Self-perception prevalence of halitosis and oral hygiene habits in volunteers admitted to the school of dentistry in Kerman, Iran

Document Type: Original Article(s)


1 Associate Professor, Oral and Dental Diseases Research Center AND Kerman Social Determinants of Oral Health Research Center, Kerman University of Medical Sciences, Kerman, Iran

2 Dentist, Private Practice, Kerman, Iran

3 Assistant Professor, Oral and Dental Diseases Research Center AND Kerman Social Determinants of Oral Health Research Center, Kerman University of Medical Sciences, Kerman, Iran

4 Dentist, Student Research Committee, School of Dentistry, Kerman University of Medical Sciences, Kerman, Iran


BACKGROUND AND AIM: This study was conducted to investigate the self-perception of mouth odor and its correlation with different variables.METHODS: This cross-sectional study was carried out on 260 individuals who were asked about their perception of personal mouth odor. Factors such as age, gender, oral hygiene, periodontal and dental status, tongue coating, and medical history were recorded on a checklist. Halitosis was evaluated using an etiquette checker. The variables were analyzed using the independent samples t-test and multiple logistic regressions.RESULTS: Of 260 individuals, 101 persons claimed to have halitosis. The prevalence of pseudo-halitosis was 13.5%. Female gender, spontaneous bleeding and bleeding during dental brushing, periodontal index (PI), and tongue coating had a significant association with genuine halitosis according to logistic regression. The decayed, missing, and filled teeth (DMFT) index had a significant association with pseudo- and genuine halitosis.CONCLUSION: Dental status, tongue coating, female gender, and periodontal disease were most significantly related to halitosis.


  1. Rayman S, Almas K. Halitosis among racially diverse populations: An update. Int J Dent Hyg 2008; 6(1): 2-7.
  2. Murata T, Yamaga T, Iida T, Miyazaki H, Yaegaki K. Classification and examination of halitosis. Int Dent J 2002; 52(Suppl 3): 181-6.
  3. Lee PP, Mak WY, Newsome P. The aetiology and treatment of oral halitosis: An update. Hong Kong Med J 2004; 10(6): 414-8.
  4. Yaegaki K, Coil JM. Examination, classification, and treatment of halitosis; clinical perspectives. J Can Dent Assoc 2000; 66(5): 257-61.
  5. Kakoei Sh, Babak-Amini A, Kakooei S. The validation of one halitosis measuring device (Etiquette checker). J Oral Health Oral Epidemiol 2014; 3(2): 37-41.
  6. Debaty B, Rompen E. Origin and treatment of bad breath. Rev Med Liege 2002; 57(5): 324-9.
  7. van den Broek AM, Feenstra L, de Baat C. A review of the current literature on aetiology and measurement methods of halitosis. J Dent 2007; 35(8): 627-35.
  8. Kakoei S, Barkhori F, Mirzazadeh A, Mohammadi M, Gholamhoseinian A. Influence of menstrual cycle and salivary ß-estradiol on volatile sulfur compound. J Oral Health Oral Epidemiol 2012; 1(1): 41-5.
  9. Azma A. Determining the accuracy of the FOX questionnaire in evaluating oral problems [Thesis]. Kerman, Iran: Kerman University of Medical Sciences; 2009. [In Persian].
  10. Oho T, Yoshida Y, Shimazaki Y, Yamashita Y, Koga T. Characteristics of patients complaining of halitosis and the usefulness of gas chromatography for diagnosing halitosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 91(5): 531-4.
  11. Iwanicka-Grzegorek E, Michalik J, Kepa J, Wierzbicka M, Aleksinski M, Pierzynowska E. Subjective patients' opinion and evaluation of halitosis using halimeter and organoleptic scores. Oral Dis 2005; 11(Suppl 1): 86-8.
  12. Romano F, Pigella E, Guzzi N, Aimetti M. Patients' self-assessment of oral malodour and its relationship with organoleptic scores and oral conditions. Int J Dent Hyg 2010; 8(1): 41-6.
  13. Al-Ansari JM, Boodai H, Al-Sumait N, Al-Khabbaz AK, Al-Shammari KF, Salako N. Factors associated with self-reported halitosis in Kuwaiti patients. J Dent 2006; 34(7): 444-9.
  14. Nalcaci R, Baran I. Factors associated with self-reported halitosis (SRH) and perceived taste disturbance (PTD) in elderly. Arch Gerontol Geriatr 2008; 46(3): 307-16.
  15. Winkel EG. Advising patients on halitosis and oral hygiene. Lung cancer 2018; 15: 05.
  16. Lopes MH, Rosing CK, Colussi PR, Muniz FW, Linden MS. Prevalence of self-reported halitosis and associated factors in adolescents from Southern Brazil. Acta Odontol Latinoam 2016; 29(2): 93-103.
  17. Quirynen M, Dadamio J, Van Den V, De Smit M, Dekeyser C, Van Tornout M, et al. Characteristics of 2000 patients who visited a halitosis clinic. J Clin Periodontol 2009; 36(11): 970-5.
  18. Van Tornout M, Dadamio J, Coucke W, Quirynen M. Tongue coating: Related factors. J Clin Periodontol 2013; 40(2): 180-5.
  19. Ren W, Xun Z, Wang Z, Zhang Q, Liu X, Zheng H, et al. Tongue coating and the salivary microbial communities vary in children with halitosis. Sci Rep 2016; 6: 24481.
  20. Seffrin JR, Grove RB. Tobacco use and oral health. J Sch Health 1982; 52(1): 59-62.
  21. Ratcliff PA, Johnson PW. The relationship between oral malodor, gingivitis, and periodontitis. A review. J Periodontol 1999; 70(5): 485-9.
  22. Rosenberg M. Bad breath and periodontal disease: How related are they? J Clin Periodontol 2006; 33(1): 29-30.
  23. Liu XN, Shinada K, Chen XC, Zhang BX, Yaegaki K, Kawaguchi Y. Oral malodor-related parameters in the Chinese general population. J Clin Periodontol 2006; 33(1): 31-6.
  24. Genco RJ, Borgnakke WS. Risk factors for periodontal disease. Periodontol 2000 2013; 62(1): 59-94.
  25. Attia EL, Marshall KG. Halitosis. Can Med Assoc J 1982; 126(11): 1281-5.
  26. Axelsson P, Lindhe J. Effect of controlled oral hygiene procedures on caries and periodontal disease in adults. J Clin Periodontol 1978; 5(2): 133-51.
  27. Haumschild MS, Haumschild RJ. The importance of oral health in long-term care. J Am Med Dir Assoc 2009; 10(9): 667-71.
  28. Gerritsen AE, Allen PF, Witter DJ, Bronkhorst EM, Creugers NH. Tooth loss and oral health-related quality of life: A systematic review and meta-analysis. Health Qual Life Outcomes 2010; 8: 126.
  29. Aas JA, Griffen AL, Dardis SR, Lee AM, Olsen I, Dewhirst FE, et al. Bacteria of dental caries in primary and permanent teeth in children and young adults. J Clin Microbiol 2008; 46(4): 1407-17.
  30. Tanzer JM, Livingston J, Thompson AM. The microbiology of primary dental caries in humans. J Dent Educ 2001; 65(10): 1028-37.