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Halimeter for the diagnosis of bad breath

Many mouth odor specialists now use the Halimeter®, from Interscan Corporation, to assess patients who consult them about a respiratory problem. Simple yet ingenious, the device draws an air sample from the mouth through a straw, analyzes it for certain gases, and provides a reading of the gases quantified in parts per billion (ppb). This scientific analysis of breath is based on the knowledge that the bad odors associated with halitosis are usually volatile sulfur compounds (VSC) produced by anaerobic bacteria (microorganisms that live in places where there is little or no oxygen) that break down proteins in mouth. Although almost everyone has some VSC in their mouth, the gases are only noticeable to others at levels of around 200 ppb or more. A quantitative measurement of VSC is therefore very useful for diagnosing and monitoring halitosis.

Until recently, the organoleptic evaluation of halitosis was the standard method for diagnosing and classifying malodorous breath. In this procedure, an examiner asks the patient to blow air through a straw and assesses the severity of the odor based on a scale of points. Although every effort is made to obtain objective results, the rating is inevitably based on the subjective impressions of an individual. The results of this type of test are described as having low specificity and reproducibility (Lee, PPC and WY Mak. “The Aetiology and Treatment of Oral Halitosis: An Update.” Hong Kong Medical Journal Vol. 10 No. 6, 2004: 414 – 418), which means that the procedure does not test for specific odor sources and that if the test is repeated on the same patient, different results are often obtained. The arrival of the halimeter® for the diagnosis of bad breath is a clear advance in this difficult medical challenge.

There are some disadvantages of the halimeter® for the diagnosis of bad breath. One is that the cost of the instrument and the experience required to operate it mean that the patient must consult a medical professional to have the test performed (this is also true for the organoleptic evaluation of halitosis). Although this may come at a cost, it provides a professional assessment of the patient’s condition and increases the likelihood that a serious underlying medical problem will be detected early, as well as ensuring accurate test results. Additionally, the halimeter® does not measure all of the malodorous gases associated with mouth odor, only the three common ones, so it is possible that a rare case involving other gases may not be detected.

To obtain accurate halimeter® results for the diagnosis of bad breath, patients must refrain from eating, drinking, smoking, chewing gum, using oral hygiene products, or sucking on candy for a specified period of time prior to the procedure. It is important to follow the instructions of the person performing the test. The procedure is quick, painless, and carries virtually no risk. As a more accurate alternative to the organoleptic evaluation of halitosis, it is likely to become the standard method for measuring oral malodour.

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