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Review
Oral Medicine

Prevalence and related parameters of halitosis in general


population and periodontal patients
LG Soares*, EMB Tinoco

Abstract review3 of 19 studies between 1993 Prevalent studies


Introduction and 2003, with 9400 people, showed The precise prevalence of halitosis is
The present review aimed to focus on a prevalence of 92.9% of gum and still uncertain8 due to limited num-
the studies on halitosis prevalence periodontal diseases. ber of studies, and even lesser num-
and related parameters in general However, only few studies are ber of studies with large samples9.
population and periodontal patients available which evaluated the preva- It could also be due to the difficulty
because the number of epidemiologi- lence of halitosis in general popula- in evaluating some studies available
cal researches on halitosis is limited. tion, with reported rates ranging that have no specification on classi-
In this review, PubMed-MEDLINE and from 22 to 50%4. The number of fication, diagnosis or methodology
Lilacs/SciELO were searched through studies with the aim of analysing the used8.
February 2014 for appropriate stud- prevalence of halitosis in periodontal The prevalence of halitosis, ac-
ies. ‘Volatile sulphur compounds’, patients is more limited. cording to the studies published, is
‘halitosis’, ‘periodontitis+halitosis’ The number of epidemiological between 2% and 44% and this dis-
and ‘prevalence+halitosis’ were se- researches on halitosis is limited parity is justified by the subjectivity

All authors contributed to conception and design, manuscript preparation, read and approved the final manuscript.
lected as outcome variables. probably because of the difference of the diagnostic criteria, assessment
Discussion in cultural and racial appreciation of methods and sampling techniques10.
The review showed different preva- the bad breath, as for patients as well Although the prevalence of halitosis
lence of halitosis between 2% and as for investigators, and also because has been studied in various popula-
87% in the general population. Hal- there is no uniformity in evaluation tions in different parts of the world,
itosis-related parameters such as methods and diagnosis5. Owing to different assessments and cut-off
periodontal disease, older age, men, different methodologies, the preva- points were presented. Therefore,
tongue coating were more associa- lence of halitosis is unclear and there precise estimate of the prevalence of
tion with high levels of halitosis. are only a few community-based halitosis is not possible to obtain11.

All authors abide by the Association for Medical Ethics (AME) ethical rules of disclosure.
Conclusion studies evaluating the prevalence6. Many young adults complain of
Hence, one standard protocol should However, extensive studies on hali- halitosis; it is estimated that 30% of
be created to make the comparison tosis are necessary because it can be the world population suffers with
of the studies easy and to show the considered as a factor that influences this problem regularly12. A study13
real prevalence of halitosis around the quality of life of patients, which conducted in a group of 2672 Japa-
is preventable, as oral hygiene is con- nese workers showed a prevalence
Competing interests: none declared. Conflict of interests: none declared.
the world, because there is no uni-
formity in evaluation methods and sidered as responsible7. of 14% of halitosis in the morning,
diagnosis in the prevalence and re- In the present review, PubMed- 23% in the late morning, 6% in the
lated parameter studies on halitosis. MEDLINE and Lilacs/SciELO were afternoon and 16% at night. An ob-
searched through February 2014 servational study14 conducted in a
Introduction to identify appropriate studies. sample of 99 volunteers measured
Periodontal diseases have high preva- ‘Volatile sulphur compounds’, ‘hali- halitosis with gas chromatography
lence worldwide, and they have been tosis’, ‘periodontitis+halitosis’ and and found a prevalence of 49%. A
described by several studies. A study ‘prevalence+halitosis’ were selected French study15 showed about 22% of
conducted in Germany1 verified the as outcome variables. There were self-reported halitosis.
prevalence to be 76.9% in adults, and no restrictions regarding language According to another study16, near-
another study in France2 observed a or date of publication. The reference ly more than 50% of the general pop-
prevalence of 82.2%, and a literature lists of articles were also searched ulation has halitosis. In a Swedish17
to check the availability of further study conducted in 840 men, halito-
studies. So, the present review aimed sis was reported to be around 2% of
* Corresponding author
Email: dr_leog@hotmail.com
to focus on the studies on halito- the population. Studies based on a
sis prevalence and halitosis-related questionnaire in 1551 subjects in Ku-
Rio de Janeiro University, Periodontology
Department, Rio de Janeiro, Brazil, zip CEP ­parameters in the general population wait18 and 254 healthy elderly sub-
20551-030. and periodontal patients. jects19 reported 23% and 28% of the

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For citation purposes: Soares LG, Tinoco EMB. Prevalence and related parameters of halitosis in general population and
periodontal patients. OA Dentistry 2014 Feb 25;2(1):4.
Page 2 of 7

Review

samples with halitosis, respectively. ranging from 5% to 75% of subjects According to the Brazilian Asso-
Another study20 with 1052 subjects tested27,28. Another study29 showed ciation of Halitosis33, the incidence
in Italy showed 19% of self-reported 40% of children with a mouth- of bad breath in Brazilian population
halitosis. breathing pattern. This was observed may reach 40%. And, according to
A cross-sectional Brazilian study21 in a greater number of males, than fe- the American Dental Association34,
among university students and their males, according to a stuy28. about 50% of the adult population
families showed a halitosis incidence In 2012, a study30 was conducted had at least an occasional complaint
of 15%. Japanese researchers inves- to evaluate the prevalence of halitosis of oral halitosis. In a study conduct-
tigated22 33,000 adults and 15% of in subjects with periodontal disease. ed in a group of patients in Brazil33,
them were reported to be suffering The average of VSC in 50 patients the authors found that about 17%
from halitosis, with a peak of more with chronic periodontitis and 50 of population were aged 0–12 years,
than 20% in the city of Tokyo. patients without periodontitis were, 41% were 12–65 years and 71% over
A study23 evaluated a sample of respectively, 455.08 and 150.34 ppb. 65 years. In 679 Brazilian citizens in-
2000 Chinese subjects (1000 men Hence, the amount of VSC was higher terviewed through a questionnaire,
and 1000 women), aged between in patients with chronic periodon- halitosis was found to be a common
15 and 64 years, to try to establish titis, which suggests that control of problem; with 87% of them report-
the relationship between halitosis periodontal disease could be effec- ing to know some people with hali-
and oral health, and social and be- tive in reduction of VSC values. tosis and 59% knew more than seven
havioural factors. The authors found Another study31 evaluated oral people with this problem.
prevalence of halitosis to be 27% in health status and halitosis in 137
the sample, and the tongue coating periodontal and 80 gingivitis pa- Halitosis-related parameters

All authors contributed to conception and design, manuscript preparation, read and approved the final manuscript.
and periodontal condition were the tients. In the periodontitis group, Halitosis can be treated if its aetiol-
main related factors. halitosis was significantly correlat- ogy can be detected accurately. If the
In Switzerland, 626 young male ed with decayed teeth, periodontal aetiology is not accurate, the treat-
adults were evaluated through a uni- parameters and tongue coating. In ment can be unsuccessful; therefore,
fied questionnaire and clinical ex- the gingivitis group, halitosis was investigation and adequate diagnosis
amination to study the prevalence significantly correlated with the are crucial. Therefore, the most im-
of halitosis24. The questionnaire re- plaque index, bleeding on probing portant issue in the treatment of hali-
vealed that only 17% of recruits had and tongue coating. The authors tosis is detecting aetiology, which in
never complained of halitosis. The concluded that dental plaque, bleed- turn helps make the analyses of the
organoleptic evaluation identified 8 ing on probing and tongue coating correct halitosis-related parameters.

All authors abide by the Association for Medical Ethics (AME) ethical rules of disclosure.
people with grade 3, 148 people with contribute to halitosis, but in differ- Although most of the cases are from
grade 2 and 424 people with grade 1 ent degrees in periodontitis and gin- the oral cavity, sometimes other ae-
or 0 halitosis. The study also found givitis patients. tiologies can also contribute to oral
that tongue coating was the only fac- In an assessment of halitosis32 in halitosis. If halitosis is not related to
tor that contributed to high counts of 27 patients diagnosed with chronic oral cavity causes, such as respira-

Competing interests: none declared. Conflict of interests: none declared.


volatile sulphur compounds (VSCs) periodontitis, the VSC was 463.41 tory, gastrointestinal and hepatic,
and organoleptic values. The same ppb and the frequency of high or- renal, endocrine or haematological
group of researches25 in Switzerland, ganoleptic scores (3–5) declined disease, the patients should consult
with 419 subjects of the city of Bern, from 96.29% (day 0) to 81.48% (day the specialist35.
revealed the prevalence of self-re- 30), with a reduction of around 50% A population study conducted in
ported halitosis to be 32%. by day 180. The authors concluded Germany36 showed a strong positive
In a retrospective study conduct- that supragingival plaque control re- association between gastro-oesoph-
ed from February 2003 to February duced halitosis in patients with peri- ageal reflux disease and halitosis
201026, with medical histories of 465 odontitis. in denture-wearing subjects and
patients, all reported to have suffered Approximately one-third of the a moderate positive association in
from halitosis, but 87% of patients individuals with halitosis were af- dentate subjects. Two Swiss stud-
were diagnosed with true halitosis. fected with moderate chronic hali- ies24,25 showed that tongue coating
Within this group, 96% had an oral tosis; whereas less than 5% of the was an important factor for halitosis
cause. Most of the patients (94%) had population were affected with severe development, and smoking and peri-
used a mouthwash (62.9%) and only halitosis. It is clear that halitosis is a odontal disease were associated with
11% attempted a tongue cleaner. prevalent problem, and that the den- higher halitosis rankings.
In children, the literature describes tal profession needs to take its re- A cross-sectional study6 conducted
the prevalence of mouth breathing sponsibility in its management11. in 901 patients who responded to an

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For citation purposes: Soares LG, Tinoco EMB. Prevalence and related parameters of halitosis in general population and
periodontal patients. OA Dentistry 2014 Feb 25;2(1):4.
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Review

anonymously constructed question- A study42 with Turkish individuals find age as a risk factor, but another
naire between October 2007 and showed an incidence of around 28%. study46 found a higher incidence of
February 2009 showed high preva- The Swiss studies24,25 also found the halitosis in elderly population.
lence of self-perceived halitosis, but same incidence. In Sweden17, it was A study47 found higher rate of
a low prevalence those seeking treat- verified that plaque and dental cal- halitosis among male students than
ment in Thailand. Older age, tongue culus were significantly correlated female students (83% versus 71%),
coating and bleeding when brushing with severe halitosis. Tongue coat- and there were no differences in
teeth were the factors most strongly ing area exposed to the oral cavity the rate of halitosis among students
associated with self-perceived halito- is much larger than the area of sub- from different academic years or age
sis. gingival plaque from the gingival groups. Some authors48 stated that
A study37 conducted among pa- margin, which is alone considered to the use of dental floss did not con-
tients of the dentistry course showed be responsible for halitosis43. Plaque tribute significantly to reduce the
that the knowledge about halitosis is and tongue coating were highly as- VSC, and other authors13,43 found no
controversial in some aspects, espe- sociated with halitosis44. A study5 difference in regards to smoking.
cially about the causes and prevention suggested that halitosis is caused by A study21 found that the preva-
methods, and there was no improve- tongue coating in the younger gen- lence was higher in men, according
ment in the knowledge on halitosis eration and by periodontitis with to gender, and above 20 years in age.
in the group that received additional tongue coating in elderly population. The study in Japan13 found that men
information. The authors concluded showed a higher level of VSC than
that both, professionals and patients, Discussion women. In a study49 conducted in
should be better oriented in relation The authors have referenced some periodontal patients in Israel, men

All authors contributed to conception and design, manuscript preparation, read and approved the final manuscript.
to physiological and pathological fac- of their own studies in this review. had a higher degree of halitosis.
tors of halitosis to act in preventing These referenced studies have been Some authors18,19,50,51 found no dif-
their individual and social effects. conducted in accordance with the ference in the prevalence of halitosis
An observational study14 found a Declaration of Helsinki (1964) and between men and women; however,
statistically significant association the protocols of these studies have others52,53 found a higher prevalence
between halitosis and male sex, age been approved by the relevant ethics in men compared with women.
≥61 years, antidepressant use and committees related to the institution In a Chinese evaluation23, the
lack of regular hygiene habits such as in which they were performed. All tongue coating and periodontal con-
flossing and tongue cleaning. How- human subjects, in these referenced dition were the main factors related
ever, there was no statistical associa- studies, gave informed consent to to halitosis. In other studies24,25, the

All authors abide by the Association for Medical Ethics (AME) ethical rules of disclosure.
tion between halitosis and smoking participate in these studies. tongue coating was found as the only
and alcohol consumption, frequent Varieties of data suggest that there factor contributing to organolep-
brushing of teeth and self-perception are large shortcomings in the meth- tic scores and the highest values of
of halitosis. A study19 showed asso- odology of the overall research pro- VSC. Some authors54,55 found a strong
ciation of dental caries, older age and jects45, and a standardised evalua- relationship between the tongue
­

Competing interests: none declared. Conflict of interests: none declared.


smoking with halitosis. tion protocol is needed to compare coating on the organoleptic test;
A research23 showed that men had epidemiological data of halitosis5. The however, others authors56 did not
more halitosis than women; and oth- prevalence of halitosis, as reported by find this relationship. A strong rela-
er studies38,39 suggested that women several studies, is ranging from 2% tionship between tongue coating and
seek help and treatment. Men and to 87% (Table 1), but the diagnostic organoleptic test was also verified50,
women seem to suffer in the same methods, the samples and protocols of but the coating was not related to
proportions; however, women look the studies were different to compare. periodontal parameters. Yet accord-
for professional help faster than As studies do not have a standard- ing to a few authors, there was a re-
men40. In adults, there was a huge ised evaluation protocol, it is difficult duction in halitosis, according to the
correlation between age and halito- to obtain exact data on the halitosis- organoleptic test and VSC, only with
sis; whereas older groups had more related parameters. In a study6, the the removal of tongue coating.
intense bad breath13. This study also authors found no difference in terms Patients with chronic periodontitis
showed that patients with severe of gender, smoking and dental floss, have more tongue coating, and also
periodontitis had higher halitosis but found differences in terms of age, found that the production of coating
scores than healthy subjects. gingival bleeding and frequency of in these patients was higher when
In the United States41, it was found brushing. However, other studies13,43 compared with healthy subjects57.
that 43% of people aged over 60 found a relationship between VSC Few studies48,58,59 showed that the
years complained about halitosis. and tongue coating. A study23 did not tongue has been identified as the

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For citation purposes: Soares LG, Tinoco EMB. Prevalence and related parameters of halitosis in general population and
periodontal patients. OA Dentistry 2014 Feb 25;2(1):4.
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Review

Table 1 Chronological summary of halitosis prevalence and related parameters in general population
Popula- Diagnostic Prevalence
Authors Year Place Related parameters
tion (n) method (%)
Association No associa-
tion
Sulser et al. 68
1939 200 — Osmoscope 56 Age Gender
Tonzetich and Plaque and tongue coating
1977 — — Organoleptic 30
Kestenbaum12
Age, men, tongue coating and
Miyazaki et al.13 1995 2672 Japan Halimeter 14 Smoking
severe periodontitis
Loesche et al.41 1996 370 USA Self-report 31 Age —
Frexinos et al. 15
1998 4815 France Self-report 22 — —
Periodontitis patients and
Söder et al.17 2000 1681 Sweden Organoleptic 2.4 Smoking
dental visits
Saito and Kawa- —
2002 33000 Japan Interview 15 —
guchi22
ADA Council on —
Scientific Af- 2003 — USA — 50 —
fairs34

All authors contributed to conception and design, manuscript preparation, read and approved the final manuscript.
Gastrointestinal disorders,
Questionnaire
Al-Ansari et al.18 2006 1551 Kuwait 23.3 chronic sinusitis, older age, Gender
self-report
and lower education levels
Organoleptic Men, tongue coating and peri-
Liu et al.23 2006 2000 China 27.50 Age
and halimeter odontal condition
Faveri et al.48 2006 19 Brazil Clinical analysis Tongue coating Dental floss
Nadanovsky et Over 20 years and men
2007 — Brazil Interview 15 —
al.21
Questionnaire Tongue coating, hygiene prac-

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Nalcaci and self-reported tice, older age, lower educa-
2008 254 Turkey 28.3 tion levels and smoking Gender
Baran19 and perceived
taste
Ger- Self-reported Heartburn or acid regurgita-
Struch et al.36 2008 3005 — —
many interviews tion
ABHA33 2009 Brazil Questionnaire 40 — — Competing interests: none declared. Conflict of interests: none declared.
Switzer- Self-report and Tongue coating, smoking and
Bornstein et al.25 2009 419 32 and 28 —
land VSC periodontal disease
Switzer- Self-report and Tongue coating, smoking and
Bornstein et al.24 2009 626 20 —
land clinical analysis periodontal disease
Anxiety, stress, smoking, gum
Self-reported problems, oral hygiene, medi-
Settineri et al.20 2010 1052 Italy 19.39 —
questionnaire cation and gastrointestinal
urinary problems
Yokoyama et Self-report and —
2010 474 Japan 39.6 —
al.44 clinical analysis
Self-perceived Tongue coating, bleeding
Youngnak-
questionnaire, when brushing teeth and Gender, smok-
Piboonratanakit Thai-
2010 839 organoleptic 61.1 more than 30 years of age ing and dental
and Vachiraro- land
test and halim- floss
jpisan6
eter

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For citation purposes: Soares LG, Tinoco EMB. Prevalence and related parameters of halitosis in general population and
periodontal patients. OA Dentistry 2014 Feb 25;2(1):4.
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Review

Table 1 (Continued)
Popula- Diagnostic Prevalence
Authors Year Place Related parameters
tion (n) method (%)
No associa-
Association
tion
The Literature
van der Sleen et Tongue brushing and tongue
2010 Nether- review — —
al.62 scraping
lands
Clinical evalua-
tion and Breath
Motta et al.29 2011 55 Brazil 23.6 Boys —
Alert™ in chil-
dren
Gas chromatog- Men, older age, dental floss,
Nunes et al.14 2012 99 Portugal 49.5 Smoking
raphy tongue brushing
Zurcher and Switzer- Clinical analysis
2012 465 87.2 — —
Filippi26 land
Clinical analysis Dental plaque, bleeding on
Pham et al.31 2012 218 Japan — —
probing, tongue coating
Organoleptic,

All authors contributed to conception and design, manuscript preparation, read and approved the final manuscript.
Tongue clean-
Silveira et al.32 2012 27 — VSC and clinical 96.29 Supragingival plaque
ing
analysis
Questionnaire
Arinola and
2012 100 Nigeria and practical 2–22% — —
Olukoju67
testing
Evirgen and Halimeter and
2013 268 — — Men Age
Kamburoğlu47 organoleptic
Neuropsycho-
Greater age, lower educa- Demographic

All authors abide by the Association for Medical Ethics (AME) ethical rules of disclosure.
Scala et al.69 2014 42 Italy logic rating test —
tional level differences
and halimeter
Tseng70 2014 — — — — Stroke patients —

most responsible for the production but this was not reported by other the tongue, but the evidence was not Competing interests: none declared. Conflict of interests: none declared.
of VSC; whereas other studies48,60 still authors50. convincing enough and the authors
reveal that just brushing your teeth A study61 attempted to demon- concluded that further studies are
is not effective in reducing halito- strate that the mechanical cleaning of needed to define this relationship.
sis scores, generating the need for tongue could be an effective method Other studies62–64 have shown a re-
tongue scrapers as adjuncts. for reducing VSC, and the authors lationship between tongue scraping
The concentration of VSC in a concluded that brushing your teeth and reduced levels of VSC; however,
group with destructive periodontal and scraping your tongue was slight- in a report65, the duration was men-
condition (including probing pockets ly more effective in reducing VSC tion to be only 100 minutes. Accord-
>0.4 mm) reduced by 50% by only than just brushing teeth or ­scraping ing to a study11, scraping the tongue is
scraping the tongue. Soon after, peri- the tongue separately; however, the a component for reduction of halito-
odontal treatment was performed, authors questioned the clinical ef- sis but cannot be the only treatment.
where the halitosis, however, signifi- fects of this reduction due to the A scraped tongue proved ­ superior
cantly reduced the concentration of limitation of the duration, which was with less than 35% VSC66. Most of the
CH3SH. The authors48 found that pa- about 30 minutes. A systematic re- studies13,23,54,61 have found a strong re-
tients with periodontal disease have view62 attempted to demonstrate the lationship ­between tongue cleaning
more CH3SH than healthy subjects, potential of mechanical scraping of and reduction of organoleptic scores.

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For citation purposes: Soares LG, Tinoco EMB. Prevalence and related parameters of halitosis in general population and
periodontal patients. OA Dentistry 2014 Feb 25;2(1):4.
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Review

But we are still missing a defined 7. Domingos PAS, Abreu AC, Dantas AAR, 21. Nadanovsky P, Carvalho LB, Ponce de
standard for the treatment of hali- Oliveira ALBM. Halitosis: limiting the Leon A. Oral malodour and its association
tosis because the protocols defined quality of life. Rev de Odont Univ Cid de with age and sex in a general population
vary widely ­without ­consensus8,9,48,55. São Paulo. 2011 May–Aug;23(2):171–81. in Brazil. Oral Dis. 2007 Jan;13(1):105–9.
8. Scully C, Greenman J. Halitosis (breath 22. Saito H, Kawaguchi Y. Halitosis pre-
odor). Periodontol 2000. 2008;48:66–75. vention campaign: a report of oral health
Conclusion 9. van den Broek AM, Feenstra L, de Baat promotion activities in Japan. Int Dent J.
The review showed different preva- C. A review of the current literature on 2002 Jun;52(Suppl 3):197–200.
lence of halitosis, between 2% and aetiology and measurement methods of 23. Liu XN, Shinada K, Chen XC, Zhang
87% in the general population. It was halitosis. J Dent. 2007 Aug;35(8):627–35. BX, Yaegaki K, Kawaguchi Y. Halitosis-
not possible to identify the correct 10. Sanz M, Roldán S, Herrera D. Funda- related parameters in the Chinese gen-
prevalence of halitosis in periodontal mentals of breath malodour. J Contemp eral population. J Clin Periodontol. 2006
patients. Dent Pract. 2001 Nov;2(4):1–17. Jan;33(1):31–6.
Halitosis-related parameters, peri- 11. Rosing CK, Loesche W. Halitosis: an 24. Bornstein MM, Stocker BL, Seemann
odontal disease, older age, men, and overview of epidemiology, etiology and R, Bürgin WB, Lussi A. Prevalence of
tongue coating were associated with clinical management. Braz Oral Res. 2011 halitosis in young male adults: a study
Sep–Oct;25(5):466–71. in swiss army recruits comparing self-
high levels of halitosis. Tongue clean-
12. Tonzetich J, Kestenbaum RC. Halito- reported and clinical data. J Periodontol.
ing (scraping or brushing the tongue)
sis: a review of mechanisms and methods 2009 Jan;80(1):24–31.
was considered just a complement and of analysis. J Periodontol. 1977 Jan;48(1): 25. Bornstein MM, Kislig K, Hoti BB, See-
not the only treatment for ­halitosis. 13–20. mann R, Lussi A. Prevalence of halitosis
Hence, it is concluded that there is 13. Miyazaki H, Sakao S, Katoh Y, Take- in the population of the city of Bern, Swit-
no uniformity in evaluation methods hara T. Correlation between volatile sul- zerland: a study comparing self-reported

All authors contributed to conception and design, manuscript preparation, read and approved the final manuscript.
and diagnosis in prevalent studies phur compounds and certain oral health and clinical data. Eur J Oral Sci. 2009
of halitosis. The number of studies measurements in the general population. Jun;117(3):261–7.
on relationship between periodon- J Periodontol. 1995 Aug;66(8):679–84. 26. Zürcher A, Filippi A. Findings, di-
tal patients and halitosis are limited. 14. Nunes JC, Oliveira L, Martínez-Sahu- agnoses and results of a halitosis clin-
So, one standard protocol should be quillo A. Halitose: estudo de prevalência e ic over a seven year period. Res Sci.
factores de riscoassociadosnumaUnidade 2012;122(3):205–10.
created for comparison of the stud-
de Saúde Familiar. Rev Port Med Geral 27. Kharbanda OP, Sidhu SS, Sundaram
ies and to show the real prevalence
Fam. 2012;28:344–9. in Portuguese. K, Shukla DK. Oral habits in school go-
of halitosis around the world. 15. Frexinos J, Denis P, Allemand H, Al- ing children of Delhi:a prevalence study.
louche S, Los F, Bonnelye G. Descriptive J Indian Soc Pedod Prev Dent. 2003
Abbreviation list

All authors abide by the Association for Medical Ethics (AME) ethical rules of disclosure.
study of digestive functional symptoms in Sep;21(3):120–4.
VSC, volatile sulphur compound. the French general population. Gastroen- 28. Polanco CMS, Saldna AR, Yanez EER,
terol Clin Biol. 1998 Oct;22(10):785–91. Araujo RC. Respiracion bucal, Ortodoncia,
References 16. Nachnani S. Halitosis: causes, assess- 9 ed. pp.5–11.
1. Holtfreter B, Schwahn C, Biffar R, Koch- ment, and treatment. Compend Contin 29. Motta LJ, Bachiega JC, Guedes CC,
er T. Epidemiology of periodontal diseas- Educ Dent. 2011 Jan–Feb;32(1):22–4. Laranja LT, Bussadori SK. Association

Competing interests: none declared. Conflict of interests: none declared.


es in the study of health in Pomerania. J 17. Soder B, Johansson B, Soder PO. The between halitosis and mouth breathing
Clin Periodontol. 2009 Feb;36(2):114–23. relation between foetor ex ore, oral hy- in children. Clinics (Sao Paulo). 2011
2. Bourgeois D, Bouchard P, Mattout C. Ep- giene and periodontal disease. Swed Jun;66(6):939–42.
idemiology of periodontal status in den- Dent J. 2000;24(3):73–82. 30. Fontoura AP, Prado DF, Lima AAM,
tate adults in France, 2002-2003. J Peri- 18. Al-Ansari JM, Boodai H, Al-Sumait N, Azoubel MCF, Sousa SB. Halitose em Pa-
odontal Res. 2007 Jun;42(3):219–227. Al-Khabbaz AK, Al-Shammari KF, Salako cientes com Periodontite Crônica. Anais
3. Chambrone L, Lima APA, Chambrone N. Factors associated with self-reported da MCC. 2012 Sep;1(3). in Portuguese.
A. Prevalência das d ­ oençasperiodontais halitosis in Kuwaiti patients. J Dent. 2006 31. Pham TA, Ueno M, Zaitsu T, Takehara
no Brasil. Revista Odonto. 2008 Aug;34(7):444–9. S, Shinada K, Lam PH, Kawaguchi Y. Clini-
Jan;16(31):69–76. in Portuguese. 19. Nalcaci R, Baran I. Factors associated cal trial of halitosis treatment in patients
4. Corrao S. Halitosis: new insight into with selfreportedhalitesis (SRH) and with periodontal diseases. J Periodontal
a millennial old problem. Intern Emerg perceived taste disturbance (PTD) in el- Res. 2011 Dec;46(6):722–9.
Med. 2011 Aug;6(4):291–2. derly. Arch Gerontol Geriatr. 2008 May– 32. Silveira EM, Piccinin FB, Gomes SC,
5. Bollen CM, Beikler T. Halitosis: the Jun;46(3):307–16. Oppermann RV, Rösing CK. Effect of gin-
multidisciplinary approach. Int J Oral Sci. 20. Settineri S, Mento C, Gugliotta SC, givitis treatment on the breath of chronic
2012 Jun;4(2):55–63. Saitta A, Terranova A, Trimarchi G. Self- periodontitis patients. Oral Health Prev
6. Youngnak-Piboonratanakit P, Vachi- reported halitosis and emotional state: Dent. 2012;10(1):93–100.
rarojpisan T. Prevalence of self-perceived impact on oral conditions and treat- 33. Associação Brasileira de Halitose
halitosis in a group of Thai dental patients. ments. Health Qual Life Outcomes. 2010 (ABHA). Halitose 2009. http://www.
J Dent (Tehran). 2010 Sep;7(4):196–204. Mar;8:34. abha.org.br, accessed 23 January 2013.

Licensee OA Publishing London 2014. Creative Commons Attribution License (CC-BY)

For citation purposes: Soares LG, Tinoco EMB. Prevalence and related parameters of halitosis in general population and
periodontal patients. OA Dentistry 2014 Feb 25;2(1):4.
Page 7 of 7

Review

34. ADA Council on Scientific Af- tratamento. Anais do 15° Conclave Odont. 59. Riggio MP, Lennon A, Rolph HJ, Hodge
fairs. Halitosis. J Am Dent Assoc. 2003 Intern de Campinas 2003 Mar;104(1):1– PJ, Donaldson A, Maxwell AJ. Molecular
Feb;134(2):209–14. 8. in Portuguese. identification of bacteria on the tongue
35. Aylıkcı BU, Çolak H. Halitosis: from 47. Evirgen S, Kamburoğlu K. Effects of dorsum of subjects with and without
diagnosis to management. J Nat Sci Biol tongue coating and oral health on hali- halitosis. Oral Dis. 2008 Apr;14(3):
Med. 2013 Jan;4(1):14–23. tosis among dental students. Oral Health 251–8.
36. Struch F, Schwahn C, Wallaschofski H, Prev Dent. 2013;11(2):169–73. 60. Kleinberg I, Codipilly DM. Cysteine
Grabe HJ, Volzke H, Lerch MM, et al. Self- 48. Faveri M, Hayacibara MF, Pupio GC, challenge testing: a powerful tool for
reported halitosis and gastro-esophageal Cury JA, Tsuzuki CO, Hayacibara RM. A examining halitosis processes and treat-
reflux disease in the general population. J cross-over study on the effect of vari- ments in vivo. Int Dent J. 2002 Jun;
Gen Intern Med. 2008 Mar;23(3):260–6. ous therapeutic approaches to morning 52(Suppl 3):221–8.
37. Abreu AC, Domingos PAS, Dantas breath odour. J Clin Periodontol. 2006 61. Seemann R, Kison A, Bizhang M,
AAR. Causes and symptoms of halitosis: Aug;33(8):555–60. Zimmer S. Effectiveness of mechanical
a study of knowledge among patients of 49. Rosenberg M, Leib E, editors. Experi- tongue cleaning on oral levels of volatile
the dentistry course. Rev Odontol Univ ences of an Israeli malodor clinic. In: Bad sulfur compounds. J Am Dent Assoc. 2001
Cid São Paulo 2011 Jan;23(1):30–41. in breath: research perspectives. Tel Aviv: Sep;132(9):1263–7.
Portuguese. Ramot Publishing; 1995.pp.137–48. 62. Van der sleen MI, Slot DE, Van Trijffel
38. Murata T, Rahardjo A, Fujiyama Y, 50. Tsai CC, Chou HH, Wu TL, Yang YH, Ho E, Winkel EG, Van der Weijden GA. Effec-
Yamaga T, Hanada M, Yaegaki K. Develop- KY, Wu YM. The levels of volatile sulfur tiveness of mechanical tongue cleaning
ment of a compact and simple gas chro- compounds in mouth air from patients on breath odour and tongue coating: a
matography for halitosis measurement. J with chronic periodontitis. J Periodont systematic review. Int J Dent Hyg. 2010
Periodontol. 2006 Jul;77(7):1142–7. Res. 2008 Apr;43(2):186–93. Nov;8(4):258–68.
39. Iwakura M, Yasuno Y, Shimura M, 51. Soares LG, Falabella MEV, Teixeira HGC, 63. Roldan S, Herrera D, Sanz M. Biofilms

All authors contributed to conception and design, manuscript preparation, read and approved the final manuscript.
Sakamoto S. Clinical characteristics of Tinoco EMB, Silva DG. The use of bucal- and the tongue: therapeutical approachs
halitosis: differences in two patient mouthrinses in the reductions of halitosis: for the control of halitosis. Clin Oral In-
groups with primary and secondary review. Perionews. 2009 Jun;3(1):48–52. vestig. 2003 Dec;7(4):189–97.
complaints of halitosis. J Dent Res. 1994 52. Paradowska A, Marczewski B, Paw- 64. Outhouse TL, Al-Alawi R, Fedorowicz
Sep;73(9):1568–74. lowska-Cierniak E. Self-perception of Z, Keenan JV. Tongue scraping for treat-
40. Rosenberg M. Halitose Perspectivas halitosis among students of Wroclaw ing halitosis. Cochrane Database Syst Rev.
em pesquisa, 2nd ed. Rio de Janeiro: Edit- Medical University. Adv Clin Exp Med. 2006 Apr;(2):CD005519.
ora Guanabara Koogan; 2003. ­Portuguese. 2007;16:543–8. 65. Bordas A, McNab R, Staples AM, Bow-
41. Loesche WJ, Grossman N, Dominguez 53. Almas K, Al-Hawish A, Al-Khamis W. man J, Kanapka J, Bosma MP. Impact of
L, Schork MA. Oral malodour in the elder- Oral hygiene practices, smoking habit, different tongue cleaning methods on

All authors abide by the Association for Medical Ethics (AME) ethical rules of disclosure.
ly. In: van Steenberghe D, Rosenberg M, and selfperceivedhalitosis among dental the bacterial load of the tongue dorsum.
editors. Bad breath: a multi-disciplinary students. J Contemp Dent Pract. 2003 Arch Oral Biol. 2008 Apr;53(Suppl 1):
approach. Leuven: Leuven University Nov;15(4):77–90. S13–8.
Press; 1996.pp.181–94. 54. Bosy A, Kulkarni GV, Rosenberg M, 66. Pedrazzi V, Sato S, de Mattos Mda
42. Avcu N, Ozbek M, Kurtoglu D, Kur- McCulloch CA. Relationship of halitosis to G, Lara EH, Panzeri H. Tongue-cleaning
toglu E, Kansu O, Kansu H. Oral findings periodontitis: evidence of independence methods: a comparative ­ clinical trial

Competing interests: none declared. Conflict of interests: none declared.


and health status among hospitalized in discrete subpopulations. J Periodontol. employing a toothbrush and a tongue
­
patients with physical disabilities, aged 1994 Jan; 65(1):37–46. scraper. J Periodontol. 2004 Jul;75(7):
60 or above. Arch Gerontol Geriatr. 2005 55. Rosenberg M. Bad breath and peri- 1009–12.
Jul–Aug;41(1):69–79. odontal disease: how related are they? J 67. Arinola JE, Olukoju OO. Halitosis
43. Loesche WJ, Kazor C. Microbiology Clin Periodontol. 2006 Jan;33(1):29–30. amongst students in tertiary institu-
and treatment of halitosis. Periodontol 56. Tonzetich J, Ng SK. Reduction of tions in Lagos state. Afr Health Sci. 2012
2000. 2002;28:256–79. malodor by oral cleansing procedures. Dec;12(4):473–8.
44. Yokoyama S, Ohnuki M, Shinada K, Oral Surg Oral Med Oral Pathol. 1976 68. Sulser GF, Brening RH, Fosdick LS.
Ueno M, Wright FA, Kawaguchi Y. Halito- Aug;42(2):172–81. Some conditions that effect the odot
sis and related factors in Japanese senior 57. Yaegaki K, Sanada K. Volatile sulfur concentration of breath. J Dent Res.
high school students. J Sch Health. 2010 compounds in mouth air from clinically 1939;18(4):355–9.
Jul;80(7):346–52. healthy subjects and patients with peri- 69. Scala A, Nazzani R, Villa A, Sed-
45. Vandekerckhove B, Bollen C. Epidemi- odontal disease. J Periodontol Res. 1992 da A, Abati S. A case series of 42
ology in the general population, specific Jul;27(4 Pt 1):233–8. non-­
­ complaining bad breath patients
populations and in a multidisciplinary 58. Donalsdon AC, McKenzie D, Riggio MP, and the neuropsychology of their dis-
halitosis consultation. In: van Steen- Hodge PJ, Rolph H, Flanagan A. Micro- ease. Ann Stomatol. 2013 Oct;2(Suppl 2):
berghe D, editor. Ademgeur. Houten: biological culture analysis of the tongue 1–48.
Prelum Uitgevers; 2009.pp.3–10. anaerobic microflora in subjets with and 70. Tseng WS. Halitosis: could it be a pre-
46. Uliana R. Halitose–Conceitosbásicos- without halitosis. Oral Dis. 2005;11(Sup- dictor of stroke? Med Hypotheses. 2014
sobrediagnóstico, microbiologia, causas, pl 1):61–3. Mar;82(3):335–7.

Licensee OA Publishing London 2014. Creative Commons Attribution License (CC-BY)

For citation purposes: Soares LG, Tinoco EMB. Prevalence and related parameters of halitosis in general population and
periodontal patients. OA Dentistry 2014 Feb 25;2(1):4.