Association between oral malodour and periodontal disease-related parameters in the general population

To determine the association between halitosis detection and periodontal status in systemically healthy non-smokers and to assess whether halitosis was related to quantities of Fusobacterium nucleatum and Porphyromonas gingivalis on the tongue dorsum.

Periodontal examinations, tongue coating determination, Halimeter® readings and organoleptic assessments of mouth odour were performed in 28 chronic periodontitis patients, 23 chronic gingivitis patients and 27 healthy individuals. The quantities of P. gingivalis and F. nucleatum were determined in tongue specimens by real-time PCR.

Halitosis was more likely to be detected in patients with periodontitis (OR = 9.2) and gingivitis (OR = 4.6) than in healthy subjects. The posterior tongue odour was similar for all groups; had the highest score of all organoleptic assessments and was significantly correlated with Halimeter® scores and the odour of the whole mouth air. Periodontitis patients harboured significantly greater amounts of P. gingivalis on their tongue, yet similar quantities of F. nucleatum compared to gingivitis patients and healthy subjects. The amount of P. gingivalis residing on the tongue dorsum of periodontitis patients was significantly associated with halitosis recordings, while the amount of F. nucleatum was related to tongue coating in healthy controls, which corroborates its role in biofilm formation.

Patients with periodontal disease were at higher risk for halitosis detection than healthy individuals. The posterior portion of the tongue dorsum seems to be an important source of odourous compounds, regardless of periodontal condition. P. gingivalis residing on the tongue of periodontitis patients may play a key role in oral malodour production.