Self-perceived halitosis and associated factors among university students in Dhaka, Bangladesh.
Alcohol
Dhaka, Bangladesh
Gender
Halitosis
Oral Hygiene
Prevalence
Self-perceived halitosis
Smoke
Tongue clean
University students
Journal
BMC oral health
ISSN: 1472-6831
Titre abrégé: BMC Oral Health
Pays: England
ID NLM: 101088684
Informations de publication
Date de publication:
07 Aug 2024
07 Aug 2024
Historique:
received:
01
11
2023
accepted:
08
07
2024
medline:
8
8
2024
pubmed:
8
8
2024
entrez:
7
8
2024
Statut:
epublish
Résumé
Bad 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. A 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. A 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. This 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.
Sections du résumé
BACKGROUND
BACKGROUND
Bad 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.
METHODS
METHODS
A 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.
RESULTS
RESULTS
A 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.
CONCLUSION
CONCLUSIONS
This 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.
Identifiants
pubmed: 39113016
doi: 10.1186/s12903-024-04586-y
pii: 10.1186/s12903-024-04586-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
909Informations de copyright
© 2024. The Author(s).
Références
Tungare S, Zafar N, Paranjpe AG. Halitosis [Internet]. StatPearls. 2024. http://www.ncbi.nlm.nih.gov/pubmed/22722640 .
Azodo CCOPN and OM. Psychological and social impacts of halitosis: a review. J Soc Psch Sc. 2011;9:1–11.
Silva MF, Leite FRM, Ferreira LB, Pola NM, Scannapieco FA, Demarco FF, et al. Estimated prevalence of halitosis: a systematic review and meta-regression analysis. Clin Oral Investig. 2018;22(1):47–55.
doi: 10.1007/s00784-017-2164-5
pubmed: 28676903
Hasan SMM, Afrin S, Chowdhury NU. Female are More Prone to Halitosis Due to the Changing of the Hormonal Balance-A Cross Sectional Study in Bangladesh. Am J Biomed Sci Res [Internet]. 2019;3(2):106–10. https://biomedgrid.com/fulltext/volume3/female-are-more-prone-to-halitosis-due-to-the-changing-of-the-hormonal-balance-a-cross-sectional-study.000643.php .
Kapoor U, Sharma G, Juneja M, Nagpal A, Halitosis. Current concepts on etiology, diagnosis and management. Eur J Dent [Internet]. 2016;10(02):292–300. http://www.thieme-connect.de/DOI/DOI?10.4103/1305-7456.178294 .
Wu J, Cannon RD, Ji P, Farella M, Mei L. Halitosis: prevalence, risk factors, sources, measurement and treatment – a review of the literature. Aust Dent J. 2020;65(1):4–11.
doi: 10.1111/adj.12725
pubmed: 31610030
De Geest S, Laleman I, Teughels W, Dekeyser C, Quirynen M. Periodontal diseases as a source of halitosis: a review of the evidence and treatment approaches for dentists and dental hygienists. Periodontol 2000 [Internet]. 2016;71(1):213–27. https://onlinelibrary.wiley.com/doi/ https://doi.org/10.1111/prd.12111 .
Aylikci B, Çolak H. Halitosis: from diagnosis to management. J Nat Sci Biol Med. 2013;4(1):14–23.
doi: 10.4103/0976-9668.107255
pubmed: 23633830
pmcid: 3633265
Carmela M, Lombardo C, Mariacristina M, Whithorn NI, Boronat-Catalá M, Almiñana-Pastor PJ, et al. Adolescence, adulthood and self-perceived halitosis: a role of psychological factors. Med. 2021;57(6):1–23.
Bin Mubayrik A, Al Hamdan R, Al Hadlaq EM, AlBagieh H, Alahmed D, Jaddoh H, et al. Self-perception, knowledge, and awareness of halitosis among female university students. Clin Cosmet Investig Dent. 2017;9:45–52.
doi: 10.2147/CCIDE.S129679
pubmed: 28603430
pmcid: 5457280
Maha S. Mezied, 1 Dalal Al Bouri, 2 Ahad Al Omani, 2 Ghadeer Al Ramadhan, 2 Sara Al Bootie, 2 Ali Barakat 3 and Pradeep Koppolu4. A cross-sectional study on Self-Perceived Halitosis among Undergraduate University Students in Riyadh, Saudi Arabia.
Nazir MA, Almas K, Majeed MI. The prevalence of halitosis (oral malodor) and associated factors among dental students and interns, Lahore, Pakistan. Eur J Dent [Internet]. 2017;11(04):480–5. http://www.thieme-connect.de/DOI/DOI?10.4103/ejd.ejd_142_17 .
AlSadhan SA. Self-perceived halitosis and related factors among adults residing in Riyadh, Saudi Arabia. A cross sectional study. Saudi Dent J [Internet]. 2016;28(3):118–23. https://doi.org/10.1016/j.sdentj.2016.06.001 .
Ashwath B, Vijayalakshmi R, Malini S. Self-perceived halitosis and oral hygiene habits among undergraduate dental students. J Indian Soc Periodontol. 2014;18(3):357–60.
doi: 10.4103/0972-124X.134575
pubmed: 25024551
pmcid: 4095630
Alssum L, Alsaleh L, Alzoman H. Self-perceived halitosis and its social impact on females: a cross-sectional study. Med (United States). 2023;102(38):E35164.
Schertel Cassiano L, Abdullahi F, Leite FRM, López R, Peres MA, Nascimento GG. The association between halitosis and oral-health‐related quality of life: A systematic review and meta‐analysis. J Clin Periodontol [Internet]. 2021;48(11):1458–69. https://onlinelibrary.wiley.com/doi/ https://doi.org/10.1111/jcpe.13530 .
Obute P, Oyira EJ, Obeten JN. Knowledge and perception of Halitosis of Self-Esteem among students in University of Calabar. J Posit Sch Psychol. 2022;6(3):7265–78.
Mezied MS, Al Bouri D, Al Omani A, Al Ramadhan G, Al Bootie S, Barakat A et al. A Cross-Sectional Study on Self-Perceived Halitosis among Undergraduate University Students in Riyadh, Saudi Arabia. J Pharm Bioallied Sci [Internet]. 2023;15(Suppl 1):S575–81. https://journals.lww.com/ https://doi.org/10.4103/jpbs.jpbs_680_22 .
Harmouche L, Reingewirtz Y, Tuzin N, Lefebvre F, Davideau JL, Huck O. Knowledge and Management of Halitosis in France and Lebanon: A Questionnaire-Based Study. J Clin Med [Internet]. 2021;10(3):502. https://www.mdpi.com/2077-0383/10/3/502 .
Kim SY, Sim S, Kim SG, Park B, Choi HG. Prevalence and associated factors of subjective halitosis in Korean adolescents. PLoS ONE. 2015;10(10):1–11.
doi: 10.1371/journal.pone.0140214
Lee PPC, Mak WY, Newsome P. The aetiology and treatment of oral halitosis: an update. Hong Kong Med J. 2004;10(6):414–8.
pubmed: 15591601
Lu HX, Tang C, Chen X, Wong MCM, Ye W. Characteristics of patients complaining of halitosis and factors associated with halitosis. Oral Dis. 2014;20(8):787–95.
doi: 10.1111/odi.12198
pubmed: 24134214
Arinola J, Olukoju O. Halitosis amongst students in tertiary institutions in Lagos state. Afr Health Sci [Internet]. 2013;12(4). http://www.ajol.info/index.php/ahs/article/view/85079 .
Porter SR, Scully C. Oral malodour (halitosis). BMJ [Internet]. 2006;333(7569):632–5. https://www.bmj.com/lookup/doi/10.1136/bmj.38954.631968.AE .
Su S, Lipsky MS, Licari FW, Hung M. Comparing oral health behaviours of men and women in the United States. J Dent [Internet]. 2022;122:104157. https://linkinghub.elsevier.com/retrieve/pii/S0300571222002135 .
Kateeb E. Gender-specific oral health attitudes and behaviour among dental students in Palestine. East Mediterr Heal J [Internet]. 2010;16(03):329–33. http://applications.emro.who.int/emhj/V16/03/16_3_2010_0329_0333.pdf .
Alzoman H, Alssum L, Helmi M, Alsaleh L. Relationship between hormonal changes and self-perceived halitosis in females: a cross-sectional study. Healthc. 2023;11(1):1–15.
Lipsky MS, Su S, Crespo CJ, Hung M. Men and Oral Health: A Review of Sex and Gender Differences. Am J Mens Health [Internet]. 2021;15(3):155798832110163. http://journals.sagepub.com/doi/10.1177/15579883211016361 .
Mamai-Homata E, Koletsi-Kounari H, Margaritis V. Gender differences in oral health status and behavior of Greek dental students: A meta-analysis of 1981, 2000, and 2010 data. J Int Soc Prev Community Dent [Internet]. 2016;6(1):60. https://journals.lww.com/ https://doi.org/10.4103/2231-0762.175411 .
Oyapero A, Oyapero O, Akinleye A. Burden of tobacco, kola nut and alcohol consumption and its association with periodontal disease, potentially malignant lesions and quality of life among bus drivers, Lagos State, Nigeria. Popul Med [Internet]. 2020;2(March). http://www.journalssystem.com/popmed/Burden-of-tobacco-and-alcohol-consumption-and-its-association-with-periodontal-disease,118726,0,2.html .
Fan X, Peters BA, Jacobs EJ, Gapstur SM, Purdue MP, Freedman ND et al. Drinking alcohol is associated with variation in the human oral microbiome in a large study of American adults. Microbiome [Internet]. 2018;6(1):59. https://microbiomejournal.biomedcentral.com/articles/ https://doi.org/10.1186/s40168-018-0448-x .
Federica Romano 1. Enrico Pigella 2, Nicoletta Guzzi 2, Valeria Manavella 2, Lorena Campanelli 2 MA 2. Etiology and characteristics of halitosis in patients of a halitosis center in Northern Italy.
Khan KM, Hameed S, Shamim S. Natural Products to Cure Bad Breath. In: Pharmacological Studies in Natural Oral Care [Internet]. Wiley; 2023. pp. 217–52. https://onlinelibrary.wiley.com/doi/ https://doi.org/10.1002/9781394167197.ch12 .
Poniewierka E, Pleskacz M, Łuc-Pleskacz N, Kłaniecka-Broniek J. Halitosis as a symptom of gastroenterological diseases. Gastroenterol Rev [Internet]. 2022;17(1):17–20. https://www.termedia.pl/doi/ https://doi.org/10.5114/pg.2022.114593 .
Izidoro C, Botelho J, Machado V, Reis AM, Proença L, Alves RC et al. Revisiting Standard and Novel Therapeutic Approaches in Halitosis: A Review. Int J Environ Res Public Health [Internet]. 2022;19(18):11303. https://www.mdpi.com/1660-4601/19/18/11303 .
Zanetti F, Zivkovic Semren T, Battey JND, Guy PA, Ivanov NV, van der Plas A et al. A Literature Review and Framework Proposal for Halitosis Assessment in Cigarette Smokers and Alternative Nicotine-Delivery Products Users. Front Oral Heal [Internet]. 2021;2. https://www.frontiersin.org/articles/ https://doi.org/10.3389/froh.2021.777442/full .
Banotra MDP, Prasanth CDT, Kosala LCDM, Bhandari BS, Nanavati SLCDG. The Influence of Tongue Cleaning Habit on the Occurrence of Adverse Halitosis Outcomes: A Review of Literature on the Current Evidence. Int J Sci Res Publ [Internet]. 2020;10(10):530–6. http://www.ijsrp.org/research-paper-1020.php?rp=P10610639 .
Peng X, Cheng L, You Y, Tang C, Ren B, Li Y et al. Oral microbiota in human systematic diseases. Int J Oral Sci [Internet]. 2022;14(1):14. https://www.nature.com/articles/s41368-022-00163-7 .
Santacroce L, Passarelli PC, Azzolino D, Bottalico L, Charitos IA, Cazzolla AP et al. Oral microbiota in human health and disease: A perspective. Exp Biol Med [Internet]. 2023;248(15):1288–301. http://journals.sagepub.com/doi/ https://doi.org/10.1177/15353702231187645 .
Shiyao L, Yamei X, Deyu H. [Anti-halitosis effect of sugar-free chewing gum]. Hua Xi Kou Qiang Yi Xue Za Zhi [Internet]. 2015;33(2):166–8. http://www.ncbi.nlm.nih.gov/pubmed/26189234 .
Al-Haboubi M, Zoitopoulos L, Beighton D, Gallagher J. The potential benefits of sugar‐free chewing gum on the oral health and quality of life of older people living in the community: a randomized controlled trial. Community Dent Oral Epidemiol [Internet]. 2012;40(5):415–24. https://onlinelibrary.wiley.com/doi/ https://doi.org/10.1111/j.1600-0528.2012.00685.x .
Nasseripour M, Newton JT, Warburton F, Awojobi O, Di Giorgio S, Gallagher JE et al. A Systematic Review and Meta-Analysis of the Role of Sugar-Free Chewing Gum on Plaque Quantity in the Oral Cavity. Front Oral Heal [Internet]. 2022;3. https://www.frontiersin.org/articles/ https://doi.org/10.3389/froh.2022.845921/full .
Musić L, Par M, Peručić J, Badovinac A, Plančak D, Puhar I. Relationship Between Halitosis and Periodontitis: a Pilot Study. Acta Stomatol Croat [Internet]. 2021;55(2):198–206. https://hrcak.srce.hr/file/376419 .
Memon MA, Memon HA, Muhammad FE, Fahad S, Siddiqui A, Lee KY et al. Aetiology and associations of halitosis: A systematic review. Oral Dis [Internet]. 2023;29(4):1432–8. https://onlinelibrary.wiley.com/doi/ https://doi.org/10.1111/odi.14172 .