{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T03:41:17Z","timestamp":1792294877743,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dental Hygiene"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n To determine the superior efficacy of real\u2010time volatile sulphur compounds (VSCs) biofeedback via the Oral Chroma as a motivational tool over conventional oral hygiene instruction (OHI) for improving oral hygiene behaviours and clinical parameters in periodontitis patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This quasi\u2010experimental, parallel\u2010group trial enrolled 60 participants (age\u2009\u2265\u200930\u2009years) with periodontitis in accordance with the 2018 AAP\/EFP classification. Subjects were allocated to receive either standard\u2010of\u2010care OHI alone or supplemental VSCs biofeedback. VSCs levels were evaluated exclusively in the test group at baseline (charting) and at the 2nd oral hygiene check\u2010up visit. Non\u2010surgical periodontal therapy was administered to both groups. Clinical periodontal health outcomes, including bleeding on probing (BOP) and plaque index (PI), were assessed at baseline, the 1st and the 2nd oral hygiene check\u2010up visits.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The final analysis included 52 participants (Test:\n n<\/jats:italic>\n \u2009=\u200928, Control:\n n<\/jats:italic>\n \u2009=\u200924). Most participants presented with comparable disease severity (\n p<\/jats:italic>\n \u2009=\u20090.623). The prevalence of Stage III and Stage IV periodontitis was 87.5% (\n n<\/jats:italic>\n \u2009=\u200921) in the control and 82.1% (\n n<\/jats:italic>\n \u2009=\u200923) in the test group. Although the test group exhibited significantly higher baseline BOP compared to the control (68.3% vs. 48.4%;\n p<\/jats:italic>\n \u2009=\u20090.025), both groups demonstrated significant longitudinal improvements in PI and BOP (\n p<\/jats:italic>\n \u2009<\u20090.001). Notably, by the 2nd oral hygiene check\u2010up visit, inter\u2010group BOP differences were not significant, with both groups reaching comparable levels (test: 22.6% vs. control: 22.5%;\n p<\/jats:italic>\n \u2009=\u20090.295). Given the initial 20 percentage\u2010point difference, the greater absolute reduction in the test group may have been contributed by the intervention's effect alongside regression to the mean. Though both groups showed significant longitudinal reductions, no significant inter\u2010group differences in PI were observed at any time point (\n p<\/jats:italic>\n \u2009>\u20090.05). Furthermore, the test group displayed a substantial reduction in VSCs levels at the 2nd oral hygiene check\u2010up visit compared to the charting visit (\n p<\/jats:italic>\n \u2009<\u20090.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Real\u2010time VSCs biofeedback significantly accelerated initial reductions in BOP, although it did not achieve greater plaque reduction than standard OHI. Both groups reached similar clinical outcomes by the study's conclusion. Biofeedback may serve as a useful clinical tool to expedite the early improvement of gingival inflammation in individuals with periodontitis.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n Thai Clinical Trials Registry: TCTR20190701002<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/idh.70180","type":"journal-article","created":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T03:20:15Z","timestamp":1792293615000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of Real\u2010Time Volatile Sulphur Compounds Biofeedback as a Motivational Tool in Non\u2010Surgical Periodontal Therapy: A Quasi\u2010Experimental Parallel\u2010Group Trial"],"prefix":"10.1111","author":[{"given":"Kaewkwan","family":"Tanthai","sequence":"first","affiliation":[{"name":"Department of Conservative Dentistry, Faculty of Dentistry Prince of Songkla University Hat Yai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8542-8783","authenticated-orcid":false,"given":"Thanarut","family":"Tangkham","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry, Faculty of Dentistry Prince of Songkla University Hat Yai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praphansri","family":"Ruangsri","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry, Faculty of Dentistry Prince of Songkla University Hat Yai Thailand"},{"name":"Research Center of Excellence for Oral Health, Faculty of Dentistry Prince of Songkla University Hat Yai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7258-732X","authenticated-orcid":false,"given":"Mutita","family":"Wongsuwanlert","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry, Faculty of Dentistry Prince of Songkla University Hat Yai Thailand"},{"name":"Research Center of Excellence for Oral Health, Faculty of Dentistry Prince of Songkla University Hat Yai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2840-327X","authenticated-orcid":false,"given":"Supawadee","family":"Naorungroj","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry, Faculty of Dentistry Prince of Songkla University Hat Yai Thailand"},{"name":"Research Center of Excellence for Oral Health, Faculty of Dentistry Prince of Songkla University Hat Yai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"\u201cThe 9th National Oral Health Survey of Thailand\u201d(2023 Bureau of Dental Health Department of Health Ministry of Public Health) https:\/\/dental.anamai.moph.go.th\/th\/national\u2010oral\u2010health\u2010survey\u2010report\/4952#wow\u2010book\/."},{"issue":"5","key":"e_1_2_12_3_1","first-page":"242","article-title":"Oral Health\u2010Related Quality of Life in the Elderly: A Review and Future Challenges in Thailand","volume":"67","author":"Naorungroj S.","year":"2015","journal-title":"Siriraj Medical Journal"},{"issue":"2","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1111\/jcpe.13072","article-title":"Relationship of Periodontal Disease and Domains of Oral Health\u2010Related Quality of Life","volume":"46","author":"Masood M.","year":"2019","journal-title":"Journal of Clinical Periodontology"},{"issue":"2","key":"e_1_2_12_5_1","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/PHH.0000000000000408","article-title":"Self\u2010Awareness of \u2018Gum Disease\u2019 Among US Adults","volume":"23","author":"Luo H.","year":"2017","journal-title":"Journal of Public Health Management and Practice"},{"key":"e_1_2_12_6_1","first-page":"19","article-title":"Self\u2010Awareness of Individuals With Severe Periodontitis in Thai Adults","volume":"71","author":"Tuntrakul S.","year":"2017","journal-title":"Journal of the Dental Association of Thailand"},{"issue":"1","key":"e_1_2_12_7_1","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1186\/s12903-023-03203-8","article-title":"Oral Health Profile and Periodontal Diseases Awareness and Knowledge Among the Jordanian Population: A Cross\u2010Sectional Study","volume":"23","author":"Naser M. Y.","year":"2023","journal-title":"BMC Oral Health"},{"issue":"4","key":"e_1_2_12_8_1","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1902\/jop.2015.150458","article-title":"Periodontitis Awareness Amongst the General Public: A Critical Systematic Review to Identify Gaps of Knowledge","volume":"87","author":"Varela\u2010Centelles P.","year":"2016","journal-title":"Journal of Periodontology"},{"issue":"5","key":"e_1_2_12_9_1","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1111\/jcpe.12732","article-title":"Impact of the Global Burden of Periodontal Diseases on Health, Nutrition and Wellbeing of Mankind: A Call for Global Action","volume":"44","author":"Tonetti M. S.","year":"2017","journal-title":"Journal of Clinical Periodontology"},{"issue":"6","key":"e_1_2_12_10_1","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1007\/s00784-024-05732-0","article-title":"The Association Between Halitosis and Periodontitis: A Systematic Review and Meta\u2010Analysis","volume":"28","author":"Nini W.","year":"2024","journal-title":"Clinical Oral Investigations"},{"key":"e_1_2_12_11_1","doi-asserted-by":"crossref","DOI":"10.1590\/pboci.2025.051","article-title":"Prevalence of Self\u2010Reported Halitosis and Associated Factors: A Cross\u2010Sectional Study Among Dental Patients","volume":"25","author":"Alievi M.","year":"2025","journal-title":"Pesquisa Brasileira em Odontopediatria e Cl\u00ednica Integrada"},{"key":"e_1_2_12_12_1","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1007\/s00784-017-2164-5","article-title":"Estimated Prevalence of Halitosis: A Systematic Review and Meta\u2010Regression Analysis","volume":"22","author":"Silva M. 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L. V.","year":"2024","journal-title":"Odontology"},{"issue":"5","key":"e_1_2_12_30_1","doi-asserted-by":"crossref","first-page":"229","DOI":"10.4103\/jioh.jioh_184_18","article-title":"Oral Hygiene Status, Self\u2010Reported Oral Malodor, Oral Hygiene Practices, and Oral Health Knowledge: A Cross\u2010Sectional Study in a Group of Muslim Thai Pregnant Women","volume":"10","author":"Naorungroj S.","year":"2018","journal-title":"Journal of International Oral Health"},{"issue":"3","key":"e_1_2_12_31_1","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/idh.12572","article-title":"Self\u2010Perceived Halitosis Among Young Adults Undergoing Orthodontic Treatment","volume":"20","author":"Banjar A. A.","year":"2022","journal-title":"International Journal of Dental Hygiene"}],"container-title":["International Journal of Dental Hygiene"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/idh.70180","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/idh.70180","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/idh.70180","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T03:20:37Z","timestamp":1792293637000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/idh.70180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,17]]},"references-count":30,"alternative-id":["10.1111\/idh.70180"],"URL":"https:\/\/doi.org\/10.1111\/idh.70180","archive":["Portico"],"relation":{},"ISSN":["1601-5029","1601-5037"],"issn-type":[{"value":"1601-5029","type":"print"},{"value":"1601-5037","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,17]]},"assertion":[{"value":"2026-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"idh.70180"}}