Desktop Device Diagnoses What Causes Bad Breath

Dentistry Today


Halitosis is no laughing matter. Bad breath can be the result of a range of problems, from the need for a good cleaning to systemic illnesses like acid reflux or diabetes. Nissha USA’s OralChroma is designed to help dentists identify those causes so effective treatment can begin, restoring fresh breath as well as good health.

“The OralChroma is a gas chromatograph. The only one of its kind currently available in the marketplace,” said Val Di Giovanni, P.Eng., who has been in the gas sensor industry for more than 25 years and is now the technical consultant of Nissha USA. “It will take a breath sample and analyze it and tell you what levels of the 3 major components of halitosis exist in that breath sample.”

Patients simply blow into a small, disposable syringe. The dental professional then inserts the syringe into the OralChroma, which analyzes the air sample. Within 4 minutes, the OralChroma measures the levels of those halitosis components in the sample. It then sends its findings to a computer that runs the associated data management software and presents the results.

The first component, hydrogen sulfide, is directly related to oral hygiene. Patients who haven’t been brushing or flossing, or those who haven’t had a recent cleaning or scaling, may see a buildup of organic debris on the dorsum of the tongue, producing the bad breath.

Methyl mercaptan, the second component, is associated with the bacteria that cause periodontitis, gingivitis, pockets, and cavities. The third component, dimethyl sulfide, is blood borne and comes from elsewhere in the system, possibly resulting from digestive issues, liver or kidney disease, or even cancer.

“Once you know the levels of these gases, then the professional involved—whether it’s a hygienist, a dentist, or even a medical doctor with the dimethyl sulfide—uses their experience to treat it,” said Di Giovanni.

A high level of hydrogen sulfide, for example, would prompt the hygienist to initiate a verbal examination of the patient’s diet, followed by an inspection of the mouth to see if cleaning is necessary. After a large methyl mercaptan reading, the dentist would perform an exam to find the infection causing the odor. High levels of dimethyl sulfide may require a referral to the patient’s primary care physician.

Once the source of the odor has been determined, the dental personnel would devise and execute a treatment plan. The OralChroma’s software then monitors the ongoing treatment, maintaining records of the readings from each dental visit and then charting them over time.

“So someone who has hydrogen sulfide up in the 700 range starts a treatment plan,” Di Giovanni said. “You’ll be able to show the patient how effective it is. Even though the bad breath hasn’t gone away, for instance, maybe it’s dropped from 700 to 500, and looking to drop to 300 the next time around. And that comes as they get better at brushing and flossing.”

The OralChroma plugs into any computer via a USB port, and its software is compatible with both Windows and Mac systems. Software updates are automatic. Also, the software is calibrated for variations in temperature, humidity, altitude, and cross-sensitivity to other gases, though Nissha recommends new calibrations every 2 years.

Though the OralChroma is new to the dental market, it is not new technology. Research and development departments at food and oral hygiene companies as well as many universities have been using it across North America for internal purposes. And while other gas chromatographs can cost more than $100,000, the OralChroma is just several thousand dollars.

“I think it’s going to be very effective,” said Di Giovanni. “As people get familiar with it and see what it can do as far as treating a patient, giving a patient more confidence in what the dental professional is doing, it will become a very common machine.”

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Video: OralChroma