Why the Halimeter Is Not the Final Answer in Diagnosing Bad Breath
By Richard Miller
Let’s face it, no matter what it smells like, be it rotten eggs, garlic, or even worse, bad breath stinks. And if you’re like most people, you don’t care what the smell is, you just want to get rid of it! The harsh reality is that bad breath is made up of a complex set of odor compounds. In order to get a complete diagnosis of the primary cause of the problem, more than just the popular Halimeter® test is needed.
What the Halimeter® Will Detect
If you have visited a dentist regarding a bad breath or halitosis problem, he/she may have used a device called a Halimeter®. The Halimeter® can quickly and accurately measure the Volatile Sulfur Compounds (VSC’s) present in your breath. VSC’s can be any combination of the following chemicals:
- Hydrogen Sulfide (rotten egg smell)
- Methyl Mercaptan (feces smell)
- Dimethyl Sulfide (cabbage/gasoline smell)
- Dimethyl Disulfide (garlic smell)
Wait, There’s More!
I find that most people, between 80-90%, have sulfur-based compounds as the primary source of breath odor. However, it is important to go beyond only testing for sulfur compounds because many individuals have a “mixture” of sulfur and non-sulfur odors lurking in their mouth. Remember, these odor compounds are actually bacteria that live in your mouth and thrive in places like:
- under the gums
- places where food can be trapped or lodged
- spaces between your teeth
- the coating on your tongue
- under poorly fitting fillings or crowns
Bacteria love the dark, moist, air-deprived areas in your mouth because they can easily live on the proteins and sugars found in your saliva, dead mouth cells, blood cells, food particles and mucous. Those with allergies or sinus problems usually have protein-rich post nasal drip that collects on the very back of the tongue. In time, the bacteria feeding on this mucous will produce waste products in the form of Volatile Sulfur Compounds which creates a thick, whitish biofilm coating on the tongue. In other words — more odor!
Odors Found in the Mouth
Here is a list of the eight most common odor compounds causing bad breath/halitosis and their resulting smell.
8 of the Most Common Bad Breath Odors
|Odor Compound||Smells Like|
|Dimethyl Sulfide||Cabbage, Gasoline|
|Hydrogen Sulfide||Rotten Eggs|
Here’s what we use at the National Breath Center …….
The Four-Test Approach to Diagnosing Bad Breath & Halitosis
- Halimeter® Reading. This measures the levels of volatile sulfur compounds (VSCs) in the breath. The reading is compared to a scale that I developed over the last 20 years to discern severity of bad breath.
- Organoleptic Test. This is a certified way of measuring bad breath and is considered the gold standard. While the name may seem intimidating, this “smell test” measures the intensity of the odor and is rated 0 – 5 where 5 is severe bad breath.
- Gauze Test #1. Using a piece of sterile gauze, I wipe off the top of the biofilm coating (usually a whitish color) near the back of the tongue to reveal any darker colors which can signify the seriousness of the problem and how long it has been there. We rate and record the odor level from the gauze test sample.
- Gauze Test #2. The gauze and the tongue biofilm are photographed in detail and used as a visual comparison tool throughout treatment.
By using all four tests instead of solely relying on the Halimeter® reading, we are able to provide an accurate and more complete diagnosis of an individual’s bad breath/halitosis condition.
The Low-Down on Bad Breath Diagnosis
It is important to understand that bad breath is a complex set of odors caused by bacteria. The majority of mouth odors are produced from sulfur-based chemicals which can be detected by the Halimeter®. However, since the same bacteria also produce odors that the Halimeter® does not measure, we use three additional time-proven tests to provide our patients with a complete diagnosis of bad breath severity and a plan for complete elimination of all odors.