Bad Breath (Increased Levels Of Volatile Sulfur Compounds) Linked To The Beginning Of Gum Disease
Journal of Periodontal Research
The relationship of oral malodor in patients with or without periodontal disease
By Figueiredo LC, Rosetti EP, Marcantonio E Jr, Marcantonio RA, Salvador SL
Halitosis has been correlated with the concentration of volatile sulfur compounds
(VSC) produced in the oral cavity by metabolic activity of bacteria colonizing the
periodontal area and the dorsum of the tongue. The aim of this study was to
determine whether there is some relationship between the presence of
N-benzoyl-DL-arginine-2-napthylamide (BANA)-positive species Treponema denticola,
Porphyromonas gingivalis, and Bacteroides forsythus and clinical and oral malodor
Twenty-one subjects (21 to 59 years old) with probing depths (PD) > 3.0 mm and
20 subjects (21 to 63 years old) with PD < or = 3.0 mm (controls) participated.
The quality of the mouth air was assessed organoleptically, and a portable sulfide
monitor was used to measure the concentration of VSC. Clinical parameters, plaque
index (PI) and gingival index (GI), were obtained from 6 teeth. Samples for BANA
test were taken from the dorsal surface of the tongue, saliva, and the 6 reference
The scores of PI, GI, subgingival samples that tested positive for BANA hydrolyzing
species, organoleptic ratings, and VSC values were significantly higher in the
subjects with PD > 3.0 mm (P < 0.01, Mann-Whitney U test). There was a correlation
between BANA hydrolysis by subgingival plaque bacteria and VSC values (r = 0.55, P < 0.01),
and between GI and VSC values (r = 0.48, P < 0.05) in patients with PD > 3.0 mm.
There was no significant correlation between these parameters in the control group.
These results confirm that the BANA hydrolyzing bacteria in the subgingival
plaque are an important source of malodor production in the oral cavity.