Due to the fact that only a human can judge the objectionability of an odor, organoleptic examination (sniffing and scoring oral odor) was used as a reference standard of oral halitosis measurement. However, there are several...
moreDue to the fact that only a human can judge the objectionability of an odor, organoleptic examination (sniffing and scoring oral odor) was used as a reference standard of oral halitosis measurement. However, there are several problems that make the diagnostic value of organoleptic examination questionable.
There is no universally accepted, precise definition, standardization and calibration in organoleptic examination, including scoring, scaling or safety protocols. Standardization, calibration, reproducibility, reliability, objectivity, specificity, accuracy, sensitivity of organoleptic measurement are doubtful. It is extremely subjective, emotional, instinctive, intuitive, speculative, hedonic or highly flexible. Also it is found repulsive, primitive and moreover even shame is experienced by patients or examiners.
Nonstandard protocols on premeasurement, scoring, scaling, and training processes may cause misinterpretation or misdiagnose since it depends on examiner's emotional mood, gender, ethnicity, odor detection spectrum, threshold, and even climate conditions. It is not gold standard, even not standard.
It is difficult to recognize, identify or focus on a particular gas among thousands in the breath. Organoleptic examination may not be necessary due to not being a good diagnostic tool for halitosis.
There may be infection risk for sniffer or patient. Moreover, female examiners may have disadvantages in olfactory accuracy during organoleptic examination, since menstruation, pregnancy, menopause may alter their odor sensation.
Also, the age, limits reliability of examiners due to age-related smell loss. According to the psychophysics laws, the human nose can recognize odors logarithmically. There is no reason to think that scoring the oral malodor by sniffing the mouth of the patients obtains sufficient evidence for the diagnosis of halitosis.
Portable multi-gas detectors, electronic noses can be suggested as alternative instead of sniffing patients.
This is the first paper in the literature to criticize organoleptic examination, revalues health risks, inconsistencies in assesment protocols.