Self-perceived Halitosis Research Articles

Development and validation of the Thai Halitosis Associated Life-Quality Test (T-HALT): an evaluation of psychometric properties.

Halitosis appears to have significant impacts on quality of life, necessitating reliable assessment tools. The Halitosis Associated Life-Quality Test (HALT) has been validated in various populations, but not among Thai people. While HALT provides a valuable foundation, there is a need for a culturally adapted and expanded instrument for the Thai context. Consequently, this study aimed to develop and validate a comprehensive questionnaire for assessing halitosis-related quality of life in Thai populations, incorporating a Thai version of HALT (T-HALT) as a core component. This cross-sectional study involved 200 dental patients at Mahidol University. The original HALT was translated into Thai using forward-backward translation. Cultural adaptation and psychometric properties of T-HALT were evaluated through multiple approaches. Content validity was ensured through expert reviews, while face validity was assessed by patient feedback. Reliability was examined via test-retest and internal consistency measures. Criterion and discriminant validity was evaluated by correlating T-HALT scores with self-perceived halitosis and volatile sulfur compound (VSC) measurements, respectively. VSCs were quantified using the OralChroma™ device, which analyzes breath samples collected directly from patients' mouths. Construct validity was assessed through exploratory (EFA) and confirmatory factor analysis (CFA), providing insights into the questionnaire's underlying structure. T-HALT demonstrated excellent internal consistency (Cronbach's alphas = 0.940-0.943) and test-retest reliability (ICC = 0.886). Criterion validity was supported by a significant correlation between T-HALT scores and self-perceived halitosis (r = 0.503, P < 0.001). Discriminant validity was confirmed by the absence of a significant correlation between T-HALT scores and VSC levels (r = 0.071, P = 0.32). EFA revealed a four-factor structure, which was subsequently confirmed by CFA. However, Items 1 and 7 were excluded due to poor standardized factor loadings. T-HALT demonstrates good reliability and validity for assessing halitosis-related quality of life in Thai populations. It performs well as a unidimensional measure, but its multidimensional application requires modifications. Future research should validate a modified version excluding Items 1 and 7 across diverse Thai populations, potentially enhancing its cultural specificity.

Self-perceived halitosis and associated factors among university students in Dhaka, Bangladesh

BackgroundBad breath (halitosis) is a common problem affecting psycho-social wellbeing of young people. We aimed to explore the extent of self-perceived halitosis and associated factors among university students in Dhaka, Bangladesh.MethodsA cross-sectional study was conducted among university students from November 2021 to April 2022. Six private and two public universities were approached. A total of 318 participants were conveniently selected for the study. A self-administered questionnaire was used for data collection. Students unwilling to participate were excluded. Multivariable logistic regression analysis was used to examine factors associated with halitosis. Statistical analysis was conducted using Stata Version 17.ResultsA total of 55.97% of students had self-perceived halitosis, with females (74.53%) having a significantly higher proportion than males (36.94%) (p < 0.001). A significantly higher proportion of halitosis was found among participants who were overweight ( 61%), had obesity (60.77%), smoked cigarette (46.79%), consumed alcohol (71.43%), lacked exercise (66.29%), were on unhealthy diet (57.35%), consumed coffee/tea (61.35%), breathed through mouth (64.60%), brushed tooth infrequently (85.71%), changed toothbrush after 6 months (77.42%), did not use toothpaste (94.74%), did not use/ sometimes used fluoride toothpaste (75.76%), lacked dental floss use (60.85%), did not use toothpick (62.87%), did chew or sometimes chewed sugar-free chewing gum (75.82%), did not clear / cleaned tongue sometimes (76.14%), did use mouth freshener regularly or occasionally (64.97%), did not use or used mouthwash sometimes (58.87%) were also associated with higher self-perceived halitosis (p < 0.05 for all). Students with gum bleeding, swollen gums, dry mouth, dental caries, food accumulation, and tooth sensitivity had a significantly (p < 0.05 for all) higher proportion of self-perceived halitosis (76.85%, 81.82%, 72.50%, 67.78%, 64.13% and 67.40%, respectively) compared to those without this problem. Being female (OR = 5.04; 95% CI: 2.01–12.62; p < 0.001), alcohol consumers (OR 7.35; 95% CI: 1.77–30.50; p = 0.006); not using sugar free chewing gum (OR = 0.25; 95% CI: 0.10–0.58; p = 0.001), lack of tongue cleaning (OR 4.62; 95% CI: 2.16–9.84; p < 0.001), and gum bleeding (OR = 7.43; 95% CI: 3.00-18.35; p < 0.001) were independently associated with halitosis on multivariable regression.ConclusionThis study reveals a high proportion of self-perceived halitosis and relevant factors. There should be more public education on the causes of halitosis and potential management approaches.

Comparison of Clinical and Self-Reported Halitosis among Secondary School Adolescents in Maiduguri, Borno State Nigeria.

Background: Halitosis is of extreme relevance in adolescents due to their peculiar predisposition to conditions that affect social relationships.&#x0D; Objective: To assess the factors associated with halitosis and compare its prevalence using self and clinical reports among secondary school adolescents in Maiduguri, Borno State, Nigeria.&#x0D; Methods: This cross-sectional study was carried out among one hundred and fifty 12-18-year-old secondary school students in Maiduguri. The multistage sampling technique was used for the selection of participants and data was collected using an interviewer-administered structured questionnaire on socio-demography, knowledge of the aetiology of halitosis, oral hygiene practices and self-perception of halitosis. A trained and calibrated examiner did clinical halitosis by organoleptic assessment. A chi-square test and logistic regression analysis were done to determine the association between the investigated factors and halitosis. The level of test of significance (p) was set at &lt; 0.05&#x0D; Results: The prevalence of self-reported halitosis was 17.3 % while using the organoleptic method (clinical halitosis), about 12 (8.0%) had slight to moderate halitosis. There was no statistically significant association between self-reported halitosis and halitosis determined using the organoleptic method. Among the investigated factors, frequency of brushing and gingival bleeding were found to be statistically significantly associated with self-reported halitosis, (aOR 3.64; p=0.032) and (aOR 3.06; p=0.045) respectively.&#x0D; Conclusion: Adolescents reported halitosis more than was clinically present which may have led to more aggressive oral hygiene practices. There is therefore the need to increase awareness on halitosis and proper oral health behaviour in adolescents in the Northern part of Nigeria.&#x0D;

Investigating the prevalence of halitosis and its associated factors amongst the general population of Karachi, Pakistan.

To assess the prevalence of halitosis among the general population of Karachi, and to identify factors contributing to its occurrence. The cross-sectional study was conducted from March to July 2022 in Karachi after approval from the ethics review board of Dow University of Health Sciences, Karachi, and comprised the adult population of Karachi. Data was collected online using a questionnaire that was piloted before its link was distributed through social media platforms. The questionnaire evaluated the association of demographic features with self-perceived halitosis on the basis of which factors predictive of halitosis were determined. Data was analysed using SPSS 26. Of a total of 342 subjects, 182(53%) were females and 160(47%) were males. There were 141(41$) subjects aged 18-25 years, and 166(48%) were graduates. Overall, 240(70%) subjects reported to have self-perceived halitosis. Age, monthly household income, niswar and tea consumption, irregular use of dental floss and tongue cleaning were associated with higher incidence of halitosis (p<0.05). Carrying water bottle while outside was associated with decreased halitosis (p=0.007). Symptoms of gastroesophageal reflux disease, sinusitis, asthma, diabetes, hypertension and mental stress were associated with halitosis (p<0.05). Higher monthly household income and daily use of dental floss predicted lower odds of halitosis (p<0.05). Maintaining good oral hygiene and hydration reduced, while comorbid conditions increased the probability of halitosis.

Self-perceived halitosis and its social impact on females: A cross-sectional study.

Halitosis refers to socially unacceptable levels of breath odors. This affects the social life and psychological well-being of individuals. The purpose of this study was to evaluate the prevalence of self-perceived halitosis (SPH) among females and its effect on social life. This was a cross-sectional study. A previously validated questionnaire was distributed electronically through a secure link. The questionnaire consisted of 5 different parts that collected information on sociodemographic, medical history, oral hygiene and other health habits. It also included questions related to participant's knowledge and perception of halitosis and its social impact. All females who were at least 18 years were invited to participate. Data were transferred for analysis using the Statistical Package for Social Sciences program for Windows (IBM SPSS Statistics Version 26, Chicago, IL). Simple descriptive statistics such as frequency distributions and percentages were calculated for the study variables. The relationship between the variables and SPH was also evaluated using the chi-squared test of independence at 95% confidence (P ≤ .05). In total, 1089 subjects completed the questionnaire. The SPH prevalence was 62% among females. The correlation between SPH and sinusitis, gastrointestinal tract disorders, periodontal diseases were significant (P < .05). In addition, subjects with good tooth brushing habits reported no halitosis (91.6%) compared to subjects with poor tooth brushing habits who reported no halitosis (8.9%), and the difference was statistically significant (P < .001). Not using floss and tounge cleaners daily was significantly related to self-reported halitosis (P < .001). Females who reported SPH indicated that they were hesitant to talk to others (68.1%), uncomfortable around others (80.5%), did not like meeting others (44.2%), avoided by others (15%), and that halitosis affected their personal life (31.9%). This association was statistically significant for all variables of social life (P < .001). The prevalence of SPH is high and can have an incapacitating effect on females social lives. The management of halitosis includes active involvement of dental professionals and the incorporation of psychological support.

A Cross-Sectional Study on Self-Perceived Halitosis among Undergraduate University Students in Riyadh, Saudi Arabia.

The present cross-sectional observational study was conducted to evaluate the prevalence of halitosis among undergraduate university students at Riyadh Elm University, Riyadh, Saudi Arabia. A survey of 301 participants who answered a questionnaire on their self-perceived halitosis was undertaken. The response rate was 35% (301/863). Of the total, 54.5% of participants reported that they had experienced halitosis. A majority of participants (61.4%) responded to having experienced an unpleasant bad taste in the morning when they woke up, with most participants (42.4%) stating that their breath was the worst early in the morning. A majority of respondents (59.6%) reported that they were aware of their condition. Only 27% of the respondents stated that they had admitted to having undergone an examination for bad breath from their dentist, and 22.9% of the respondents reported that they had undergone an examination for conditions associated with bad breath. The measures used to reduce the condition were evenly distributed, with approximately one-third using mouthwash (34.6%), gum/mentos (38.3%), and toothpaste (27.2%). The incidence of self-perceived halitosis that was revealed in the current study is normal compare to others studies. It is unrelated to age and sex. Non-usage of dental floss, no use of mouthwash, and smoking, on the other hand, were shown to be associated with self-perceived halitosis. Furthermore, tongue cleaning was not linked to introspection halitosis. Halitosis may be also due to underlying systemic conditions. Hence it is necessary to evaluate the condition's prevalence and examine the relationship with other etiological variables with halitosis in our country.

STATUS OF TONGUE COATING AND PERCEIVED HALITOSIS AMONG THE PATIENTS SEEKING ORAL TREATMENT

Background: Tongue coating is accountable for various oral and systemic diseases. It is the prime cause of intraoral halitosis. Oral cleaning has primarily been focused on tooth cleaning, leaving the tongue neglected. Studies on tongue coating status have not been conducted in Nepal. Therefore, this study aimed to assess the tongue coating status and perceived halitosis among the patients seeking oral treatment in a tertiary care centre of Lalitpur, Nepal. Methods: A cross-sectional study was conducted among 392 randomly selected patients above 18 years of age attending the Oral Medicine and Radiology department of KIST Medical College and Teaching Hospital. Demographic details, tooth brushing, tongue cleaning, and tobacco consumption habits and self perception of halitosis were recorded. Amount of tongue coating and plaque was assessed using Winkel tongue coating index and Silness and Loe plaque index respectively. Results: The mean value of tongue coating was 5.06±3.35. Tongue cleaning was performed by 240(61.2%) participants and daily tongue cleaning was practiced by 142(36.2%) participants. Prevalence of oral malodor was 65.8%(n=258). Twenty three (5.9%) participants suffered from halitosis on a regular basis. Tongue coating was related with gender (p=.03) and tongue cleaning frequency (p=0.02). No relationship was observed between tongue coating and perceived halitosis. Conclusions: Mean value of tongue coating was lower but higher percentage of people suffered from halitosis. Halitosis reduction and other health benefits can be motivating factors for people to clean their tongue. Oral health professionals should raise the awareness of tongue cleaning among general population.

Self-reported periodontitis association with impaired smell and taste: A multicenter survey.

To investigate the association between self-reported periodontitis and the senses of taste and smell among employees of one Danish and two American universities. Data were collected through a digital survey. A total of 1239 individuals from Aarhus University - Denmark, the University of Iowa, and the University of Florida - USA were included. Self-reported periodontitis was the exposure. The perceived senses of taste and smell were the outcomes and were measured through a visual analog scale (VAS). Self-perceived halitosis was the mediator. Confounders were age, sex, income, education, xerostomia, COVID-19, smoking, body mass index, and diabetes. The total effect was decomposed into direct and indirect using a counterfactual approach. The total effect of periodontitis on an impaired sense of taste was OR 1.56 (95% CI [1.02, 2.09]), of which 23% was mediated by halitosis (OR 1.13; 95% CI [1.03, 1.22]). Additionally, individuals with self-reported periodontitis had a 53% higher chance of having impaired smell (OR 1.53; 95% CI [1.00, 2.04]), with halitosis mediating 21% of the total effect (OR 1.11; 95% CI [1.02, 1.20]). Our findings suggest that periodontitis is associated with distorted senses of taste and smell. Additionally, this association appears to be mediated by halitosis.

Mask-mouth syndrome: a looming oral health concern.

Mask-mouth syndrome: a looming oral health concern.

Self-Perceived Effect of Halitosis Related to Awareness of Maintaining Dental and Oral Health on Mask Use During the Coronavirus Disease 2019 (COVID-19) Pandemic

Background: The use of masks which have become part of daily activities during the pandemic, of course, causes various impacts, one of which is related to dental and oral health. The use of masks raises awareness of oral health because unhealthy teeth and mouth cause bad breath (halitosis). This study aimed to determine self-perceived halitosis related to awareness of oral health in using masks during the COVID-19 pandemic in the youth generation.&#x0D; Methods: This study was an analytic observational study with a cross-sectional approach. A total of 80 research subjects were included in this study. Participant inclusion criteria were new undergraduate students at the Faculty of Medicine, and Health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia and were willing to participate in the study. This study made observations about self-perceived halitosis related to wearing masks. Observations were carried out by interviews using online social media applications. Data analysis was performed using SPSS software version 25.&#x0D; Results: The majority of research subjects were 18 years old, female, and had good self-perceived halitosis when using masks. The majority of research subjects had good oral health behavior. The results of this study showed that there was no difference between subjects with poor self-perceived and good self-perceived subjects regarding behavior in maintaining oral health, p&gt; 0.05.&#x0D; Conclusion: There is no relationship between self-perceived halitosis related to the use of masks and the behavior of maintaining dental and oral health.

Relationship between Hormonal Changes and Self-Perceived Halitosis in Females: A Cross-Sectional Study.

Halitosis is a growing concern for patients seeking dental treatment. Women experience hormonal changes throughout different phases of their life. These changes may affect volatile organic compound (VOC) production and can be linked to halitosis. The aim of this study was to evaluate the effect of hormonal changes on self-perceived halitosis in a sample of females using a self-administered questionnaire. This study used a cross-sectional observational design. The questionnaire was distributed electronically through Google forms. A total of 1089 participants completed the questionnaire. Almost 50% of participants were below the age of 25; and 12% were of menopausal age (defined as 45 years and older). Most participants reported having regular menstrual cycles (63.5%) while only 20% reported having hormonal disturbances. Almost 62% of the sample reported that they notice halitosis on themselves with 27.6% indicating their perception of halitosis occurred at different times of the month. Around 12% of the sample thought that a relationship between halitosis and their menstrual cycle existed with 4.6% reporting halitosis during menstruation. The present study found that regularity of menstrual cycle and hormonal disturbances can affect females' self-perceived halitosis and the prevalence of oral health symptoms.

Self-Perceived Halitosis and Related Factors Among the Mask-Wearing Population During the COVID-19 Pandemic in Delhi, India: A Cross-Sectional Study.

Introduction Halitosis (oral malodor) is a common health condition throughout the world. In India, data on self-reported halitosis and related factors is limited. Mouth mask usage has been made compulsory after the coronavirus disease 2019 (COVID-19) pandemic. This could possibly alter oral microflora and environmentand contribute to halitosis. The aim of the study was to determine the prevalence of self-perceived halitosis (SPH) among mask-wearing patients visiting a tertiary care dental hospital in Delhi, India. Methods A cross‑sectional study was conducted among a convenience sample of 300 patients visiting a tertiary care dental hospital in the capital of India. SPH status was measured using a self-designed and structured questionnaire containing socio-demographic factors, mask-related habits, and self-perceived oral health status. Statistical analysis was done using Jamovi software (The jamovi project,Sydney, Australia) version 1.8. Descriptive analysis followed by a chi-square test and a multivariate logistic regression test was applied. Results Bad breath was perceived by 86 study subjects. Of the participants,16.7% felt that they had bad breath before the pandemic, and 38% of the participants had an increased perception or feeling of bad breath since regular mask usage. Of the participants,42.7% felt that they had an increased feeling of dryness in the mouth post-pandemic. SPH status was associated with mask usage frequency (p<0.001), change (p<0.001)and type of mask (p=0.004), increased feeling of dryness (p<0.001), frequency of toothbrushing (p<0.001), self-reported oral disease (p=0.007), and dental treatment in the past 12 months (p=0.005). Conclusion The SPH status of the study population was associated with mask-related habits and self-reported oral health status. The findings highlight the importance of possible amendments in preventive and curative care for patients with halitosis post-COVID-19 pandemic.

Relationship between psychological status and self-perception of halitosis among young adults with moderation by oral health status

Background: The present study was conducted for assessing the relationship between psychological status and self-perception of halitosis among young adults with moderation by oral health status.Materials and Methods: A total of 200 subjects were enrolled and were divided into two study groups with 100 subjects in each group as follows: Group A: Self-perceived group: Subjects who sensed halitosis, and Group B: Suggested group: Subjects who were advised about malodour by family/friends. All the subjects were given strict instructions for refraining themselves from smoking, consuming alcohol, spicy food intake or using any kind of chewing gum, drops, mint, and mouth rinses on the day of clinical examination. A questionnaire was framed and was administered to all the subjects. All results were assessed. Results: Subjects of group A had significantly higher history of dental visits in comparison to that of group B. While comparing the oral hygiene practices in between the two study groups, significant results were obtained. While comparing the DMFT and BOP in between the two study groups, it was seen that DMFT and BOP was significantly higher among subjects of group A. Incidence of anxiety and depression was also significantly higher among subjects of group A.Conclusion: Self-perceived halitosis could have a significant impact on the patient’s quality of life.

Prevalence and Risk Factors for Periodontal Disease Among Women Attending Antenatal Care in Public Hospitals, Southwest Ethiopia, 2022: A Multicenter Cross-Sectional Study.

BackgroundPeriodontal disease is characterized by the inflammation of all tissues that surround and support the teeth, and it is the most common public health problem worldwide. It has many different contributing factors, such as poor oral hygiene, smoking, anemia, bacterial plaque, poor economic status, and nutritional deficiency. It also causes different feto-maternal complications like preeclampsia, gestational diabetes, preterm labor, low birth weight, and early abortion. Thus, this study aimed to assess the prevalence and associated factors of periodontal disease among pregnant women.MethodsA cross-sectional study was conducted among 618 women at public hospitals in the Southwest Ethiopia. Data were collected using a systematic random sampling method and a structured interviewer administered questionnaire. The data were entered into Epi-Data Manager 4.2 and then transferred to a statistical package for social science (SPSS) version 21 for analysis. The logistic regression analysis was done to see the significant association between each predictor with periodontal disease by considering a p-value of <0.05 and a CI of 95%.ResultsA total of 618 women attending ANC with a 100% response rate were enrolled in this study. The mean and standard deviation of the age of the study participants was 31.07 ± 7.8 years. The periodontal disease was observed among 240 (38.8%) of the total participants with 95% C.I of (35%, 43%). Predictors like rural residency, women who could not read and write, women with poor wealth index, nutritional status of underweight, had no information about periodontal disease, depression, history of diabetes mellitus, self-perceived halitosis, no history of ANC, and lower gestational age were found to be significantly associated with periodontal disease.ConclusionIn this study, the prevalence of periodontal disease was found to be significantly higher. Therefore, in order to minimize the burden of periodontal disease among pregnant women, oral, medical, and mental health education should be promoted.

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

Background: Halitosis is a term defining a common concern of individuals with a bad odor originating from their mouth. Halitosis is a symptom related to both somatic and emotional status. There is a need to investigate the relationship between psychological status and halitosis with the moderation by oral health. Aim: To assess the relationship between psychological status and self-perception of halitosis among young adults with moderation by oral health status (OHS). Methodology: A cross-sectional study was conducted among 160 self-perceived halitosis (SPH) and 160 halitosis suggestive (HS) young adults in Bengaluru city. Questionnaire for self-perception of halitosis and Symptom Checklist-90-Revised (SCL-90-R) questionnaire for psychological status were used. Halitosis was measured using organoleptic test. OHS was assessed using the World Health Organization Oral Health Assessment form for Adults, 2013. Independent t-test, Chi-square test, and multivariate linear regression were performed. A moderation analysis was carried out to examine the effect of OHS. The P < 0.05 was considered significant. Results: The mean age was 21.56 ± 1.84 years and 23.8 ± 1.93 years in the self-perceived halitosis and HS groups, respectively. Questionnaire for self-perception of halitosis majority of them experienced bad breath for the past 3 months; were hesitant to talk to others; felt uneasy; avoided social interaction, and the workplace was affected. The mean SCL-90-R score of SPH (291.46 ± 13.17) was significantly greater than HS (137.06 ± 25.09) (P < 0.001). Most of the participants in SPH had malodor and 50% had no odor in HS group. The mean Decayed, Missing, and Filled Teeth were 2.37 ± 3.92 and 1.87 ± 2.86 in SPH and HS groups, respectively (P = 0.19). The mean of teeth with gingival bleeding was significantly higher in SPH (3.46 ± 3.87) when compared to HS groups (1.61 ± 2.44) (P < 0.001). On multivariate linear regression, there was a significant relationship noted between the self-perceived halitosis group and SCL-90-R (R2 = 0.07; P < 0.001). In the moderation analysis, the effect of oral health and self-perception of halitosis was significant with psychological status. Conclusions: There is a relationship between the psychological status and self-perception of halitosis with moderation by OHS.

Self-Perceived Halitosis according to Oral Health Behaviors and Dietary Habits of Some College Students

Self-Perceived Halitosis according to Oral Health Behaviors and Dietary Habits of Some College Students

Self-perceived halitosis among young adults undergoing orthodontic treatment.

Halitosis is a common oral health problem that significantly impacts the quality of life of the affected individuals. In most cases, poor oral hygiene is responsible for the problem. Orthodontic therapy aims to correct malocclusion using different devices. It has been suggested that orthodontic treatment can promote gingival health by facilitating daily oral hygiene measures. However, the treatment may harm gingival health as these appliances may lead to a more significant accumulation of plaque, increasing the microbial load in the subgingival environment leading to halitosis. The primary goal of this survey is to assess the prevalence of self-perceived halitosis in patients undergoing orthodontic treatment. An online questionnaire was randomly distributed to patients undergoing orthodontic treatment. A total of 289subjects completed the questionnaire. It included questions about: demographic data, medical history, social habits, past dental treatment and oral hygiene habits. Descriptive statistics as frequency distributions and percentages were calculated for the study variables. The prevalence of self-perceived halitosis was 41.5%. The majority of the participants started to notice this problem during and after orthodontic treatment (62.5%). A statistically significant correlation was found between the regular dental visits and halitosis in patients with fixed orthodontic appliances (p-value=0.010). Also, those patients had a substantial increase in tongue coating formation (p- value=0.010). Self-perceived halitosis is a common problem in patients receiving orthodontic treatment.

COVID-19 Pandemic: Effect of Different Face Masks on Self-Perceived Dry Mouth and Halitosis.

Due to the COVID-19 pandemic, the use of face masks has increased, resulting in potential health-related side-effects. Therefore, the study aimed to analyse the effect of wearing face masks on self-perceived dry mouth and halitosis. A questionnaire addressing the daily wearing time of different face masks (community masks, surgical/medical masks and KN95-/N95-/FFP2-masks) and self-perceived dry mouth and halitosis was given to adults attending or working at a university hospital. Statistical analysis was performed using Wilcoxon signed-rank test and multiple linear regression analysis (p < 0.05). 3750 participants (age: 50.4 ± 15.5 years; 60.0% female) were included. During the pandemic, face masks were used for 4.7 ± 3.8 h per day: community masks: 0.9 ± 2.0 h, medical/surgical masks: 1.9 ± 2.8 h and KN95-/N95-/FFP2-masks: 1.9 ± 2.5 h per day. The use of face masks significantly increased self-perceived dry mouth and halitosis (both p < 0.001). Self-perceived dry mouth and halitosis increased with increasing wearing time (community masks: dry mouth: p < 0.001, halitosis: p = 0.014; medical/surgical masks: both: p < 0.001; KN95-/N95-/FFP2-masks: dry mouth: p < 0.001, halitosis: p = 0.011). The perception of dry mouth and halitosis was increased in females compared to males (both: p < 0.001). Participants used to wearing face masks prior to the pandemic perceived dry mouth to a higher extent (p = 0.043). Self-perceived halitosis was lower in older than in younger participants (p < 0.001). Due to the increased perception of dry mouth and halitosis, people might abstain from wearing face masks. Further studies need to analyse measurable changes in dry mouth or halitosis.

Self-perceived and self-reported breath odour and the wearing of face masks during the COVID-19 pandemic.

ObjectivesTo 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 MethodsThis 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.ResultsChanges 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.ConclusionChanges 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.

Adolescence, Adulthood and Self-Perceived Halitosis: A Role of Psychological Factors.

(1) Background: Halitosis is a frequent condition that affects a large part of the population. It is considered a “social stigma”, as it can determine a number of psychological and relationship consequences that affect people’s lives. The purpose of this review is to examine the role of psychological factors in the condition of self-perceived halitosis in adolescent subjects and adulthood. (2) Type of studies reviewed: We conducted, by the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) guidelines, systematic research of the literature on PubMed and Scholar. The key terms used were halitosis, halitosis self-perception, psychological factors, breath odor and two terms related to socio-relational consequences (“Halitosis and Social Relationship” OR “Social Issue of Halitosis”). Initial research identified 3008 articles. As a result of the inclusion and exclusion criteria, the number of publications was reduced to 38. (3) Results: According to the literature examined, halitosis is a condition that is rarely self-perceived. In general, women have a greater ability to recognize it than men. Several factors can affect the perception of the dental condition, such as socioeconomic status, emotional state and body image. (4) Conclusion and practical implication: Self-perceived halitosis could have a significant impact on the patient’s quality of life. Among the most frequent consequences are found anxiety, reduced levels of self-esteem, misinterpretation of other people’s attitudes and embarrassment and relational discomfort that often result in social isolation.