Before a dental researcher can evaluate various cures for bad breath they must first have a way to measure its severity, both initially and after the cure they are studying has been administered. Some of the different methods researchers have used to measure bad breath are discussed below. Judging a person's breath by way of organoleptic testing simply means that the researcher performing the breath evaluation has used their sense of smell (their nose) as the means for making the determination. Historically this method of breath testing has been a frequent choice among dental researchers. Noses are readily available, inexpensive to obtain and operate, and to their credit, noses can detect up to 10,000 different smells.
One of the problems associated with using organoleptic testing is that this technique is not totally objective. Another is that factors other than just breath odors can and do influence organoleptic evaluations. In fact research has shown that factors such as hunger, menstrual cycle, head position, and the degree of attentiveness and expectation can each influence a judge's interpretation of what they smell.
As for quantifying the organoleptic measurement itself, what exactly does constitute a weak, strong, or average level of bad breath? Will each judge participating in the research be able to make equivalent comparisons? Complicating things even more, as we all know when we are repeatedly exposed to a bad odor our sense of smell acclimates to the odor, and therefore loses much of its sensitivity. Bad breath that seems exceedingly objectionable at the beginning of testing may seem quite less so as the evaluation continues. Researchers in a number of scientific fields use gas chromatographs to identify compounds found in the samples they are studying. Likewise, gas chromatographs have been utilized by dentists in bad breath studies and have provided a means by which a researcher can definitively quantify the precise levels of specific compounds present in someone's breath.
While gas chromatography is probably the best way to test for the compounds associated with bad breath it has not been widely utilized in research studies for several reasons. Gas chromatographs are relatively expensive and require personnel with special training to operate them. The equipment is not portable and a significant amount of time is needed to make each breath measurement. A specialized type of sulfide monitor (termed a Halimeter) has been developed and it provides a means by which a tester can quantify degrees of bad breath. These machines, first introduced in 1991, measure the level of sulfide gas found in a person's breath. Some sulfides, such as hydrogen sulfide and methyl mercaptan (collectively referred to in dental literature as volatile sulfur compounds or "VSC's"), are known to be causative agents for bad breath. A Halimeter's reading showing a high level of sulfides in a person's breath suggests that a correlating high level of VSC's are present, although the apparatus does not test for individual types of VSC's specifically.
Since a Halimeter tests for a fewer number of compounds (sulfides only) than gas chromatographs, and in fact test for no individual compounds at all but instead just sulfides as a class, Halimeters provide for a less definitive evaluation of a person's bad breath than gas chromatographs. Additionally, compounds such as ethanol (alcohol) and essential oils (both of which are frequently found in mouthwashes) interfere with a Halimeter's ability to make a measurement. The advantages of using a Halimeter for a study rather than a gas chromatograph are that a Halimeter requires no special training to use, is portable, breath measurements can be made quickly, and the apparatus itself is comparatively inexpensive.
Some of the bacteria that cause periodontal disease (gum disease) produce waste products that are quite odiferous and as a result contribute in causing bad breath. The presence of some of these types of bacteria can be tested for by way of preforming a BANA test.
The bacteria in question have the characteristic of being able to produce an enzyme that degrades the compound benzoyl-D, L-arginine-naphthylamide (abbreviated BANA). When a sample of a patient's saliva that contains these bacteria is placed in with the BANA testing compound they cause it to break down. As a result of this degradation the testing compound changes color.
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