Halitosis, reduced salivary flow and the quality of life in pre-kidney transplantation patients

Abstract

Background Halitosis is a condition that affects 50% of adults and one third of patients with chronic kidney disease. The aim of this study was to evaluate oral manifestations and volatile sulfur compounds (VSCs) associated with halitosis and quality of life in pre-kidney transplantation candidates. Material and Methods The organoleptic test (OT) and halimetry (HA) (before and after cysteine mouthwash) were performed in patients with the Oralchroma® device, stimulated (SE) and non-stimulated sialometry (SN), Tongue Coating Index (TCI). The OHIP-14 questionnaire was administered to assess the impact of oral health on quality of life. Results Fourteen individuals with a mean age of 49.64 ± 13.35 years were evaluated. In the organoleptic test, 57.14% of the individuals presented halitosis. Oralchroma results showed that dimethyl sulfide was above the threshold in 85.71% of the individuals, while hydrogen sulfide and methyl mercaptan were above threshold in 28.57%; after the use of cysteine, hydrogen sulfide was present in 100% of the cases, dimethyl sulfide in 57.14% and methyl mercaptan in 50%. In the non-stimulated sialometry, 57.14% of the individuals presented hyposalivation and 21.42% in the stimulated. Regarding the tongue coating index, 100% of the individuals presented tongue coating, with a mean of 7.64. The assessment of impact of oral health on quality of life showed a negative impact in all dimensions. Conclusions Tongue coating, in association with hydrogen sulfide, was the main cause of halitosis in the study subjects, and hyposalivation may contribute to higher tongue-coating indices. These oral changes negatively affect the quality of life for pre-kidney transplantation patients. Key words: Halitosis, chronic kidney disease, quality of life, kidney transplantation.

Natural Bioactive Compounds in the Management of Oral Diseases in Nephropathic Patients

“…Several studies have shown a direct correlation between the serum accumulation of urea, and other uremic toxins, with the present of ammonia in CKD patients' exhalation [37]. The ammonia accumulation in the oral cavity is responsible for the reduction in salivary flow and for the mouth dry, phenomena usually observed in ESRD patients [36]. Furthermore, this condition leads to the perception of a metallic and unpleasant taste following the ingestion of food, which induces the patient to reduce caloric and protein intake, contributing to the development of protein-energy wasting (PEW) syndrome, typical of CKD patients [38].…”

“…Nearly one third of end stage renal disease (ESRD) patients show a condition known as uremic halitosis [36]. In fact, the loss of renal function, especially in more advanced CKD stages, induces urea accumulation both in saliva and serum.…”

Aetiology and associations of halitosis: A systematic review

“…The cross‐sectional studies (HajiFattahi et al, 2015; Han et al, 2014; Herman et al, 2018; Komori et al, 2016; Nazir et al, 2017; Rani et al, 2016; Romano et al, 2020; Santaella et al, 2020; Sikorska‐Żuk & Bochnia, 2018; Suzuki et al, 2016; Takeuchi et al, 2017) exhibited several intra‐oral and extra‐oral factors associated with the systemic diseases for halitosis. Most of the factors are intra‐oral.…”

Clinical Trial Evaluating Quality of Life in Patients with Intra-Oral Halitosis

“…These feelings were more likely to be especially present among individuals with a strong belief that others were noticing their breath odor [3]. The assessment of the impact of intra-oral health on QOL by Santaella et al [45] showed a negative influence of halitosis on social disability and psychological discomfort. According to Troger et al [46], halitosis may cause embarrassment, depression and make relationships more difficult.…”