Prevalence and Social Importance of Halitosis

The reported incidence ratio between female and male patients with oral malodour is almost the same;  no gender-based differences have been found with regard to prevalence and severity of halitosis.^9,10  However, it has been observed that women seek treatment more often than men.^6,9  This could be explained because women are normally more concerned about their health status and appearance.  Moreover a significant age-related increase in the mean values of odor-causing VSCs has been reported when different age groups have been assayed.⁶

In spite of this reported high prevalence of breath malodour, only a few patients visit dental clinics seeking treatment.  This fact has been termed the "bad breath paradox" since people suffering from bad breath often remain completely unaware of this fact.  Whereas, others remain convinced they suffer from oral malodour, although in some circumstances, no objective basis can be found (pseudohalitosis or halithophobia).¹¹ This fact does not mean that all patients coming to seek treatment present a psychological component.  They frequently are pushed to seek therapy by people living in close contact with them such as a spouse, family member, or friend.¹²

Although there is anecdotal and indirect evidence suggesting people have trouble estimating their own bad breath, the first quantitative study to address this question was carried out by Rosenberg and co-workers in a group of 52 subjects, 83% of whom complained of having bad breath.¹³ The results of the study demonstrated the subjects studied were generally incapable of scoring their own oral malodour in an objective way.  Subjects' preconception scores recorded prior to self-measurement were not associated with the scores of the odour judge, the laboratory tests, or the dental measurements.  Self-estimates of whole mouth and tongue malodour were closely related to preconception scores and were similarly subjective.  Only in the case of saliva were subjects partially capable of objective self-estimation.  Nevertheless, in the subsequent post-measurement self-assessment, participants reverted to subjective scores closely resembling their initial preconception.¹³ Moreover, it seems that objective, self-estimation of oral malodour is not an ability that can be acquired with training or experience as was demonstrated by this research group.  They demonstrated that despite the initial consultation and instruction, subjects remained unable to self-estimate their own oral malodour in an objective way one year after the consultation.¹⁴  Some gender based differences in regards to the ability to self-estimate the malodour level have been identified, with women tending to overestimate their own malodour.  The underlying reasons leading people to believe mistakenly they suffer from bad breath or to exaggerate self-estimations of bad breath are not yet clear.¹⁵

Click Here To Navigate Within Article >> Abstract Introduction Prevalence and Social Importance of Halitosis Classification of Halitosis Etiology of Halitosis Factors Involved In The Etiology of Halitosis The Role of Bacteria In Oral Halitosis The Role of Physical and Chemical Conditions of the Oral Cavity The Role of Substrates The Role of the Dorsum of the Tongue Association Between Halitosis and Periodontal Disease Diagnosis of Halitosis References About the Authors
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Citation Number: Vol. 2, No. 4, Page 005