Self-reported halitosis and gastro-esophageal reflux disease in the general population

Exploring the therapeutic potential of medicinal plants and their active principles in dental care: A comprehensive review

Since the human population realized how important it was to maintain overall health and the weight of disease, they have been looking for therapeutic qualities in natural environments. The use of plants having medicinal qualities for the treatment and prevention of illnesses that may have an impact on general health is known as herbal medicine. There has been a noticeable increase in interest lately in the combination of synthetic contemporary medications and traditional herbal remedies. About 80 % of people rely on it for healthcare, particularly in developing nations. One important aspect of overall health is said to be oral healthcare. The World Health Organization views oral health as a crucial component of overall health and well-being. Because they are more readily available, less expensive, and have fewer adverse effects than pharmaceutical treatments, using natural medicines to treat pathologic oro-dental disorders can make sense. The current evaluation of the literature sought to investigate the range and scope of the use of herbal products and their secondary metabolites in maintaining oral health, encompassing several oral healthcare domains such as halitosis, gingivitis, periodontitis, and other oral disorders. Therefore, there are many herbs discussed in this work and their mechanism in the treatment and improvement of many oral ailments. Besides, compounds that are useful in oral treatment with their natural sources and the cases where they can be used. To prevent any possible side effects or drug interactions, a doctor's consultation is necessary before using dental medicine. Although herbal therapy is safe and with minimum side effects, it is also strongly advised to do a more thorough preclinical and clinical evaluation before using herbal medicines officially.

Influence of tobacco smoking on the development of halitosis

Background

Halitosis is the general term used to describe any disagreeable odor in exhaled air, regardless of whether the odorous substances originate from oral or non-oral sources. Previous research has strongly associated tobacco smoking in the development of halitosis, as it increases the synthesis of toxic volatile sulfur compounds in diseased periodontal pockets. In this review, we summarize the etiopathology and epidemiology of halitosis as well as the current evidence on the impact of smoking by means of a meta-analysis.

Methods

PubMed and Embase were searched to identify publications that reported halitosis in smokers and nonsmokers. Meta-analyses were performed if a sufficient number (n ≥ 3) of articles were available that evaluated the same outcome.

Results

The meta-analyses showed that there was an increased risk of halitosis in current smokers versus nonsmokers (odds ratios). These results were consistent both in fixed and random effects models. Even though the interstudy heterogeneity was high (I2 = 91%), sensitivity analysis by limiting the number of studies yielded similar results, with no-to-moderate heterogeneity (I2 = 0-65%). The analysis comparing ever smokers with never smokers showed no significant difference in the risk of halitosis in ever smokers. The same effect was observed when upon stratifying the analyses on the basis of ascertainment of halitosis (self-reported or measured by a Halimeter).

Conclusions

Halitosis is a common condition which can affect the quality of life of those affected. The results from this literature review and meta-analysis show that current smokers are more likely to suffer from halitosis, even if they are less likely to report it.

A Literature Review and Framework Proposal for Halitosis Assessment in Cigarette Smokers and Alternative Nicotine-Delivery Products Users

Halitosis is a health condition which counts cigarette smoking (CS) among its major risk factors. Cigarette smoke can cause an imbalance in the oral bacterial community, leading to several oral diseases and conditions, including intraoral halitosis. Although the best approach to decrease smoking-related health risks is quitting smoking, this is not feasible for many smokers. Switching to potentially reduced-risk products, like electronic vapor products (EVP) or heated tobacco products (HTP), may help improve the conditions associated with CS. To date, there have been few systematic studies on the effects of CS on halitosis and none have assessed the effects of EVP and HTP use. Self-assessment studies have shown large limitations owing to the lack of reliability in the participants' judgment. This has compelled the scientific community to develop a strategy for meaningful assessment of these new products in comparison with cigarettes. Here, we compiled a review of the existing literature on CS and halitosis and propose a 3-layer approach that combines the use of the most advanced breath analysis techniques and multi-omics analysis to define the interactions between oral bacterial species and their role in halitosis both in vitro and in vivo. Such an approach will allow us to compare the effects of different nicotine-delivery products on oral bacteria and quantify their impact on halitosis. Defining the impact of alternative nicotine-delivery products on intraoral halitosis and its associated bacteria will help the scientific community advance a step further toward understanding the safety of these products and their potentiall risks for consumers.

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.

Association of periodontitis with oral malodor in Korean adults

This study aimed to evaluate the association of periodontitis with the organoleptic score (OLS)-defined oral malodor after validating OLS with odoriferous sulfur compounds in mouth air among Korean adults. A total of 330 adults aged 47–86 years were recruited from the Yangpyeong health cohort, South Korea, in 2015. Oral malodor was assessed using a 6-point OLS by a trained dentist and validated with the concentrations of hydrogen sulfide (HS) and methyl mercaptan (MM) using a gas chromatographer. Periodontitis was measured by assessing the radiographic alveolar bone loss on digital orthopantomography. Statistical analyses including descriptive statistics, partial correlation, ANOVA, and multivariable logistic regression with putative confounders were applied. OLS was significantly correlated with the concentrations of HS and MM (partial r = 0.401 and 0.392, respectively; both p<0.001) after controlling for confounders. Individuals with periodontitis had 1.8 times the risk of OLS-defined oral malodor in multivariable models (adjusted odds ratio = 1.77 in the model with the number of teeth and 1.82 in the model with denture wearing; p = 0.047 and 0.035, respectively). Periodontitis was associated with OLS-defined oral malodor among Korean adults independent of known confounders. Periodontal conditions should be considered for clinical practice and research of oral malodor.

[The application of the BL-38 subjective complaints scale in an epidemiological cohort study (Study of Health in Pomerania)]

The application of the BL-38 subjective complaints scale in an epidemiological cohort study (Study of Health in Pomerania) Objective: We provide an overview of the application of the BL-38 complaints scale in the epidemiological Study of Health in Pomerania. We examine the influence of socio-demographic variables on complaint burden and the stability of complaint burden over time. Methods: 16 studies that used the BL-38 in analyses of SHIP-data were examined in terms of how the BL-38 was operationalised and the statistically significant results yielded. We conduct linear regression analyses to assess effects of sociodemographic variables on complaint burden in four SHIP populations and assess test-retest-reliability over a 17-year period. Results: The BL-38 is predominantly used flexibly to depict specific complaints in analyses covering a heterogeneous range of disciplines and study questions. Total, somatic and mental complaint burden have different determinant, predictive and confounding effects. Test-retest-reliability was moderate. Conclusions: The BL-38 allows consideration of (specified) health complaint patterns across many research disciplines. Cross-sectional and longitudinal reproducibility of significant results underlines its validity. The results underscore the importance of subjective health complaints in epidemiological and psychosomatic research.

Small, but smelly: the importance of Solobacterium moorei in halitosis and other human infections

Solobacterium moorei (S. moorei) has been described as Gram-positive, non spore forming, obligate anaerobic bacillus from human feces. The traditional culture and identification of these strains is very difficult (as the strains are often not cultivable or they grow only relatively slowly, in addition to producing only a very few positive biochemical reactions in commercially available identification kits); thus, reliable identification may only be carried out using methods, such as matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and DNA sequencing. Regarding its pathogenic role, the relevance of S. moorei in halitosis (oral malodor) has a good standing, as it has been suggested by multiple studies, while the isolation of these bacteria from invasive infections is very rare; there are only a few reports available in the literature, regarding infections outside the oral cavity. Based on these reports, affected patients are predominantly characterized compromised immunity and are frequently associated with a dental focus of infection. The aim of our present review is to summarize the currently available knowledge on the pathogenic role of S. moorei in halitosis and other infections and to emphasize the relevance of this neglected anaerobic pathogen.

Halitosis And Its Associated Factors Among Kermanshah High School Students (2015)

Introduction

Halitosis as a common dental problem results in psychological social problems and relates to many factors. The aim of this study was to evaluate the prevalence of halitosis and its associated factors among students aged from 14 to 18 years in Kermanshah in 2015.

Materials and methods

The study was conducted in high school students of Kermanshah city in 2015. The questionnaire including questions about bad breath and other associated factors (demographic information, background diseases, oral and dental problems, decay-missing-filled (DMF) index, etc.) was completed by students or determined by the examiner. Organoleptic evaluation was conducted. Prevalence of organoleptic and self-reported halitosis and related factors was reported. The relationship between malodor and variables was evaluated and the most important factor was determined by multiple logistic regression analysis. The diagnostic agreement between self-perception and organoleptic halitosis was assessed using Kappa coefficient as well.

Results

The prevalence of halitosis in the organoleptic evaluation was 29.75% and higher in boys (32.6% male vs. 25.2% female) and 27.47% in self-perception (32.9% male vs. 19% female). The diagnostic agreement between organoleptic and self-perception halitosis was moderate or poor. Among the studied factors, the most important factor related to the organoleptic evaluation of halitosis was DMF≥4 (P<0.001 and OR=2.253).

Conclusion

The DMF index was the factor most strongly associated with organoleptic halitosis in this sample of high school students. Other factors with significant association included parent's lower education level, not brushing, not flossing, bleeding gums, tongue coating, pericoronitis, and plaque index. Also, older age, male gender, and gastrointestinal disease increased the possibility for halitosis.

Impact of the halitosis on QoL in overweight and obese patients: Based on six years of experience in two centers in sulaimani governorate, Kurdistan Region/Iraq, and case series study

BACKGROUND/OBJECTIVES

The patients who are overweight and obese, are under stress of excess body weight, embarrassed, one may imagine the impact of halitosis on this group of patients, this is an attempt to evaluate this extra impact, and which aspect of quality of life will be affect in the overweight and obese.

SUBJECTS/METHODS

A prospective case series study including 885 overweight or obese patients, they were consulting for advice, diet and or drugs and various bariatric operations. A group of normal weight patients with halitosis, matched in age group and gender were enrolled as a control group for comparison. Patients who have either oral causes of the condition or pseudo halitosis or halite-phobia or were using drugs like phenytoin, cyclosporine or calcium channel blockers, isosorbide di-nitrate, Chloral hydrate, Nitrites and Nitrates, Dimethyl sulphoxide, Disulphiram, cytotoxic agents, Phenothiazine were excluded.

INTERVENTIONS/METHODS

The work conducted over a period of 6 years from February 1st, 2012 to March 1st, 2018. Prospective evaluation of the type and etiology of halitosis was done by using organoleptic measurement, which is not a slandered but evaluated by a group of academic colleagues. The patients were advised to avoid eating odiferous foods for 48 hours before the assessment and both the patient and the examiner should refrain from drinking coffee, tea or juice, smoking and using scented cosmetics before the assessment.

RESULTS

Halitosis in the overweight and obese patients magnifies the negative aspects of quality of life: avoidance, narrow social circle (P Value = 0.3415, 95% confidence interval = 11.43924-29.67085), avoidance of sex by partner (P Value = 0.0143, 95% confidence interval = 04.11537-17.08480), low self-esteem (P Value = 0.0100, 95% confidence interval = 10.66794-28.44776), teasing by others and negative thoughts (P Value = 0.4013, 95% confidence interval = 11.43924-29.67085). While obesity was not a cause of avoidance of to be kissed by partner in obese patients, but was a direct cause for this avoidance in obese patients with halitosis (P Value = 0.0143, 95% confidence interval = 04.11537-17.08480). Halitosis in normal weight patients affects the quality of life remarkably but not to the extent of halitosis in overweight and obese patients, especially social life and self-esteem which will suffer most.

CONCLUSIONS

The quality of life of overweight and obese, especially emotional and social aspects was significantly disturbed by halitosis more than normal weight subjects with halitosis.

Oral manifestations of gastrointestinal disorders

Background

A considerable number of gastrointestinal disorders (GIDs) of varied nature (inflammatory, infectious, genetic and other etiology) may produce alterations in the hard and soft oral tissues. Among these are Crohn’s disease, ulcerative colitis, celiac and gastroesophageal reflux disease.

Material and Methods

Article search was done using the National library of medicine (PubMed) database using different search terms and analyzed according to their importance.

Results

A large variety of GIDs can give rise to oral lesions, including: RAS like ulceration, mucosal tags, cobblestoning, mucogingivitis, labial and facial swelling, pyostomatitis vegetans, disgeusia and dental abnormalities, among others. Although in most cases the gastrointestinal signs and symptoms highlight in the clinical picture, a considerable percentage of these patients are affected by oral manifestations before the onset of gastrointestinal symptoms. This lesions can cause significant functional and aesthetics damages as well deteriorate the patient quality of life.

Conclusions

Although the frequency of oral manifestations is variable across GIDs and in most cases is non-specific, these alterations may precede the underlying disease and therefore can facilitate an opportune diagnosis.

Key words:Gastrointestinal disorders, oral lesions, oral mucosal disorders.

Halitosis and helicobacter pylori infection: A meta-analysis

BACKGROUND

Halitosis is used to describe any disagreeable odor of expired air regardless of its origin. Numerous trials published have investigated the relation between Helicobacter pylori (H pylori) infection and halitosis, and even some regimes of H pylori eradication have been prescribed to those patients with halitosis in the clinic. We conducted a meta-analysis to define the correlation between H pylori infection and halitosis.

OBJECTIVES

To evaluate whether there is a real correlation between H pylori infection and halitosis, and whether H pylori eradication therapy will help relieve halitosis.

METHODS

We searched several electronic databases (The Cochrane Library, MEDLINE, EMBASE, PubMed, Web of Science, and Wanfangdata) up to December 2015. Studies published in English and Chinese were considered in this review. After a final set of studies was identified, the list of references reported in the included reports was reviewed to identify additional studies. Screening of titles and abstracts, data extraction and quality assessment was undertaken independently and in duplicate. All analyses were done using Review Manager 5.2 software.

RESULTS

A total of 115 articles were identified, 21 of which met the inclusion criteria and presented data that could be used in the analysis. The results showed that the OR of H pylori infection in the stomach between halitosis-positive patients and halitosis-negative patients was 4.03 (95% CI: 1.41-11.50; P = 0.009). The OR of halitosis between H pylori-positive patients and H pylori-negative patients was 2.85 (95% CI: 1.40-5.83; P = 0.004); The RR of halitosis after successful H pylori eradication in those H pylori-infected halitosis-positive patients was 0.17 (95% CI: 0.08-0.39; P <0.0001), compared with those patients without successful H pylori eradication. And the RR of halitosis before successful H pylori eradication therapy was 4.78 (95% CI: 1.45-15.80; P = 0.01), compared with after successful H pylori eradication therapy.

CONCLUSIONS

There is clear evidence that H pylori infection correlates with halitosis. H pylori infection might be important in the pathophysiological mechanism of halitosis, and H pylori eradication therapy may be helpful in those patients with refractory halitosis.

Halitosis: Current concepts on etiology, diagnosis and management

Halitosis or oral malodor is an offensive odor originating from the oral cavity, leading to anxiety and psychosocial embarrassment. A patient with halitosis is most likely to contact primary care practitioner for the diagnosis and management. With proper diagnosis, identification of the etiology and timely referrals certain steps are taken to create a successful individualized therapeutic approach for each patient seeking assistance. It is significant to highlight the necessity of an interdisciplinary method for the treatment of halitosis to prevent misdiagnosis or unnecessary treatment. The literature on halitosis, especially with randomized clinical trials, is scarce and additional studies are required. This article succinctly focuses on the development of a systematic flow of events to come to the best management of the halitosis from the primary care practitioner's point of view.

Association between halitosis diagnosed by a questionnaire and halimeter and symptoms of gastroesophageal reflux disease

Background/Aims

The relationship between halitosis and gastroesophageal reflux disease (GERD) remains controversial. The aim of this study was to investigate an association between subjective and objective halitosis and GERD.

Methods

The subjects were enrolled from participants who visited a health promotion center at Seoul National University Bundang Hospital. For diagnosis of halitosis, a questionnaire was requested, and volatile sulfur compounds (VSCs) were measured by Halimeter. Self-conscious halitosis was defined as halitosis perceived by himself or herself. Informed halitosis was defined as halitosis perceived by others. Objective halitosis was defined when mean VSCs values were > 100 parts per billion. GERD was defined based on a questionnaire and endoscopy, including erosive esophagitis and non-erosive reflux disease (NERD).

Results

A total of 54 subjects (male:female = 33:21) with mean age of 46.0 ± 11.4 years were analyzed. The mean VSCs values were not significantly different between presence and absence of self-conscious halitosis (P = 0.322), but significantly different between presence and absence of informed halitosis (P = 0.021). Informed halitosis was associated with objective halitosis (P = 0.039). GERD, erosive esophagitis and NERD did not correlate with objective halitosis (P = 0.556, 0.206 and 0.902, respectively). In multivariable analysis, the relationship between objective halitosis and GERD symptoms including chest pain, heart burn, acid regurgitation, epigastric pain, hoarseness, globus sensation and coughing was not significant. Besides, GERD was not associated with self-conscious halitosis, informed halitosis and objective halitosis, respectively.

Conclusions

GERD might not be associated with self-conscious, informed halitosis and objective halitosis indicated by Halimeter results. Informed halitosis could be correlated with objective halitosis determined by the Halimeter.

Increase of lower esophageal sphincter pressure after osteopathic intervention on the diaphragm in patients with gastroesophageal reflux

The treatment of gastroesophageal reflux disease may be clinical or surgical. The clinical consists basically of the use of drugs; however, there are new techniques to complement this treatment, osteopathic intervention in the diaphragmatic muscle is one these. The objective of the study is to compare pressure values in the examination of esophageal manometry of the lower esophageal sphincter (LES) before and immediately after osteopathic intervention in the diaphragm muscle. Thirty-eight patients with gastroesophageal reflux disease - 16 submitted to sham technique and 22 submitted osteopathic technique - were randomly selected. The average respiratory pressure (ARP) and the maximum expiratory pressure (MEP) of the LES were measured by manometry before and after osteopathic technique at the point of highest pressure. Statistical analysis was performed using the Student's t-test and Mann-Whitney, and magnitude of the technique proposed was measured using the Cohen's index. Statistically significant difference in the osteopathic technique was found in three out of four in relation to the group of patients who performed the sham technique for the following measures of LES pressure: ARP with P= 0.027. The MEP had no statistical difference (P= 0.146). The values of Cohen d for the same measures were: ARP with d= 0.80 and MEP d= 0.52. Osteopathic manipulative technique produces a positive increment in the LES region soon after its performance.

Gastroesophageal reflux, dental erosion, and halitosis in epidemiological surveys: a systematic review

In published studies, it has been suggested that dental wear is associated with gastroesophageal reflux disease (GERD). This systematic review was carried out to evaluate the association of GERD, dental erosion, and halitosis and to compare the indices adopted in epidemiological surveys. The Medline database (until October, 2011) was searched systematically to identify studies evaluating the prevalence of oral alterations, such as dental erosion and halitosis, in patients with GERD symptoms. Two reviewers analyzed all reports and the selected studies were evaluated according to the quality of evidence, using the validated Newcastle-Ottawa Quality Assessment Scale. Full-text copies of a total of 32 publications were obtained in duplicate. Sixteen publications were identified among the citations in the Bibliographic lists of studies that fulfilled the exclusion/inclusion criteria and quality of evidence. The relationship between dental erosion and GERD patients was significant in only seven studies. According to three studies, halitosis could be one of several extraesophageal symptoms or manifestations in GERD patients. In one study, it was found that the mucosa of GERD patients was significantly more acidic in comparison with that of the control group. This systematic review showed that there is a relationship between GERD and oral diseases (dental erosion and halitosis). The epidemiological surveys used different indices to analyze GERD and dental erosion. Further research could investigate the best method for assessing the two diseases.

Reflux and aerodigestive tract diseases

Gastroesophageal reflux disease can present with a wide variety of extraesophageal symptoms. In particular, the type of disease characterized predominately by laryngopharyngeal reflux may be difficult to diagnose because of the absence of regurgitation or heartburn. The available battery of diagnostic tools is often insufficient to confirm a diagnosis of reflux, so the diagnosis is often made by elimination. In many cases, treatment with proton pump inhibitors will relieve symptoms and respiratory complications, despite the persistence of non-acidic reflux. Such treatment is often employed to "confirm" the diagnosis, as measured by patient response. Many diseases have been related to this condition in the literature. The authors review knowledge about these manifestations and their relationship with refluxed gastric content. Physiopathology, symptoms and treatment are reviewed in order to clarify our understanding of laryngopharyngeal reflux diseases and related manifestations.

Halitosis: the multidisciplinary approach

Halitosis, bad breath or oral malodour are all synonyms for the same pathology. Halitosis has a large social and economic impact. For the majority of patients suffering from bad breath, it causes embarrassment and affects their social communication and life. Moreover,halitosis can be indicative of underlying diseases. Only a limited number of scientific publications were presented in this field until 1995. Ever since, a large amount of research is published, often with lack of evidence. In general, intraoral conditions, like insufficient dental hygiene, periodontitis or tongue coating are considered to be the most important cause (85%) for halitosis. Therefore, dentists and periodontologists are the first-line professionals to be confronted with this problem. They should be well aware of the origin, the detection and especially of the treatment of this pathology. In addition, ear-nose-throat-associated (10%) or gastrointestinal/endocrinological (5%) disorders may contribute to the problem. In the case of halitophobia, psychiatrical or psychological problems may be present. Bad breath needs a multidisciplinary team approach: dentists, periodontologists, specialists in family medicine, ear-nose-throat surgeons, internal medicine and psychiatry need to be updated in this field, which still is surrounded by a large taboo.Multidisciplinary bad breath clinics offer the best environment to examine and treat this pathology that affects around 25% of the whole population. This article describes the origin, detection and treatment of halitosis, regarded from the different etiological origins.

Halitology (breath odour: aetiopathogenesis and management)

This article reviews the aetiopathogenesis of halitosis (oral malodour) and management. Halitosis is any disagreeable breath odour. In most patients, the odour originates from the oral cavity. In some patients, it has an extra-oral aetiology and, in a few, metabolic anomalies are responsible. In other patients complaining of malodour, this is imagined rather than real. Volatile sulphur compounds (VSCs) and other elements appear largely responsible for the malodour. Predisposing factors include poor oral hygiene, hyposalivation, dental appliances, gingival and periodontal disease and mucosal disease. The first step in assessment is objective measurement to determine whether malodour is present. If present, the oral or extra-oral origin should be determined, because the latter requires medical investigation and support in therapy, as is also the case where the malodour is imagined rather than real. Oral malodour is managed largely by oral health improvement, plus use of one or more of the wide range of antimalodour therapies, and sometimes also with use of a malodour counteractive. Emergent treatments include probiotics and vaccines targeted against causal micro-organisms or their products.

Effect of body weight and esophageal damage on the severity of gastroesophageal reflux symptoms. Mexican GERD working group

BACKGROUND AND AIMS

Several studies have demonstrated overweight and obesity are strong independent risk factors of GERD symptoms and esophageal erosions. Our aim was to analyze the joint effect of BMI with the grade of esophageal damage over symptoms' intensity of GERD.

METHODS

We used a questionnaire with a Likert scale for severity of symptoms related to GERD. The distal portion of the esophagus was evaluated to determine the presence of mucosal injury, classified by Los Angeles criteria (LA).

RESULTS

We included 917 subjects (53.76% females) with average age 36.8+/-7 years. Males had higher BMI than females (26.8+/-3.5 vs. 25.2+/-4.5, p<0.001). Severe damage (C-D ulcers) was associated with overweight (BMI 25-30), severity of heartburn,retching, halitosis, regurgitation, and chest oppression. BMI >30 had high score for heartburn and retching, but low score for nausea, compared with lower weight. The model with interaction showed a non-linear association between BMI and LA. Overweight (but not obese) patients with damage scored C-D had the highest score for intensity of heartburn and retching.

CONCLUSIONS

BMI and LA do not have additive effects on the severity of symptoms of GERD. Those with BMI between 25 and 30 had severe symptoms score, but those with BMI >30 showed lower scores. These findings could explain controversial results found in other studies.

Prevalence of self-perceived oral malodor in a group of thai dental patients

OBJECTIVE

To determine the prevalence and correlated factors of self-reported oral malodor in Thai dental patients from Chulalongkorn Dental Hospital.

MATERIALS AND METHODS

A self-administered questionnaire was developed to assess the self-reported perception of oral malodor in 839 patients. Significant associations between self-perceived oral malodor and sociodemographics, oral problems and oral hygiene practice variables were determined by Chi-square test.

RESULTS

The prevalence of currently self-perceived oral malodor was 61.1%. A higher prevalence of self-perceived oral malodor was significantly correlated with a number of factors including being 30 years of age or older, having a high school or lower educational level, tongue coating, xerostomia, bleeding when brushing teeth, never receiving professional tooth cleaning and a lower toothbrushing frequency. However, multivariable analysis showed that tongue coating was the factor most strongly associated with self-perceived oral malodor (OR=3.53; CI=2.05-6.08), followed by bleeding when brushing teeth (OR= 2.96) and being 30 years of age or older (OR=2.46). Subjects with oral malodor perceived by themselves and others had a higher level of self-perceived oral malodor, a higher prevalence of bad odor when talking, in the morning and throughout the whole day, and a higher prevalence of consulting with other people in comparison with those with perception by themselves alone.

CONCLUSION

Tongue coating, bleeding when brushing teeth and being 30 years of age or older were significantly associated with self-perceived oral malodor. The level of self-perceived oral malodor and consulting with other people was more prevalent in subjects with oral malodor perceived by themselves and others.