Periodontal Conditions in Subjects with Bad Breath

Abstract

Objective: The aim was to study periodontal conditions, presence of micro-organisms, and inflammatory mediators, in subjects with bad breath.

Methods: Eight subjects with bad breath, 10 with periodontal disease, and 10 controls participated. Bad breath was assessed by the organoleptic method. Clinical, microbiological and biochemical parameters were analyzed. Mann-Whitney, paired Student's t-test, and chi-square tests were used.

Results: Plaque, gingival indices and number of periodontal pockets were significantly higher in patients with bad breath than in those with periodontitis or controls. Patients with bad breath more frequently had Actinobacillus actinomycetemcomitans ( A.a.) and Porphyromonas gingivalis (P.g.) than the other groups. Significantly more subjects with than without bad breath harboured (P.g.) (p<0.01). Levels of prostaglandin E2 and elastase were higher while matrix metalloproteinase-9 and interleukin 1-ß were lower in patients with bad breath. The periodontal condition of patients with bad breath was worse than that of periodontitis patients without the symptom.

Conclusion: Subjects with bad breath and periodontal disease had higher plaque level, more gingival inflammation, more severe periodontal disease, and higher levels of PGE2 and elastase in gingival crevicular fluid than periodontal patients without bad breath. More subjects with bad breath harboured A.a. and P.g. than those without the symptom. In particular P.g. was significantly more often detected in the group with bad breath.

Acknowledgments: This study was supported by the Karolinska Institutet, and AFA Insurance Company (Dnr S-04:03) Stockholm, Sweden.