The University of the West of England (UWE) in Bristol has drawn attention to an unusual course run at its Centre for Research in Biosciences. Participants are trained to recognise and identify the main groups of malodour compounds that occur on the breath of individuals to help diagnose oral diseases. The course is run by microbiologists and aimed at doctors, dentists, hygienists, nurses and technicians.

Oral malodour is the third most common reason for people visiting their dentists, according to the researchers. Prof. John Greenman, who runs the course, and Dr Saliha Saad, a trained oral malodour judge, point out that smells on the breath come from either microbes or the metabolism of the body. In 80 per cent of cases, bad breath is due to microbes in the mouth, and not to conditions elsewhere in the body. Oral malodour can be caused by microbes on the tongue, inflammation of the gums or tooth decay. These conditions give off specific smells, which a trained nose can detect and differentiate for appropriate treatment.

The five-day step-by-step course starts with training participants’ noses by getting them to smell dozens of chemical odours and asking them to score them in order of increasing strength. This familiarises them with the type of smells likely to be found on breath. They then go on to sniff the breath of human volunteers and learn how to score it using two scoring methods.

These are the organoleptic method, which scores the intensity of the odour on a scale of 0 to 5, and the hedonic method, which assesses the “quality” of the smell in terms of pleasant or unpleasant and by making associations with familiar odours such as eggs, cabbage, flowers, etc.

On the third day, participants are introduced to instrumental methods for detecting malodour and the various oral hygiene means and chemoprevention, such as cleaning the tongue, dental flossing and use of mouthwash, then retesting the patient’s breath to determine whether this has resolved the issue.

“The complaint of bad breath usually comes from the patient, but often dental staff are not trained to deal with the issue,” according to Saad. “They need to distinguish between odours that are present on ‘mouth’ breath, which can be caused by microbes on the tongue, gum disease or tooth decay, all of which can be easily treated, and volatiles carried on the breath from the lungs that could denote more serious diseases or organ failure.”

“Before people can go on the course, we screen them to determine that they have the correct smell receptors in their nasal epithelium—some people are scent blind, or anosmic. People need to score 80 per cent or more in the screening test to benefit from the course. Then we can help them to use their brain to separate and understand the smells they are experiencing. We also teach them how to use analytical instruments such as the Halimeter and oral gas chromatography. This course puts together the knowledge with the ability to use instruments—dental professionals shouldn’t rely on one method alone, although the nose is the gold standard!”

Original Source: The Dental Tribune

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