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Estimated prevalence of halitosis: a systematic review and meta-regression analysis

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Abstract

Objective

This study aims to conduct a systematic review to determine the prevalence of halitosis in adolescents and adults.

Methods

Electronic searches were performed using four different databases without restrictions: PubMed, Scopus, Web of Science, and SciELO. Population-based observational studies that provided data about the prevalence of halitosis in adolescents and adults were included. Additionally, meta-analyses, meta-regression, and sensitivity analyses were conducted to synthesize the evidence.

Results

A total of 584 articles were initially found and considered for title and abstract evaluation. Thirteen articles met inclusion criteria. The combined prevalence of halitosis was found to be 31.8% (95% CI 24.6–39.0%). Methodological aspects such as the year of publication and the socioeconomic status of the country where the study was conducted seemed to influence the prevalence of halitosis.

Conclusions

Our results demonstrated that the estimated prevalence of halitosis was 31.8%, with high heterogeneity between studies. The results suggest a worldwide trend towards a rise in halitosis prevalence.

Clinical relevance

Given the high prevalence of halitosis and its complex etiology, dental professionals should be aware of their roles in halitosis prevention and treatment.

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References

  1. Aimetti M, Perotto S, Castiglione A, Ercoli E, Romano F (2015) Prevalence estimation of halitosis and its association with oral health-related parameters in an adult population of a city in North Italy. J Clin Periodontol 42:1105–1114. doi:10.1111/jcpe.12474

    Article  PubMed  Google Scholar 

  2. Chen X, Zhang Y, Lu HX, Feng XP (2016) Factors associated with halitosis in white-collar employees in Shanghai, China. PLoS One 11:e0155592. doi:10.1371/journal.pone.0155592

    Article  PubMed  PubMed Central  Google Scholar 

  3. Scully C, Greenman J (2012) Halitology (breath odour: aetiopathogenesis and management). Oral Dis 18:333–345. doi:10.1111/j.1601-0825.2011.01890.x

    Article  PubMed  Google Scholar 

  4. Quirynen M, Dadamio J, Van den Velde S, De Smit M, Dekeyser C, Van Tornout M, Vandekerckhove B (2009) Characteristics of 2000 patients who visited a halitosis clinic. J Clin Periodontol 36:970–975. doi:10.1111/j.1600-051X.2009.01478.x

    Article  PubMed  Google Scholar 

  5. Struch F, Schwahn C, Wallaschofski H, Grabe HJ, Volzke H, Lerch MM, Meisel P, Kocher T (2008) Self-reported halitosis and gastro-esophageal reflux disease in the general population. J Gen Intern Med 23:260–266. doi:10.1007/s11606-007-0486-8

    Article  PubMed  PubMed Central  Google Scholar 

  6. Yaegaki K, Coil JM (2000) Genuine halitosis, pseudo-halitosis, and halitophobia: classification, diagnosis, and treatment. Compend Contin Educ Dent 21(880–886):888–889 quiz 890

    Google Scholar 

  7. Miller K, Eke PI, Schoua-Glusberg A (2007) Cognitive evaluation of self-report questions for surveillance of periodontitis. J Periodontol 78:1455–1462. doi:10.1902/jop.2007.060384

    Article  PubMed  Google Scholar 

  8. De Geest S, Laleman I, Teughels W, Dekeyser C, Quirynen M (2016) Periodontal diseases as a source of halitosis: a review of the evidence and treatment approaches for dentists and dental hygienists. Periodontol 71:213–227. doi:10.1111/prd.12111

    Article  Google Scholar 

  9. Soder B, Johansson B, Soder PO (2000) The relation between foetor ex ore, oral hygiene and periodontal disease. Swed Dent J 24:73–82

    PubMed  Google Scholar 

  10. Hammad MM, Darwazeh AM, Al-Waeli H, Tarakji B, Alhadithy TT (2014) Prevalence and awareness of halitosis in a sample of Jordanian population. J Int Soc Prev Commun Dent 4:S178–S186. doi:10.4103/2231-0762.149033

    Article  Google Scholar 

  11. Settineri S, Mento C, Gugliotta SC, Saitta A, Terranova A, Trimarchi G, Mallamace D (2010) Self-reported halitosis and emotional state: impact on oral conditions and treatments. Health Qual Life Outcomes 8:34. doi:10.1186/1477-7525-8-34

    Article  PubMed  PubMed Central  Google Scholar 

  12. Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097. doi:10.1371/journal.pmed.1000097

    Article  PubMed  PubMed Central  Google Scholar 

  13. JBI (2014) Joanna Briggs Institute Reviewers’ Manual: 2014 edition/supplement. The Joanna Briggs Institute, Adelaide

    Google Scholar 

  14. Peres KG, Cascaes AM, Nascimento GG, Victora CG (2015) Effect of breastfeeding on malocclusions: a systematic review and meta-analysis. Acta Paediatr 104:54–61. doi:10.1111/apa.13103

    Article  PubMed  Google Scholar 

  15. Wang T, Liu K, Li Z, Xu Y, Liu Y, Shi W, Chen L (2017) Prevalence of attention deficit/hyperactivity disorder among children and adolescents in China: a systematic review and meta-analysis. BMC Psychiatry 17:32. doi:10.1186/s12888-016-1187-9

    Article  PubMed  PubMed Central  Google Scholar 

  16. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188

    Article  PubMed  Google Scholar 

  17. Egger M, Smith GD (1998) Bias in location and selection of studies. BMJ 316:61–66

    Article  PubMed  PubMed Central  Google Scholar 

  18. Al-Ansari JM, Boodai H, Al-Sumait N, Al-Khabbaz AK, Al-Shammari KF, Salako N (2006) Factors associated with self-reported halitosis in Kuwaiti patients. J Dent 34:444–449. doi:10.1016/j.jdent.2005.10.002

    Article  PubMed  Google Scholar 

  19. Bornstein MM, Kislig K, Hoti BB, Seemann R, Lussi A (2009) Prevalence of halitosis in the population of the city of Bern, Switzerland: a study comparing self-reported and clinical data. Eur J Oral Sci 117:261–267. doi:10.1111/j.1600-0722.2009.00630.x

    Article  PubMed  Google Scholar 

  20. de Jongh A, van Wijk AJ, Horstman M, de Baat C (2016) Self-perceived halitosis influences social interactions. BMC Oral Health 16:31. doi:10.1186/s12903-016-0189-9

    Article  PubMed  PubMed Central  Google Scholar 

  21. Frexinos J, Denis P, Allemand H, Allouche S, Los F, Bonnelye G (1998) Descriptive study of digestive functional symptoms in the French general population. Gastroenterol Clin Biol 22:785–791

    PubMed  Google Scholar 

  22. Kim SY, Sim S, Kim SG, Park B, Choi HG (2015) Prevalence and associated factors of subjective halitosis in Korean adolescents. PLoS One 10:e0140214. doi:10.1371/journal.pone.0140214

    Article  PubMed  PubMed Central  Google Scholar 

  23. Liu XN, Shinada K, Chen XC, Zhang BX, Yaegaki K, Kawaguchi Y (2006) Oral malodor-related parameters in the Chinese general population. J Clin Periodontol 33:31–36. doi:10.1111/j.1600-051X.2005.00862.x

    Article  PubMed  Google Scholar 

  24. Miyazaki H, Sakao S, Katoh Y, Takehara T (1995) Correlation between volatile sulphur compounds and certain oral health measurements in the general population. J Periodontol 66:679–684. doi:10.1902/jop.1995.66.8.679

    Article  PubMed  Google Scholar 

  25. Nwhator SO, Isiekwe GI, Soroye MO, Agbaje MO (2015) Bad-breath: perceptions and misconceptions of Nigerian adults. Niger J Clin Pract 18:670–675. doi:10.4103/1119-3077.158974

    Article  PubMed  Google Scholar 

  26. Ueno M, Yanagisawa T, Shinada K, Ohara S, Kawaguchi Y (2007) Prevalence of oral malodor and related factors among adults in Akita Prefecture. J Med Dent Sci 54:159–165

    Google Scholar 

  27. Vali A, Roohafza H, Keshteli AH, Afghari P, Javad Shirani M, Afshar H, Savabi O, Adibi P (2015) Relationship between subjective halitosis and psychological factors. Int Dent J 65:120–126. doi:10.1111/idj.12153

    Article  PubMed  Google Scholar 

  28. Petersen PE, Ogawa H (2012) The global burden of periodontal disease: towards integration with chronic disease prevention and control. Periodontol 60:15–39

    Article  Google Scholar 

  29. Thomson WM, Sheiham A, Spencer AJ (2012) Sociobehavioral aspects of periodontal disease. Periodontol 60:54–63. doi:10.1111/j.1600-0757.2011.00405.x

    Article  Google Scholar 

  30. Nascimento GG, Leite FR, Do LG, Peres KG, Correa MB, Demarco FF, Peres MA (2015) Is weight gain associated with the incidence of periodontitis? A systematic review and meta-analysis. J Clin Periodontol 42:495–505. doi:10.1111/jcpe.12417

    Article  PubMed  Google Scholar 

  31. Lv J, Qi L, Yu C, Yang L, Guo Y, Chen Y, Bian Z, Sun D, Du J, Ge P, Tang Z, Hou W, Li Y, Chen J, Chen Z, Li L, China Kadoorie Biobank Collaborative Group (2015) Consumption of spicy foods and total and cause specific mortality: population based cohort study. BMJ 351:h3942. doi:10.1136/bmj.h3942

    Article  PubMed  PubMed Central  Google Scholar 

  32. Tapsell LC, Hemphill I, Cobiac L et al (2006) Health benefits of herbs and spices: the past, the present, the future. Med J Aust 185(4 Suppl):S4–24

    PubMed  Google Scholar 

  33. World Health Organization (2014) Global status report on alcohol and health, 2014th edn. World Health Organization, Geneve

    Google Scholar 

  34. Porter SR (2011) Diet and halitosis. Curr Opin Clin Nutr Metab Care 14:463–468. doi:10.1097/MCO.0b013e328348c054

    Article  PubMed  Google Scholar 

  35. Suzuki N, Yoneda M, Naito T, Iwamoto T, Yamada K, Hisama K, Okada I, Hirofuji T (2009) The relationship between alcohol consumption and oral malodour. Int Dent J 59:31–34

    PubMed  Google Scholar 

  36. Scherer W, Gultz J, Lee SS, Kaim J (1998) The ability of an herbal mouthrinse to reduce gingival bleeding. J Clin Dent 9:97–100

    PubMed  Google Scholar 

  37. Freires IA, Rosalen PL (2016) How natural product research has contributed to oral care product development? A critical view. Pharm Res 33:1311

    Article  PubMed  Google Scholar 

  38. Rösing CK, Loesche W (2011) Halitosis: an overview of epidemiology, etiology and clinical management. Braz Oral Res 25:466–471

    Article  PubMed  Google Scholar 

  39. Loesche WJ, Kazor C (2002) Microbiology and treatment of halitosis. Periodontol 28:256–279

    Article  Google Scholar 

  40. Donaldson AC, Riggio MP, Rolph HJ, Bagg J, Hodge PJ (2007) Clinical examination of subjects with halitosis. Oral Dis 13:63–70

    Article  PubMed  Google Scholar 

  41. Dadamio J, Laleman I, De Geest S, Vancauwenberghe F, Dekeyser C, Coucke W, Quirynen M (2013) Usefulness of a new malodour-compound detection portable device in oral malodour diagnosis. J Breath Res 7:046005

    Article  PubMed  Google Scholar 

  42. Vandekerckhove B, Van den Velde S, De Smit M, Dadamio J, Teughels W, Van Tornout M, Quirynen M (2009) Clinical reliability of non-organoleptic oral malodour measurements. J Clin Periodontol 36:964–969

    Article  PubMed  Google Scholar 

  43. Bornstein MM, Stocker BL, Seemann R, Bürgin WB, Lussi A (2009) Prevalence of halitosis in young male adults: a study in Swiss army recruits comparing self-reported and clinical data. J Periodontol 80:24–31. doi:10.1902/jop.2009.080310

    Article  PubMed  Google Scholar 

  44. Cascaes AM, Peres KG, Peres MA, Demarco FF, Santos I, Matijasevich A, Barros AJ (2011) Validity of 5-year-old children’s oral hygiene pattern referred by mothers. Rev Saude Publica 45:668–675

    Article  PubMed  Google Scholar 

  45. Marmot M (2006) Health in an unequal world: social circumstances, biology and disease. Clin Med 6:559–572

    Article  Google Scholar 

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Correspondence to Gustavo G. Nascimento.

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The authors declare that they have no competing interests.

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The work was not supported by any funding.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Electronic supplementary material

Fig. S1

Sensitivity analysis demonstrating the influence of each study in the pooled prevalence of halitosis. Data are presented as new prevalence of halitosis for each study omission (circles) and 95%CI (horizontal lines). (GIF 48 kb)

High resolution (TIFF 8856 kb)

Table S1

(DOCX 45 kb)

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Silva, M.F., Leite, F.R.M., Ferreira, L.B. et al. Estimated prevalence of halitosis: a systematic review and meta-regression analysis. Clin Oral Invest 22, 47–55 (2018). https://doi.org/10.1007/s00784-017-2164-5

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  • DOI: https://doi.org/10.1007/s00784-017-2164-5

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