Relationship between sulcular sulfide bevel and oral malodor in subjects with periodontal disease

Background: The relationship between oral malodor and sulfide levels in periodontal pockets (pS) has not yet been determined. The aims of this study were: 1) to identify the correlation among oral malodor, pS levels, and the BANA (benzoyl-DL-arginine-naphthylamide) test and 2) to recognize the interaction between oral malodor, demographic factors, tongue coating, and periodontal condition. Methods: Eighty-one peridontal patients participated in this study. A portable sulfide monitor and organoleptic method were used to evaluate oral malodor. Demographic data included age, gender, race, and smoking habits. The volume of tongue coating and periodontal condition for all teeth were assessed. The pS levels of 3 different radiographic bone loss (RBL) sites: RBL <2 mm, healthy; RBL <greater than or equal to>2 to <4 mm; low to moderate; RBL <greater than or equal to>4 mm, severe, were measured using an industrial sulcular sulfide-monitoring device. Subgingival plaque samples from the above 3 sites and tongue scraping were examined by the BANA test. Results: The volume of tongue coating (P<0.001), extent of periodontal disease (P <0.05), pS levels of the sites with low to moderate bone loss (P<0.05), and BANA score of tongue scrapings (P <0.05) were significantly associated with oral malodor. Stepwise multiple regression analysis examined the degree of association between oral malodor and potential explanatory variables. The volume of tongue coating and percent of sites BOP (bleeding on probing) were significantly associated with oral malodor. Females and smoking habit were negatively correlated with organoleptic measurements. Conclusions: The pS level of the representative sites with low to moderate bone loss demonstrated a modest association with oral malodor. Oral malodor in periodontal patients was primarily associated with tongue coating and gingival inflammation.