Effects of training on odor judges scoring intensity.

OBJECTIVE: This pilot study was intended to test whether a training protocol improved validity of odor judges (OJs), with or without experience, and whether odorant types differed in error proneness. METHODS: The OJs (four experienced, two inexperienced) completed a 4-phase training protocol based on the American Society of Testing and Materials standards (ASTM): (i) introduction to sensory scales, n-butanol reference, sniffing techniques; (ii) pretraining measurements; 20 samples of varying intensities of four unpleasant and three pleasant odorants; (iii) exercises assessing quality, intensity, ranking, and matching; and (iv) post-training measurements. MAIN OUTCOME MEASURES: Subjects' intensity scores were analyzed as the absolute difference from the 'true' intensity (ASTM n-butanol standard) using repeated measures ANOVA. RESULTS: Training significantly (P = 0.02) reduced OJ errors. Experienced and novice judges did not differ in average errors (P = 0.99), or in improvement in error from pre- to post-training (P = 0.94). Improvement was consistent from pre- to post-training for all odorants except dimethylsulfide for which errors worsened (P = 0.01). Unpleasant and pleasant odorants differed (P = 0.006) in error. After removing water the effects of water control scores from the pleasant odorants, the difference was not significant (P = 0.26). CONCLUSIONS: The OJs improved in their ability to assess odor intensity irrespective of previous experience. Training is recommended for all OJs prior to research trials.

Study on the organoleptic intensity scale for measuring oral malodor.

The 0-5 organoleptic scale is used widely in breath research and in trials to measure the efficacy of anti-odor agents. However, the precise relationship between odor scores and gas concentrations of target odorants is unknown. The purpose of this study was to relate mean organoleptic scores from odor judges (n = 7) for pure odorants (n = 8) representative of those found in oral malodor. Judges used a common 0-5 scale to report the odor intensity of sample sets in random order of concentration. Regression analysis of data showed that odor score was proportional to the log concentration of odorant, and comparison of slopes showed H(2)S to be the most significant in terms of odor power. Detection thresholds (mol.dm(-3)) were: Skatole (7.2 x 10(-13)) < methylmercaptan (1.0 x 10(-11)) < trimethylamine (1.8 x 10(-11)) < isovalerate (1.8 x 10(-11)) < butyrate (2.3 x 10(-10)) < hydrogen sulphide (6.4 x 10(-10)) < putrescine (9.1 x 10(-10)) < dimethyl disulphide (5.9 x 10(-8)). The study demonstrates the exponential nature of the olfactory response and shows that any single compound's contribution to malodor depends on odor power and threshold in addition to concentration.

Comparison of volatile sulfur compound concentrations measured with a sulfide detector vs. gas chromatography.

The accuracy of the Halimeter, an inexpensive, simple instrument that measures total breath volatile sulfur compounds (VSCs), has not been adequately tested. We compared Halimeter measurements with those obtained with a specific and sensitive gas chromatographic (GC) technique. The Halimeter gave different, biexponential responses to a constant concentration of different VSCs: The relative response rate and sensitivity were hydrogen sulfide > methyl mercaptan > dimethylsulfide. The transient peak VSC concentration of oral samples was reached long before the sulfide detector fully responded. The GC measurement of initial total VSCs in breath samples was 2.7+/-0.48 times greater than the peak concentration of the Halimeter. However, the plateau phase measurement of the Halimeter was 25% greater than that of GC. While GC and Halimeter measurements positively correlated, appreciable differences were observed. In studies where relatively precise VSC measurements are required, GC is the preferable technique.

Spontaneous fluctuations in the concentrations of oral sulfur-containing gases.

Breath hydrogen sulfide (H2S) and methyl-mercaptan (CH3SH) concentrations are used as quantitative indicators of halitosis. However, measurements of these gases in duplicate oral samplings often show poor reproducibility. To determine if this poor reproducibility is an artifact of the collection/analytical procedure or a true biological phenomenon, we used a standardized technique to collect from 20 to 30 oral gas samples at two-minute intervals from 11 healthy subjects. The samples were analyzed for sulfur gases and CO2. Sizable variations in H2S and CH3SH concentrations were not associated with alterations in CO2, indicating that the variations did not reflect variable contamination with atmospheric or pulmonary gas. In addition, fluctuations in H2S and CH3SH were not identical and often were not random. We conclude that minute-to-minute variability in oral sulfur gas concentrations is a true biological phenomenon. This fluctuation complicates experimental studies designed to show that interventions alter halitosis.

Counseling and treating bad breath patients: a step-by-step approach.

Bad breath (oral malodor, halitosis) can be detrimental to one's self-image and confidence causing social, emotional, and psychological anxiety. With the majority of breath problems having an oral origin, the dental office is the most logical place for patients to seek treatment. When patients look to dental professionals for expert advice, it is critical they have the knowledge base and communication techniques to provide quality clinical assessment and implement effective intervention programs. Moreover, dental professionals should feel comfortable proactively counseling patients about oral malodor without fear of offending the patient. Numerous continuing education programs and journal articles related to the diagnosis and treatment of oral malodor are available. In addition, electronic sources are accessible for dental professionals to expand their knowledge base regarding oral malodor information. Fewer resources are available, however, regarding techniques to facilitate an effective dialogue with patients on this sensitive issue. This article seeks to provide such information and to help professionals tailor the target communication message to meet the specific needs of individual patients.

Dental hygienists' knowledge and opinions about fluorides and fluoridation.

This article reports results of a study of 563 practicing Minnesota and Wisconsin dental hygienists' knowledge and opinions about fluorides and water fluoridation. Two independent samples were selected randomly from the populations of licensed dental hygienists residing in the two states. Data were collected using a pretested, 42-item, mailed questionnaire. An 84 percent response was achieved with two followup reminders. These data provide baseline information about the caries prevention knowledge and attitudes of practicing dental hygienists in two states. Respondents from both states held similar levels of knowledge about fluorides and opinions about decision making on fluoridation. Fluoride topics, especially water fluoridation, were not receiving high priority in patient education, although nearly all believed that dental hygienists should promote water fluoridation actively. Two-thirds of respondents from both states believed fluoridation decisions should be made by health authorities, rather than by elected officials or through public vote. Greater attention to patient education about fluoride and community water fluoridation is needed by dental hygienists.

Dental hygienists' knowledge, opinions, and use of pit and fissure sealants: a comparison of two states.

This article reports results of a study of 563 practicing Minnesota and Wisconsin dental hygienists' knowledge, opinions, and use of pit and fissure sealants. The study was carried out six months prior to the 1983 NIH Consensus Development Conference on Dental Sealants in the Prevention of Tooth Decay. It therefore provides baseline information for two states prior to the initiation of widespread public information about the positive value of sealants that occurred as a result of that conference. Such baseline information is relevant for future studies of the diffusion of adoption of this caries-preventive technology by dental hygienists. Two independent samples were selected randomly from the populations of licensed dental hygienists residing in the two states. Data were collected using a 42-item mailed questionnaire, with an 84 percent response. Data were analyzed for both interstate and intrastate comparisons. Respondents were generally knowledgeable and had favorable opinions about sealants, although they had low levels of training in their use. Sealants were being used in 54 percent of the offices in which respondents practiced, with the dentist placing them most often. Among hygienists who applied sealants at all, more than two-thirds did so three or fewer times per week. Eighty-four percent indicated they would like to apply sealants more often. The most frequent reasons given for nonuse were lack of acceptance by the dentist-employer and nondelegation.