Halitosis diagnose: laboratory test

Laboratory tests

There are seven laboratory tests that are frequently used to diagnose and investigate halitosis.

The BANA test

The BANA test is a method for measuring halitosis which works by detecting an enzyme found in certain strict gram-negative proteolythic bacteria. This enzyme breaks down the benzoyl-DL-arginine-α-naphthylamide (BANA), a synthetic substrate of trypsin, which forms a coloured compound. It most significant drawback is that it is does not determine the specific role played by different bacterial species in causing halitosis. There is a strong correlation between periodontal disease and coated tongue.

Chemical sensors

These are sensors that are fitted into a probe in order to measure different volatile compounds (ammonium, methanethiol (also known as methyl mercaptan) etc.) The sensors generate an electrochemical voltage proportional to the level of elements present in compounds being measured. The voltage is measured against the operation point of the element in question and the measurement is obtained as an electronic unit and shown by a digital code. Relatively recently, a complex system of chemical sensors was developed, popularly known as the “electronic nose”.

β-galactosidase tests

β-galactosidase is one of the key enzymes involved in the deglycosylation of glycoproteins, which is one of the first stages of malodour production. The activity of this enzyme can be easily quantified by using a chromogenic substrate which is absorbed into a chromatographic paper disc. When coming into contact with the paper disc the saliva can cause the colour of the paper to change, which is then recorded by an examiner (0 = colourless; 1= light blue; 2= mid to dark blue).

Salivary incubation tests

Salivary incubation tests involve placing a sample of the patient’s saliva into a test tube. The odour is then measured by an examiner after the tube has been incubated for several hours at 37ºC in an aerobic chamber in an atmosphere of 80% nitrogen, 10% carbon dioxide, and 10% hydrogen.

Ammonium monitoring

Patients are instructed to rinse their mouth for 30 seconds with a urea solution and to then keep their mouth closed for five minutes. A portable monitor pumps air through an ammonium gas detector tube, which is connected to a mouthpiece inside the patient’s mouth. The levels of ammonium can be read directly from a scale.

Ninhydrin method

This method is used to detect amines with a low molecular weight that are present in the exhaled air and involves mixing a saliva sample with isopropanol, which then undergoes centrifugation. The supernatant is diluted with isopropanol, in a buffer solution at pH 5, and with the ninhydrin compound. The mixture is then heated using a water bath for 30 minutes, and then cooled at 21 degrees Celsius and diluted with isopropanol in a total volume of 10 ml. A spectrophotometer is used to take light-absorption readings.

Polimerase Chain Reaction (PCR)

Real-time PCR, using the Taqman® system, is a technique for identifying VSC-producing oral bacteria: an DNA-based probe with a fluorescent reporter hybridises with the DNA or RNA to be detected.

Concept

We talk about halitosis open and accessible way, so that you can understand medical terminology that scientists use. Generic Bactrim

1. What is halitosis?
2. Physical and social consequences
3. Bad breath through the ages

Causes

The Breath Institute has discovered, on the basis of the latest international research, that there are over 80 possible causes of halitosis. Flagyl 500

1. The composition of halitosis (bad breath)
2. Causes of halitosis (bad breath)
2.1 Oral causes
2.2 Respiratory causes
2.3 Digestive causes
2.4 Systemic causes, diet and habits
2.5 Neuropsychological causes

Diagnosis

We identify the most effective clinical methods when diagnosing precisely the halitosis’ origin, so that you can chose the best treatment.

1. Methods of diagnosis
1.1 Self-perception
1.2 Organoleptic tests
1.3 Breath gas measurement
1.4 Laboratory tests
2. Psychological tests
3. Signs and associated symptoms

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DIAGNOSIS