Intra-Oral Factors Influencing Halitosis in Young Women

Validation of the Romanian Version of the Halitosis Associated Life-Quality Test (HALT) in a Cross-Sectional Study among Young Adults

Halitosis is a common condition with a significant impact on individuals' quality of life. The Halitosis Associated Life-Quality Test (HALT) is a reliable instrument for measuring this impact. This study aimed to introduce and validate the Romanian translation of the HALT questionnaire (R-HALT). We hypothesized that the R-HALT would demonstrate good reliability and validity in measuring the impact of halitosis on quality of life among Romanian teenagers and young adults. Our objectives were to translate and adapt the HALT, validate it among a cross-sectional group, and evaluate the extent of halitosis in this population. A multicentric cross-sectional design followed, which was approved by the Ethics Research Committee in Romania. The translation process involved independent translations, retro-translations, expert review, and pre-testing. The psychometric properties were evaluated among 150 patients (mean age 23.6 ± 1.8; 51% males) at dental clinics, including reliability, convergent, and discriminant validity, using accepted statistical measures such as Cronbach's alpha and Intraclass Correlation Coefficient (ICC). The R-HALT revealed strong internal consistency with Cronbach's alpha values ranging from 0.93 to 0.96, and an ICC value of 0.87 (95% CI = 0.70-0.99), demonstrating excellent test-retest reliability. Mean scores of individual items ranged from 0.82 ± 0.94 (Q3) to 3.23 ± 1.15 (Q11). The corrected item-total correlation ranged from 0.30 (Q2) to 0.90 (Q19). Organoleptic test scores diagnosed 41% (62 patients) with a score of 2, with increasing severity in 9% (13 patients) with a score of 5. The R-HALT exhibited robust reliability and validity in assessing the impact of halitosis among Romanian teenagers and young adults. The questionnaire is a strong tool for understanding, diagnosing, and managing halitosis in Romania, ultimately aiming to improve the quality of life of affected individuals. Further studies with diverse populations could enhance the applicability of the R-HALT.

Prevalence and associated factors of self‐reported halitosis among institutionalized adolescents: cross‐sectional study

OBJECTIVE

To assess the prevalence and associated factors of self-reported halitosis in institutionalized adolescents in a city in southern Brazil.

METHODS

This cross-sectional study involved male institutionalized adolescents, aged 15-19 years old, at the Socio-Educational Assistance Center in the city of Passo Fundo, Brazil. Data collection was performed by a research team composed of two interviewers, two clinical examiners of oral health and two examiners of salivary flow. A structured questionnaire was applied, which included demographical, socioeconomical, general health behaviour, presence of health problems and oral health self-perception variables. Decayed, Missing, Filled Index was used for the clinical examination. The salivary flow collection was performed using the mechanically stimulated total saliva method, in which only the liquid component was measured.

RESULTS

The prevalence of self-reported halitosis in this sample was 51.5% (n = 35). In the final multivariate analysis, halitosis was significantly associated with the non-white racial group (prevalence ratio [RP]:1.703; 95% confidence interval [95%CI]:1.101-2.634), use of crack (RP:1.857; 95%CI:1.270-2.714) and number of decayed teeth (PR: 1.123; 95%CI:1.008-1.252). The use of alcohol and access to dental care in the last 12 months were not significantly associated with self-reported halitosis.

CONCLUSION

It was concluded that non-white and crack-user youngsters had a high occurrence of self-reported halitosis. Higher rates of dental caries are also associated with halitosis.

Role of Probiotics in Halitosis of Oral Origin: A Systematic Review and Meta-Analysis of Randomized Clinical Studies

Halitosis or oral malodor is a condition caused by the putrefaction of sulfur-containing amino acids. It affects 30–50% of the population and causes social rejection, reducing quality of life, and self-esteem. Probiotics, especially Lactobacillus species, have been proposed for the treatment of genuine halitosis, due to their ability to reduce bacterial colonization. Our objective was to evaluate their use for the treatment of oral halitosis. Applying the PRISMA statement guidelines, we searched PubMed, EMBASE, and Web of Science databases for scientific articles from the last 15 years, up to July 2021. The keywords used were “Probiotics”; “Halitosis”; “Mouth diseases”; “Oral health”; “Humans”; “Randomized Clinical Trials” according to the question, “Are probiotics effective for the reduction or elimination of oral halitosis?” Fourteen studies were identified, although only four met the inclusion criteria. We evaluated 283 participants treated with two different probiotics, with a follow-up of at least 2 weeks. Risk of bias was assessed using the Cochrane Collaboration tool. A fixed-effects meta-analysis was performed. No statistical significance was found (p = 0.53). Despite the limitations of this meta-analysis, we believe that some probiotics have a beneficial effect on halitosis, although more clinical trials are needed to establish real evidence on this aspect.

Systematic Review Registration:https://doi.org/10.37766/inplasy2021.9.0009, identifier: INPLASY20211900.