Diagnosis of Halitosis
People affected by halitosis are often ignorant of their condition. Research shows that self-evaluation of halitosis is difficult because receptor cells in the nose responsible for detecting odors get adapted to the continuous surge of bad breath. You have to depend on a close friend or family member to tell you if your breath smells bad. You can ask your dentist about your breath during your routine dental checkup. Your dentist will notice it while you discuss your medical history and dental problems, and inform you about your oral malodor.
Self-Diagnosis
You can do a simple test at home to find out if you have bad breath. Lick the inside of your wrist and wait for a minute till the saliva dries. Now smell the licked part of the wrist. You are most likely suffering from halitosis if you notice an unpleasant smell. However, this test is only a self-diagnosis tool and is not considered totally accurate by dental professionals because it may result in overestimation of the actual condition.
Another way to self-diagnose your condition at home is to lightly scrape the back of your tongue with a plastic disposable spoon and smell the drying residue.
Professional Diagnosis
Bad breath is diagnosed professionally at a dental office or a commercial breath clinic, under the supervision of an expert dental professional. Halitosis is diagnosed professionally using any of the 2 approaches described below:
- Organoleptic measurement
- Instrumental measurement
Organoleptic Measurement
It is the diagnosis of halitosis involving the use of sense organs. It is a sensory test based on the dentist’s perception of the patient’s oral malodor. The dentist sniffs the patient’s breath and scores the level of halitosis from 0 to 5. The dentist smells the patient’s breath at 3 distances and results are interpreted as follows:
- Unpleasant odor when the patient speaks at a distance of 10 cm: low level of severity (level 1 halitosis).
- Unpleasant odor when the patient speaks at a distance of 30 cm: moderate level of severity (level 2 halitosis).
- Unpleasant odor when the patient speaks at a distance of 1 m: high level of severity (level 3 halitosis).
Instructions for Organoleptic Measurement
- Avoid eating garlic, onion and spicy foods for 48 hours before the test.
- Do not use any mouth rinse or breath fresheners for 12 hours before the procedure.
- Avoid smoking for 12 hours before the test.
- Avoid using scented cosmetics for 24 hours before the assessment.
- The examiner should refrain from smoking, drinking coffee or tea, and using scented cosmetics before carrying out organoleptic measurement.
This test lacks objectivity and reproducibility. However, it is superior to other methods and still considered a gold standard for diagnosing halitosis.
Instrumental Measurement
This is usually done by one of the following 2 methods:
- Halimeter
- Gas chromatography
Halimeter
It is a portable monitor used to detect the level of sulfide in exhaled breath. It has a high sensitivity for measuring the level of hydrogen sulfide. The major drawback of using a halimeter is that it cannot detect the presence of other sulfides such as mercaptan in exhaled breath.
Gas Chromatography
It is a technique specifically designed to measure the levels of hydrogen sulfide, methyl mercaptan and dimethyl sulfide in exhaled breath. It is a relatively accurate technique to measure the levels of volatile sulfur compounds which are the main cause of halitosis. However, the gas chromatography equipment is not compact and it is usually impractical for dental practitioners to equip their clinics with gas chromatography.