and objective methods to evaluate the subject’s exhaled air. The most common one and the one often referred to as the ”gold standard”, is the organoleptic scoring system (OLS). OLS is a subjective method evaluating the strength of halitosis in exhaled air using a scale from 0-5. One objective method to assess the presence of volatile sulphur compounds in exhaled air is to use a sulphide monitor measuring the total sum of the volatile sulphur compounds (T-VSC) in exhaled air. The three gases (hydrogensulphide (H2S), methyl mercaptan (MM) and dimethyl sulphide (DMS)) in exhaled air related to intra-oral halitosis can be assessed separately using a simplified gas chromatograph. Different treatment models such as periodontal treatment, tongue scraping and rinsing with Zn ion containing products have been used to reduce intra-oralhalitosis. The present thesis has evaluated the efficacy of different treatment models in the treatment of intra-oral halitosis.