Abstract
The aim of this study was to investigate the prevalence of halitosis in different age groups in a general population in Debrecen, Hungary and to investigate the factors that may be associated with halitosis.
Method: Participants were recruited in connection with their annual examination at the Faculty of Dentistry, University of Debrecen. Volunteers were informed about the aims of the study and the proposed methods. Their written consent was obtained before the study began. The study protocol was approved by the Committee of Ethics in Clinical Research of the University of Debrecen. Four hundred and fifty-four volunteers (aged 14-90 years, mean 35.7 year) underwent organoleptic testing by a trained dentist and volatile sulphur compound (VSC) measurements by gas- chromatography. All had completed a standardised questionnaire to obtain information on their self-reported halitosis, oral health behaviour and life style (oral hygiene, frequency of dental visits, smoking, alcohol use, and stress level). Data were statistically analysed using chi- square and t-tests, correlations were evaluated by Spearman rank correlation analysis. A p-value of less than 0.05 was taken as significant.
Results: 230 patients (52.2%) reported oral malodour according to the questionnaire. With organoleptic testing and gas-chromatography this figure was 57.5% (261) and 51% (231), respectively. We found significant correlation between organoleptically measured halitosis and VSC levels (p=0.001), but we couldn’t find significant correlation between self-reported halitosis and organoleptic scores. In smoking, alcohol consumption and oral hygiene practices we found significant gender differences. Organoleptic testing found higher halitosis levels in males (p=0.034). The prevalence of halitosis increased with age. Significant correlations were found between organoleptic scores and smoking, alcohol consumption, dental visit frequency, stress level and mouth rinse use. It was found that self-reported halitosis had statistically significant correlation with tooth brushing frequency, mouth rinse and dental floss use, stress level and dry mouth problem.
Conclusions: Bad breath is a significant, but underestimated problem in Hungary, its prevalence is greater than in other European countries. A direct correlation exists between oral hygiene practices and halitosis. Oral hygiene education should be provided on a population level to encourage the maintenance of oral health and fresh breath, but the formulation of an appropriate preventive strategy against oral malodor should be done individually.
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