Original Research Articles
Vol. 32 No. 1 (2025)
https://doi.org/10.4081/ltj.2025.421

Normalization of blood oxygen levels and heart rate in adults using alternative measurement sites

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 27 June 2025
584
Views
133
Downloads
Oximeter, lips, pulse rate, SpO2, tongue, wavelength

Authors

Mohammed Abbood Al-Maliky
m.a.almaliky@huc.edu.iq
College of Dentistry, University of Al-Hadi, Baghdad, Iraq.
Maher Kamal Jasim
College of Dentistry, University of Al-Hadi, Baghdad, Iraq.
Hind H. Enad
College of Dentistry, University of Al-Hadi, Baghdad, Iraq.
Mustafa Wathiq Abdul Kareem
College of Dentistry, University of Al-Hadi, Baghdad, Iraq.

This study addresses the need for reliable alternative measurement sites to the fingers, such as the lips and tongue, for measuring oxygen saturation (SpO2) and pulse rate (PR). This is particularly important in cases of poor circulation, finger injury, or during surgery. The study included 20 healthy participants. SpO2 and PR were measured using a pulse oximeter. Measurements were taken at the finger, lower and upper lips, and tongue. Descriptive and inferential statistics were done for site comparisons and for establishing reference ranges for these sites. SpO2 readings were normally distributed (p>0.05), with the greatest readings coming from the finger site (98.23±1.83), followed by the lower lip (97.20±1.77), the upper lip (96.40±3.17), and finally the tongue (93.56±4.25). Pairwise comparisons indicated no significant differences between the suggested locations and the finger, except for the tongue (p<0.05). The PR data seemed normally distributed (p>0.05), with the greatest PR seen at the finger location (79.25±8.26), then the lower lip (75.30±7.69), the upper lip (74.55±8.37), and finally the tongue (71.5±9.05). Lower and upper lip sites showed no statistically significant changes, but a significant difference was found at the tongue site (p<0.05). Based on our findings, the lower and upper lips can serve as alternative sites for SpO2 and PR measurements, as they closely align with values observed from the finger site. However, the tongue site showed significantly lower SpO2 and PR values.

Downloads

Download data is not yet available.

Citations

Crossref
Scopus
Google Scholar
Europe PMC
1. Hertzman AB. Observations on the finger volume pulse recorded photoelectrically. Am J Physiol 1937;119:334-5.
2. Alian AA, Shelley KH. Photoplethysmography. Best Pract Res Clin Anaesthesiol 2014;28:395-406. DOI: https://doi.org/10.1016/j.bpa.2014.08.006
3. Jubran A. Pulse oximetry. Intensive Care Med 2004;30:2017-20. DOI: https://doi.org/10.1007/s00134-004-2399-x
4. Tomer AK, Raina AA, Ayub FB, et al. Recent advances in pulp vitality testing: A review. Int J Appl Dent Sci 2019;5:08-12.
5. Estrela C, Oliveira KS, Alencar AHG, et al. Oxygen Saturation in the Dental Pulp of Maxillary and Mandibular Molars - Part 2. Braz Dent J 2017;28:704-9. DOI: https://doi.org/10.1590/0103-6440201701447
6. Suprayitno EA, Marlianto MR, Mauliana MI. Measurement device for detecting oxygen saturation in blood, heart rate, and temperature of human body. J Phys Conf Ser 2019;1402:033110. DOI: https://doi.org/10.1088/1742-6596/1402/3/033110
7. Seifi S, Khatony A, Moradi G, et al. Accuracy of pulse oximetry in detection of oxygen saturation in patients admitted to the intensive care unit of heart surgery: comparison of finger, toe, forehead and earlobe probes. BMC Nurs 2018;17:15. DOI: https://doi.org/10.1186/s12912-018-0283-1
8. Haynes JM. The ear as an alternative site for a pulse oximeter finger clip sensor. Respir Care 2007;52:727-9. DOI: https://doi.org/10.4187/respcare.07520727
9. Kashima Y, Onimaru M, Isogai R, et al. The Development of a Measuring System for Intraoral SpO2. Sensors 2024;24:435. DOI: https://doi.org/10.3390/s24020435
10. Olive S, Twentyman O, Ramsay C. Comparison of fingertip and earlobe pulse oximetry with arterial blood gas results. Eur Resp J 2016;48:PA3702. DOI: https://doi.org/10.1183/13993003.congress-2016.PA3702
11. Morey TE, Rice MJ, Vasilopoulos T, et al. Feasibility and accuracy of nasal alar pulse oximetry. Br J Anaesth 2014;112:1109-14. DOI: https://doi.org/10.1093/bja/aeu095
12. Schober P, Lust EJ, Heunks LMA, et al. Thinking Out-of-the-Box: A Non-Standard Application of Standard Pulse-Oximetry and Standard Near-Infrared Spectroscopy in a COVID-19 Patient. J Intensive Care Med 2021;36:376-80. DOI: https://doi.org/10.1177/0885066620965167
13. O'Leary RJ Jr., Landon M, Benumof JL. Buccal pulse oximeter is more accurate than finger pulse oximeter in measuring oxygen saturation. Anesth Analg 1992;75:495-8. DOI: https://doi.org/10.1213/00000539-199210000-00005
14. Coté CJ, Daniels AL, Connolly M, et al. Tongue oximetry in children with extensive thermal injury: comparison with peripheral oximetry. Can J Anaesth 1992;39:454-7. DOI: https://doi.org/10.1007/BF03008709
15. Eberhard P, Gisiger PA, Gardaz JP, et al. Combining transcutaneous blood gas measurement and pulse oximetry. Anesth Analg 2002;94:S76-80.
16. Lindholm P, Blogg SL, Gennser M. Pulse oximetry to detect hypoxemia during apnea: comparison of finger and ear probes. Aviat Space Environ Med 2007;78:770-3.
17. Simon SB, Clark RA. (Mis) Using pulse oximetry: a review of pulse oximetry use in acute care medical wards. Clin Eff Nurs 2002;6:106-10. DOI: https://doi.org/10.1016/S1361-9004(02)00088-2
18. Yönt GH, Korhan EA, Khorshid L. Comparison of oxygen saturation values and measurement times by pulse oximetry in various parts of the body. Appl Nurs Res 2011;24:e39-43. DOI: https://doi.org/10.1016/j.apnr.2010.03.002
19. Bongard F, Sue D. Pulse oximetry and capnography in intensive and transitional care units. West J Med 1992;156:57-64.
20. Aoyagi T. Pulse oximetry: its invention, theory, and future. J Anesth 2003;17:259-66. DOI: https://doi.org/10.1007/s00540-003-0192-6

Ethics Approval

This study was approved by the College of Dentistry, University of Al-Hadi Ethical Committee (2/2023). Informed consent to participate was obtained from the patients included in this study.

CRediT authorship contribution

Mohammed Abbood Al-Maliky: conceptualization, methodology, validation, formal analysis, investigation, resources, data curation, writing – original draft, visualization, project administration, supervision; Maher Kamal Jasim: conceptualization, methodology, validation, data curation, writing – review & editing, visualization, supervision; Hind H. Enad: conceptualization, methodology, validation, formal analysis; Mustafa Wathiq Abdul Kareem: investigation, resources, data curation, writing – review & editing, visualization. All the authors have read and approved the final version of the manuscript and agreed to be accountable for all aspects of the work.

Data Availability Statement

Data are available upon request from the corresponding author, under the regulations of the Al-Hadi University Ethics Committee and with the consent of the study participants.

How to Cite



Al-Maliky, M. A., Kamal Jasim, M., Enad, H. H., & Abdul Kareem, M. W. (2025). Normalization of blood oxygen levels and heart rate in adults using alternative measurement sites. Laser Therapy, 32(1). https://doi.org/10.4081/ltj.2025.421
Copyright (c) 2025 the Author(s) Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.