The correlation between different techniques for the evaluation of oral malodour in children with and without orthodontic treatment.

AIM: The aim of this work was to evaluate the correlation between different methods (organoleptic evaluation, gas chromatography, salivary ?-galactosidases activity) for the evaluation of halitosis in children. The secondary purpose was to investigate the influence of orthodontic treatment on halitosis. MATERIALS AND METHODS: Study Design: Oral malodour was detected with different methods in 50 children in the Paediatric Dentistry Unit, University of Rome Tor Vergata, Rome, Italy. During the dental visit, level of oral hygiene, tongue coating scores and presence of an orthodontic device, fixed or mobile, were recorded. Two trained and calibrated operators performed the organoleptic evaluation; the Oral ChromaTM device was used for the volatile sulfur compounds (VSCs) quantification and salivary ?-galactosidases (S?-g) activity was evaluated through the spectrophotometric method. STATISTICS: The Cohen's Kappa score was used to evaluate the level of agreement between the operators. The Pearson's correlation coefficient was used to evaluate the linear relationship between continuous variables (e.g. S?-g vs. VSCs values) and the Spearman's correlation coefficient was calculated for ordinal variables (e.g. organoleptic scores) vs. other parameters. The LSD test was used to compare the parameters analysed in the study. RESULTS: A positive and significant correlation between the organoleptic evaluation, the S?-g, the levels of hydrogen sulfide (H2S) and methyl mercaptan (CH3SH) was found. The Spearman's correlation has shown that organoleptic scores were significantly correlated with S?-g (0.664, p<0.001) and the Oral ChromaTM measurements of H2S (0.538, p<0.001) and Ch3SH (0.316, p=0.026). The Pearson's correlation showed that S?-g was statistically significantly correlated with the Oral ChromaTM measurements of H2S (0.379 p=0.007) and Ch3SH (0.299, p=0.0035). Stratifying results for orthodontic treatment, it was possible to show that children under orthodontic treatment, both fixed or removable, were characterised by higher level of S?-g. The organoleptic evaluation and Oral ChromaTM measurements showed that children wearing fixed orthodontic were characterised by higher scores. CONCLUSIONS: There was a significant correlation between the three different techniques for the evaluation of oral malodour in children. Like in the adult population, the increase of S?-g activity was associated with oral malodour. The presence of fixed orthodontic appliances was correlated to increased scores of all methods for the evaluation of halitosis.

Correlation between halitosis, oral health status and salivary ß-galactosidases and time spent in physical activities in children.

AIM: The aim of this work was to evaluate the oral health status in children and to correlate it with time spent in physical activity per week. MATERIALS AND METHODS: Fifty children (mean age 9±2 years) attending the first visit at the Paediatric Dental Unit of the University of Rome "Tor Vergata" have been included in the study. The parents of all patients were interviewed about the medical history of the children and specific data, in particular, the time spent in physical activity per week. A trained dentist examined the oral cavity of the patients and the following clinical parameters were recorded: number of deciduous and permanent teeth, caries (on deciduous and permanent teeth), presence of gingivitis (0=no; 1=yes), tongue coating score (from 0=none to 3= > 2/3 tongue dorsum surface covered)", oral infections (0=no; 1=yes), oral hygiene index (0=insufficient, 1=sufficient, 2=good), presence of at least one incongruous restoration (0=no, 1=yes), oral breathing (0=no; 1=yes), fissured tongue (0=no, 1=yes), presence of aftous ulcers, herpetic lesions or candidiasis (0=no, 1=yes), food stagnation (0=no; 1=yes). The level of salivary ?-galactosidases activity was measured spectrophotometrically. The subjects were classified into "Group 0": children who did not practice any sports beside physical education class; "Group 2": 2 hours per week; "Group 3": 3 hours; and "Group 4": 4 hours. STATISTICS: Statistical analysis was performed using SPSS for Windows version 21 (IBM SPSS Inc., Chicago, IL, USA). The Pearson's correlation coefficient (P) was used to evaluate the linear relationship between continuous variables, and the Spearman's correlation coefficient (S) was calculated for ordinal variables. Analysis of variance (ANOVA) and the Fischer's Least Significant Difference (LSD) test were used to compare the parameters analysed in the study. Data were analysed using linear regression and descriptive statistics. The significance threshold was set at 0.05. RESULTS: A more physically active lifestyle was significantly associated with a better oral hygiene and a reduced level of salivary ?-galactosidases, halitosis, gingivitis and tongue coating. Results of the organoleptic evaluation of halitosis performed by the parents and sport hours/week practiced have shown that Group 0 and 2 were characterised by statistically significant higher scores with respect to the other groups (Group 0 vs. Group 3, p=0.014; Group 2 vs. Group 3, p=0.030; Group 0 vs. Group 4, p=0.001; Group 2 vs. Group 4, p=0.002) (P= -0.458). The spectrophotometric quantification of salivary ?-galactosidases has shown that increasing the hours of sports, the enzyme activity significantly decreases (S= -0,330); similar levels were found with 0 and 2 hours of sports, but an important decrease has been recorded with both 3 (Group 0 vs. Group 3, p=0,011; Group 2 vs. Group 3, p=0,006) and 4 hours of sports practiced (Group 0 vs. Group 4, p=0,014; Group 2 vs. Group 4, p=0,008). The level of significance between children who did not practice sport and those who did for 3 and 4 hours a week was 0.005 (Group 0 vs. Group 3) and 0.0018 (Group 2 vs. Group 4) with respect to tongue coating scores (P= -0,511) and 0.012 for both groups with respect to gingivitis (Group 0 vs. Group 3; Group 0 vs. Group 4) (P=-0,427). CONCLUSION: Children who practiced sport showed a better oral hygiene level and lower halitosis, with respect to those who did not.