New form of extra-oral blood-borne halitosis caused by dimethyl sulphide

Thanks to Arun Nagrath for posting this on the MSN Body Odor Support forum

In Tangerman and Winkel's study of 58 patients who complained of halitosis, 81% had halitosis of oral origin, 10% had halitosis which did not originate from the mouth and 9% had no halitosis (halitophobia).

In patients with bad breath that comes from the mouth the main gas responsible is methyl mercaptan. In patients whose bad breath comes from somewhere else (bloodborne etc) the main gas responsible is dimethylsulfide.

Halimeter can detect methylmercaptan but is no good for detecting dimethylsulfide. Oralchroma can detect both but is hardly a state of the art instrument.

Arun


J Clin Periodontol. 2007 Sep ;34 (9):748-55 17716310 (P,S,E,B,D) Intra- and extra-oral halitosis: finding of a new form of extra-oral blood-borne halitosis caused by dimethyl sulphide.

Albert Tangerman, Edwin G Winkel
Aim: The aim of this study was to unravel the origen and cause of intra-oral and extra-oral halitosis. Material and Methods: We studied 58 patients complaining of halitosis, using gas chromatography of volatile sulphur compounds (VSCs) in mouth and nose breath, organoleptic scoring of mouth and nose breath, Halimeter((R)) readings of mouth air and tongue-coating inspection. Subjects had no precence or history of periodontitis. Result: Of 58 patients, 47 patients had halitosis of oral origin, six had halitosis of extra-oral origin and five had no halitosis (halitophobia). A strong correlation was found between the degree of intra-oral halitosis as measured by organoleptic scoring of mouth breath and the concentration of the VSCs hydrogen sulphide (H(2)S) and methyl mercaptan (CH(3)SH) in mouth breath. Taking into account the much larger odour index of CH(3)SH, it was concluded that CH(3)SH is the main contributor to intra-oral halitosis. In all six cases of extra-oral halitosis, halitosis was caused by the presence of elevated levels of dimethyl sulphide (CH(3)SCH(3)) in mouth and nose breath. Conclusion: Our study provides evidence that the VSC, CH(3)SH and to a lesser extent H(2)S are the main contributors to intra-oral halitosis and that CH(3)SCH(3) is the main contributor to extra-oral or blood-borne halitosis, due to a hitherto unknown metabolic disorder.

Source: http://www.blackwell-synergy.com/doi/abs/10.1111/j.1600-051X.2007.01116.x
related articles: http://www.unboundmedicine.com/medline/ebm/related/17716310
http://www.ncbi.nlm.nih.gov/pubmed/17716310