Diagnosis and treatment of patients with halitosis by dental hygienists and dentists in the Netherlands

Halitosis, what experiences and methods apply Dutch dental hygienists

OBJECTIVES

The aim of this research is to gain more insight in the methods and experiences of dental hygienists in the Netherlands regarding the treatment of patients with halitosis.

MATERIAL AND METHODS

A total of 92 dental hygienists completed the questionnaire (consisting of 19 questions on personal and professional characteristics, clinical observation and treatment of halitosis, the referral of patients with halitosis, the presence and usefulness of a protocol). The questionnaire was distributed using a social media platform for dental professionals in oral health care from all over the Netherlands.

RESULTS

83.4% of 90 dental hygienists had paid attention to the patient's breath but only 37.8% of dental hygienists always informed the patient. Reasons for not informing patients were the fear of the patient's possible reaction or because other oral health problems were more important. Of the included dental hygienists 67.8% had never referred a patient for treatment of halitosis. 86.7% of the dental hygienists stated there was no protocol for diagnosis and treatment of patients with halitosis. However, 90.0% of the dental hygienists acknowledged a protocol would be useful.

CONCLUSIONS

The majority of the dental hygienists in the Netherlands had paid attention to the patient's breath, but only a small group of dental hygienists informed their patients about halitosis. In dental practices halitosis is an underestimated problem. During the coronavirus pandemic people are more aware with the smell of their breath. Dental hygienists indicated scaling and root planning and/or providing information and instruction by patients with a bad breath.

Knowledge and Management of Halitosis in France and Lebanon: A Questionnaire-Based Study

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.

Practice characteristics and views of dental hygienists in Lithuania

OBJECTIVES

To evaluate the employment possibilities of Lithuanian dental hygienists.

METHODS

The questionnaire asked about the demographics of dental hygienists, characteristics of practice, patient load, career intentions, opinion about dental hygienists workforce and the need of governmental workforce regulation. The study consisted of all licensed dental hygienists in Lithuania in 2018 (N = 1109).

RESULTS

The final response rate was 52.1% (n = 578), 64% (n = 370) of respondents lived in the country's five main cities, and 73.5% (n = 425) worked in these population centres, with 94.3% (n = 545) worked in private sector. Over two-thirds of respondents said there was an excess of dental hygienists in Lithuania. Nearly 80% "always" or "sometimes" reported that they had insufficient patients, which may account for the prevalence of supplementary work (48.4%, n = 280), that is work as a dental assistant (67.9%, n = 190). Data obtained show that dental hygienists with less than ten years' experience were likely to work as a dental assistant (P < .05). Notwithstanding, 73.9% (n = 428) of the dental hygienists reported that they only want to practice their profession. Most (83.4%, n = 483) struggled to find dental hygienist work, and 70.5% (n = 408) wanted regulation of number of dental hygienists at a national level.

CONCLUSIONS

The respondents suggested there is (a) a lack of dental hygiene patients, (b) available workload for additional preventive dental hygiene services, (c) pressure to search for additional work, usually as a dental assistant. Governmental support to optimally regulate oral health human resources is, according to most dental hygienists, an emphatic wish as a possible solution at national level.

The Underestimated Problem of Intra-Oral Halitosis in Dental Practice: An Expert Consensus Review

Approximately 90% of halitosis cases originate within the oral cavity (intra-oral halitosis). With a focus on intra-oral halitosis, this narrative review article provides a current summary of the epidemiology, diagnosis and management of halitosis and discusses practical considerations for healthcare professionals (HCPs), including dentists, dental hygienists, general practitioners, community pharmacists, nurses and medical specialists. MEDLINE and PubMed were searched up to 31 December 2019. Additional information was sourced from reference lists of relevant published literature. Full-text articles which reported on the epidemiology, diagnosis and management of halitosis were considered for inclusion. Halitosis affects substantial numbers of individuals globally and is an underestimated problem in dental practice. Current estimates of the prevalence of halitosis, in addition to diagnostic methods and management considerations for halitosis, are discussed. Although not a life-threatening condition, halitosis has a significant impact on patients’ quality of life and can result in psychological consequences including social, professional and affective limitations. Using a simple step-wise approach for diagnosis and treatment, dentists and dental hygienists are ideally placed to respond to an initial consultation for halitosis.

Is there burnout related to work among Dutch dental hygienists?: Combining studies by using the UBOS and the UWES

OBJECTIVES

To investigate the prevalence of burnout among Dutch young and more experienced dental hygienists and the work experience of young professional dental hygienists.

MATERIAL AND METHODS

Two studies were carried out using the Dutch version of the Maslach Burnout Inventory; the Utrecht Burnout Scale (UBOS) and the Utrecht Work Engagement Scale (UWES). In Study I, 400 participants completed an online questionnaire, including the UBOS-general version. In Study II, a questionnaire was distributed via social media to young professionals, including the UBOS-health care version and the UWES-9.

RESULTS

2.5% of 157 dental hygienists (Study I) satisfied the norm of burnout. Dental hygienists' average work experience was 16.6 years, and one-thirds worked 25-32 hours per week. In Study II, 73 young professionals (M = 26.5 years) reported 32.9 weekly working hours. Three-quarters were employed and worked in a dental clinical team practice. UWES-mean scores indicated a moderate to high level of work engagement. Mostly, all aspects of burnout were low compared with the test Manual norms.

CONCLUSIONS

Exploratory findings show that generally burnout appears no threat for Dutch dental hygienists, and moderate to high level of work engagement coincides with a low level of burnout-related symptoms.

Periodontal screening during an oral public health promotion campaign: a study among health consumers

INTRODUCTION

Diseases such as periodontal disease and halitosis have a negative impact on both the economy and the quality of life worldwide; thus, poor oral health has become a public health concern. The aim of this study was to characterise the oral health status of visitors to a public health consumer's exhibition using demographic and social characteristics and consumers' periodontal health condition.

METHODS

During this cross-sectional study in 2010-2014, 1,223 visitors completed a questionnaire. The periodontal condition of 760 participants was screened by dental hygienists of the Dutch Dental Hygienists' Association using the Dutch Periodontal Screening Index (DPSI).

RESULTS

A total of 1,029 visitors with a mean age of 45.38 years were included. The numerically lowest mean level of DPSI (2.59) occurred in 2014, whereas the numerically highest mean of DPSI (3.67) occurred in 2012. Each year, the DPSI scores were not normally distributed and were significantly higher for men than for women. Significant differences between DPSI score and age and between DPSI score and education were observed.

CONCLUSION

Differences in DSPI score related to age and education were found. This means that specific groups of people with poorer oral health, mostly elderly or less-educated people, may need adjusted target interventions to prevent oral diseases. Insights into the benefits of public awareness and the development of optimally targeted interventions are needed for oral health promotion and the prevention of oral diseases.

Halitosis Assessment and Changes in Volatile Sulfur Compounds After Chewing Gum: A Study Performed on Dentistry Students

OBJECTIVE

The objective of this study is to estimate the prevalence of halitosis (with subjective and objective methods), evaluate the immediate effect of chewing gum on volatile sulfur compounds (VSCs), assess the perception of halitosis by dentistry students, and estimate the distribution of positive and negative frequencies, when comparing objective and subjective methods for the diagnosis of halitosis.

METHODS

The study was performed on a sample of dentistry students attending the Faculty of Medicine and Health Sciences at the University of Barcelona. A questionnaire about halitosis perception was provided and a clinical examination, organoleptic test (OT), and gas chromatography were performed to determine the presence of halitosis. The subjects were also given chewing gum to modify their breath, and gas chromatography was carried out to evaluate possible changes in VSCs.

RESULTS

The sample comprised 80 individuals. Twenty-seven (33.75%) self-perceived halitosis during the period of evaluation; the OT was positive in 38 subjects (47.5%); and individuals positive for halitosis on gas chromatography were distributed as follows: H₂S in 25 (31.25%), CH₃SH in 28 (35%), and (CH₃)₂S in 70 individuals (87.5%). A statistical difference before and after chewing gum (P < .05) was found for each VSC; a difference in frequencies was observed between the variable OT and H₂S (P < .05) and between the OT and (CH₃)₂S (P < .001). There was no significant difference (P > .05) between the positive and negative frequencies retrieved between the variable OT and CH₃SH and between the OT and the student's halitosis perception.

CONCLUSION

Prevalence of halitosis in the studied sample is high, considering that it comprised healthy individuals. The relationship between the OT and gas chromatography is not completely established. Chewing gum could be considered a therapeutic alternative to decrease or neutralize the amount of VSCs present in oral breath.

Self-perception, knowledge, and awareness of halitosis among female university students

Background

Halitosis or oral malodor is defined as an unpleasant breath odor. It can become a serious problem affecting individuals’ social communication and self-confidence. Furthermore, it is a discomforting issue for the people around the person affected, because they consider it embarrassing to inform the person of the problem.

Aim

This study was designed to measure self-perception, knowledge, and awareness of halitosis among female university students in Saudi Arabia.

Materials and methods

A cross-sectional survey was implemented with 392 volunteer participants who responded to a questionnaire on their self-perception, knowledge, and awareness of halitosis.

Results

The response rate was 89.1% (392/440). Self-perception of halitosis was low (21.4%), whereas a larger percentage (78.1%) indicated noticing people with bad breath. Most participants (80.4%) thought that the gastrointestinal tract is the primary source of halitosis. Seventy-seven percent preferred using personal methods such as mouthwash and chewing gum to treat oral malodor. According to 82.1% of respondents, a dentist is the most appropriate professional to treat halitosis.

Conclusion

The investigation revealed low self-perception and limited knowledge regarding halitosis. Therefore, the role of dentists in informing and educating their patients concerning oral malodor should be enhanced. Public education about the causes of and possible ways of managing bad breath should be increased.