Association between periodontitis severity and exhaled hydrogen sulfide measured using LTCC‐GASSET device in healthy Thai patients

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Abstract Background The potential of hydrogen sulfide (H 2 S) gas as a biomarker for periodontitis has been suggested, but the evidence remains inconclusive. This preliminary study aimed to explore the relationship between periodontitis, defined according to the 2018 classification by the American Academy of Periodontology and the European Federation of Periodontology and exhaled H 2 S gas in the Thai population. Methods In 2023, a cross‐sectional study was conducted involving 172 systemically healthy, non‐smoking individuals aged 18 years or older who were included from three healthcare centers, Chiang Mai, Thailand. Participants underwent interviews, oral and periodontal examinations, and exhaled H 2 S gas detection using an innovative LTCC‐GASSET device. H 2 S levels and periodontal status were analyzed statistically. Results H 2 S levels significantly increased in groups with periodontitis compared to those without, with the magnitude of the increase corresponding to the stage of periodontitis. This trend was particularly pronounced in the older group (≥41 years). Moderate positive linear correlations were observed between H 2 S levels and clinical periodontal parameters, with the strongest correlation found for clinical attachment loss (CAL). Multiple regression analysis confirmed significant associations between H 2 S levels, CAL, and periodontal probing depth, after adjusting for confounders. Additionally, a threshold of 177.5 ppb for H 2 S levels was found to differentiate severe periodontitis, with AUC, sensitivity, and specificity of 0.733, 0.722, and 0.720, respectively. Conclusions Exhaled H 2 S levels were associated with periodontitis severity in non‐smoking, systemically healthy individuals. Given its limitations, the LTCC‐GASSET device may have potential for non‐invasive detection of periodontitis. Plain Language Summary This study examined the association between periodontitis, diagnosed using the 2018 AAP/EFP classification, and exhaled hydrogen sulfide (H 2 S) levels in 172 non‐smoking, systemically healthy adults. H 2 S levels were measured with the LTCC‐GASSET device, revealing higher levels in individuals with periodontitis, especially in more severe cases. Older participants (aged ≥41 years) had higher H 2 S levels, particularly if they had periodontitis. The H 2 S cut‐off level appeared to help distinguish between severe and non‐severe periodontitis cases. Within the limitations of a cross‐sectional study, these findings suggest that H 2 S levels could be useful for identifying individuals at higher risk for periodontal disease.

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