Investigations
1st investigations to order
clinical diagnosis
Test
Clinical assessment of oral malodour is important and should be performed by two different examiners. The assessment is usually based on the clinician sniffing the air exhaled from the mouth and nose, and subjectively assessing the presence or absence of malodour.[1][2][3] A series of organoleptic tests that can be performed during clinical examination have been suggested.[22]
Result
presence of malodour
Investigations to consider
sulfide monitor
Test
The monitor measures VSCs in oral breath. It can be used in clinical practice. It cannot detect odorous compounds other than VSCs.
Result
high concentration of volatile sulfur compounds (VSCs) in exhaled air
gas chromatography
Test
Cumbersome and requires training.
Result
high concentration of volatile sulfur compounds, diamines, and short-chain fatty acids in exhaled air
benzol-arginine-naphthylamide (BANA) test
Test
Identifies the presence of bacteria associated with halitosis.
Result
detects trypsin-like activities of bacteria
dark-field microscopy
Test
Identifies the presence of bacteria associated with halitosis.
Result
positive
polymerase chain reaction of oral bacteria
Test
Identifies the presence of bacteria associated with halitosis.
Result
positive
selected ion flow tube mass spectroscopy
Test
Has been shown to be a means of estimating volatile sulfur compounds and non-sulfides in breath, but is not considered to be clinically practical.[24]
Result
high concentration of volatile sulfur compounds in exhaled air.
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