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Xu J, Gu Q, Lu H, Fan J, Ye W. Personality and psychological profile for patients with and without halitosis: A case-control study. Oral Dis 2024; 30:1724-1732. [PMID: 36975762 DOI: 10.1111/odi.14577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/23/2023] [Accepted: 03/25/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE To compare the personalities, social avoidance and distress, and anxiety status of Chinese patients with and without objective halitosis, and investigate the association among these psychological disorders. METHODS Patients who complained of bad breath and diagnosed with objective halitosis were enrolled into the halitosis group, while patients without objective halitosis were enrolled into the control group. The questionnaires included the sociodemographic profile of the participants, Eysenck Personality Questionnaire (EPQ), Social Avoidance and Distress Scale (SAD), and Beck Anxiety Inventory (BAI). RESULTS A total of 280 patients were assigned into objective halitosis group (n = 146) and control group (n = 134). The extraversion subscales (E) score of the EPQ in the halitosis group were significantly lower than that in the control group (p = 0.001). The total SAD score and proportion of patients with anxiety symptoms in the BAI scale in the objective halitosis was significantly higher than that in the control group (p < 0.05). There was a negative correlation between the extraversion subscale and the total SAD score, Social Avoidance and Social Distress subscales (p < 0.001). CONCLUSION Patients with objective halitosis have more introverted personality traits and are more likely to have social avoidance and distress than the nonhalitosis population.
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Affiliation(s)
- Jing Xu
- Department of Preventive Dentistry, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University, School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, China
| | - Qin Gu
- Department of Preventive Dentistry, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University, School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, China
| | - Haixia Lu
- Department of Preventive Dentistry, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University, School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, China
| | - Juan Fan
- Department of Child and Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 Wan Ping Nan Road, Shanghai, China
| | - Wei Ye
- Department of Preventive Dentistry, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University, School of Medicine, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, 639 Zhizaoju Road, Shanghai, China
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Szalai E, Tajti P, Szabó B, Kói T, Hegyi P, Czumbel LM, Varga G, Kerémi B. ORGANOLEPTIC AND HALITOMETRIC ASSESSMENTS DO NOT CORRELATE WELL IN INTRA-ORAL HALITOSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2023; 23:101862. [PMID: 37689445 DOI: 10.1016/j.jebdp.2023.101862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/12/2023] [Accepted: 03/25/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND The gold standard method for diagnosing oral halitosis is the subjective organoleptic measurement. Device-supported methods are also widespread worldwide. The challenges and safety concerns around performing organoleptic measurements during pandemics and the diversity of measuring device alternatives raised our clinical question: which halitometer is the most suitable for diagnosing halitosis? METHODS This systematic review was registered in PROSPERO (ID CRD42022320024). The search was performed on March 23, 2022 in the following electronic databases: MEDLINE, Embase, Scopus, Web of Science, and CENTRAL. Adult populations with or without halitosis were included, and patients with systemic diseases were excluded. Organoleptic (subjective) measurement and the device-supported (objective) methods were compared; the primary outcome was the correlation coefficient, and the secondary was the specificity and sensitivity of the devices. QUADAS-2 and QUADAS-C were used to evaluate the risk of bias in the studies. Random-effects meta analyses were performed on the outcomes, and the secondary outcomes were plotted on a common ROC plot. RESULTS A total of 1231 records were found in the 5 databases. After the selection process, 76 articles were eligible for the systematic review, and 14,635 patients were involved in the qualitative analysis. The pooled Spearman's correlation coefficient (c.c.) for sulfide monitors was 0.65; 95% CIs: [0.53-0.74]; I2 = 95%, P < .01. The pooled Spearman's c.c. for portable gas chromatographs was 0.69; 95% CIs: [0.63-0.74]; I2 = 12%, P < .01. The pooled Spearman's c.c. for gas chromatographs was 0.76; 95% CIs: [0.67-0.83]; I2 = 0%, P < .01. DISCUSSION None of the most commonly used halitometers proved to be significantly superior to the others. Halimeter and OralChroma measurements did not correlate well with the organoleptic level of oral halitosis in adults. Therefore, better halitometers need to be developed as an alternative to organoleptic measurements.
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Affiliation(s)
- Eszter Szalai
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Tajti
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Tamás Kói
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Stochastics, Institute of Mathematics, Budapest University of Technology and Economics, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - László Márk Czumbel
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Periodontology, Semmelweis University, Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Beáta Kerémi
- Department of Restorative Dentistry and Endodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
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Khounganian RM, Alasmari ON, Aldosari MM, Alghanemi NM. Causes and Management of Halitosis: A Narrative Review. Cureus 2023; 15:e43742. [PMID: 37727189 PMCID: PMC10506127 DOI: 10.7759/cureus.43742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 09/21/2023] Open
Abstract
Halitosis is defined as the presence of an unpleasant odor in exhaled air, regardless of its cause. In most patients with halitosis, the condition causes embarrassment and interferes with social interactions and daily life. Furthermore, bad breath can be a sign of an underlying disease. Understanding the factors and causes that lead to halitosis and its manifestations could facilitate proper management of this condition. To properly diagnose and treat patients, healthcare professionals, including primary care physicians and dental professionals, must be familiar with the etiology and appropriate management of the disease. Consequently, this review aims to provide practitioners with up-to-date information on the etiological factors of halitosis to facilitate the establishment of preventive measures and provide accurate diagnosis and management.
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Affiliation(s)
| | - Osama N Alasmari
- Dentistry, College of Dentistry, King Saud University, Riyadh, SAU
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Clinical Trial Evaluating Quality of Life in Patients with Intra-Oral Halitosis. J Clin Med 2022; 11:jcm11020326. [PMID: 35054019 PMCID: PMC8779688 DOI: 10.3390/jcm11020326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/06/2022] [Accepted: 01/08/2022] [Indexed: 02/01/2023] Open
Abstract
Halitosis is considered to be extremely unattractive in the context of social interactions. The main research objective of this study was to evaluate whether intra-oral halitosis may impact patients’ quality of life (QOL). One hundred generally healthy adult participants complaining about oral malodor and diagnosed with intra-oral halitosis were enrolled in this study. For halitosis diagnosis, a gas chromatography (GC) analysis by the Oral Chroma portable device was used. QOL assessment was based on the Short Form 36-item Health Survey (SF-36). The respondents had the highest scores in the physical functioning (PF), activity limitations caused by emotional problems (RE) and activity limitations caused by physical problems (RP) domains, and the weakest in the general health perception (GH), vitality (VT) and emotional wellbeing (MH) ones. The total volatile sulfur compounds (VSCs) level was negatively correlated with SF-36 domains. The SF-36 domains’ scores decreased the higher the level of VSC was. The respondents assessed their QOL to be at its best in physical functioning and activity limitations caused by emotional and physical problems and the worst in general health perception, vitality and emotional wellbeing. The strongest correlation between halitosis and decreased QOL was found in the social functioning (SF), vitality, emotional wellbeing and general health perception domains.
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Rani RS, Puranik M, Uma SR. Relationship between psychological status and self-perception of halitosis among young adults with moderation by oral health status in Bengaluru City: A cross-sectional study. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2022. [DOI: 10.4103/jiaphd.jiaphd_71_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Faria SFS, Costa FO, Godinho Pereira A, Miranda Cota LO. Self-perceived and self-reported breath odour and the wearing of face masks during the COVID-19 pandemic. Oral Dis 2021; 28 Suppl 2:2406-2416. [PMID: 34245645 PMCID: PMC8447418 DOI: 10.1111/odi.13958] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/26/2021] [Accepted: 07/08/2021] [Indexed: 02/07/2023]
Abstract
Objectives To assess the self‐perception of breath odour (SPBO) and oral hygiene habits (OHHs) while the wearing of face masks during the COVID‐19 pandemic. Subjects and Methods This cross‐sectional study included 4647 individuals who answered a structured questionnaire containing demographic, medical and dental variables and self‐perceived breath odour. Variables associated with changes in self‐perceived breath odour, self‐perceived halitosis and changes in OHHs were assessed through multivariate logistic regression. Results Changes in self‐perceived breath odour were reported by 1572 individuals and were associated with smoking, systemic conditions, dry mouth, tongue coating, the period of face mask use and its interaction with prior thinking of having bad breath. Likewise, 645 individuals started to consider having bad breath. This was associated with the interaction between prior family/friends saying they have bad breath and period of face mask use. Changes in OHHs were strongly associated with changes in SPBO and starting to consider having bad breath. Conclusion Changes in one's SPBO was associated with the wearing of face masks and was significant for changes in OHHs. Findings may be important to guide comprehensive preventive and therapeutic strategies in relation to oral health care.
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Affiliation(s)
- Sandro Felipe Santos Faria
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte Minas Gerais, Brazil
| | - Fernando Oliveira Costa
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte Minas Gerais, Brazil
| | - Alexandre Godinho Pereira
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte Minas Gerais, Brazil
| | - Luís Otávio Miranda Cota
- Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte Minas Gerais, Brazil
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Knowledge and Management of Halitosis in France and Lebanon: A Questionnaire-Based Study. J Clin Med 2021; 10:jcm10030502. [PMID: 33535399 PMCID: PMC7867103 DOI: 10.3390/jcm10030502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/10/2021] [Accepted: 01/25/2021] [Indexed: 12/01/2022] Open
Abstract
Halitosis is a growing issue and its management is highly challenging. The aim of this study was to evaluate the knowledge and treatment strategies used by French (FD) and Lebanese (LD) dentists. A self-administered structured questionnaire was sent to FD and LD comprising questions about professional characteristics, management, and treatment of halitosis, patients’ referral, and halitosis-related knowledge. A multivariate analysis was conducted to determine differences between FD and LD and to identify parameters that could influence dentists’ management of halitosis. The questionnaire was filled out by 156 FD and 257 LD. Among them, 78.8% of FD and 68.9% of LD were confronted with halitosis management, while only a few routinely asked their patients about halitosis (16% FD, 13.2% LD). Regarding anamnesis, oral hygiene habits were more investigated by FD than LD (p < 0.05). The overall treatment satisfaction was low with 39.7% of FD and 28.4% of LD considering their treatment effective. Regarding halitosis-related knowledge, extra-oral causes were overestimated in both populations. FD (83.4%) and LD (65.8%) considered their education regarding halitosis as insufficient. This study highlights the need of professional education in both countries, targeting proper diagnosis and treatment strategies of halitosis.
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Hampelska K, Jaworska MM, Babalska ZŁ, Karpiński TM. The Role of Oral Microbiota in Intra-Oral Halitosis. J Clin Med 2020; 9:E2484. [PMID: 32748883 PMCID: PMC7465478 DOI: 10.3390/jcm9082484] [Citation(s) in RCA: 63] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 12/18/2022] Open
Abstract
Halitosis is a common ailment concerning 15% to 60% of the human population. Halitosis can be divided into extra-oral halitosis (EOH) and intra-oral halitosis (IOH). The IOH is formed by volatile compounds, which are produced mainly by anaerobic bacteria. To these odorous substances belong volatile sulfur compounds (VSCs), aromatic compounds, amines, short-chain fatty or organic acids, alcohols, aliphatic compounds, aldehydes, and ketones. The most important VSCs are hydrogen sulfide, dimethyl sulfide, dimethyl disulfide, and methyl mercaptan. VSCs can be toxic for human cells even at low concentrations. The oral bacteria most related to halitosis are Actinomyces spp., Bacteroides spp., Dialister spp., Eubacterium spp., Fusobacterium spp., Leptotrichia spp., Peptostreptococcus spp., Porphyromonas spp., Prevotella spp., Selenomonas spp., Solobacterium spp., Tannerella forsythia, and Veillonella spp. Most bacteria that cause halitosis are responsible for periodontitis, but they can also affect the development of oral and digestive tract cancers. Malodorous agents responsible for carcinogenesis are hydrogen sulfide and acetaldehyde.
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Affiliation(s)
- Katarzyna Hampelska
- Department of Genetics and Pharmaceutical Microbiology, Poznań University of Medical Sciences, Święcickiego 4, 60-781 Poznań, Poland; (K.H.); (M.M.J.)
- Central Microbiology Laboratory, H. Święcicki Clinical Hospital, Poznań University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland
| | - Marcelina Maria Jaworska
- Department of Genetics and Pharmaceutical Microbiology, Poznań University of Medical Sciences, Święcickiego 4, 60-781 Poznań, Poland; (K.H.); (M.M.J.)
| | - Zuzanna Łucja Babalska
- Chair and Department of Medical Microbiology, Poznań University of Medical Sciences, Wieniawskiego 3, 61-712 Poznań, Poland;
| | - Tomasz M. Karpiński
- Chair and Department of Medical Microbiology, Poznań University of Medical Sciences, Wieniawskiego 3, 61-712 Poznań, Poland;
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