The Influence of Oral Malodor on Psychological Stress

Abstract

We examined the influence of oral malodor on psychological stress among patients with a chief complaint of oral malodor. A total of 101 patients (40 male and 61 female) who visited our clinic with a chief complaint of oral malodor were included in this study. The primary compounds of oral malodor—volatile sulfur compounds (VSC)—were measured using the Oral Chroma TM instrument. Salivary stress markers, cortisol, and chromogranin A were measured using an enzyme-linked immunosorbent assay (ELISA) kit. The mood was measured using the Profile of Mood States 2nd Edition (POMS2). Among the participants, 60.3% had at least one level above the threshold in the following three markers: hydrogen sulfide, methyl mercaptan, and dimethyl sulfide. The gender distribution was 35 female (57.4%) and 25 male (62.5%). Salivary cortisol levels, a biomarker of stress, did not vary depending on the presence or absence of oral malodor. Chromogranin A levels were higher in the oral malodor female group than in the no oral malodor female group. With respect to the POMS2, regardless of the presence or absence of oral malodor measured using gas chromatography, the participants had higher scores for “Anger-Hostility” and “Fatigue-Inertia”. Analysis by gender showed that “Depression-Dejection” was significantly higher in the oral malodor female group than in the no oral malodor female group. These results suggest that those who are worried about oral malodor have higher psychological stress than those who are not, regardless of the presence or absence of oral malodor measured using gas chromatography.