Self-reported halitosis in a sample of Brazilians: Prevalence, associated risk predictors and accuracy estimates with clinical diagnosis

Aims: To evaluate the prevalence of self-reported halitosis and its predictors, and to determine the accuracy estimates of self-reported measures with clinical evaluation of halitosis.

Materials and methods: This cross-sectional study comprised 5,420 individuals (teaching staff, administrative personnel and ongoing students from Federal University of Minas Gerais), who answered a structured questionnaire containing sociodemographic, medical and dental data, and self-reported halitosis measures. A subsample (n = 159) underwent halitosis assessment through the organoleptic method. Predictors for self-reported halitosis were determined through univariate and multivariate analyses. Accuracy estimates of self-reported measures were evaluated in this subsample.

Results: Prevalence of self-reported halitosis varied from approximately 4%-35%, depending on the self-reported measure. Self-reported halitosis was mainly associated with socio-economic variables (age, gender, educational level), parameters of oral health (gingival bleeding, gingival infections, tongue coating, general oral health evaluation) and impacts on daily activities (family/social environment and intimate relations). Specificity values for self-reported halitosis measures were determined to be high for clinical (organoleptic score ≥2) and strong (organoleptic score ≥4) halitosis. Combinations of self-reported measures retrieved useful accuracy estimates for strong halitosis.

Conclusion: Prevalence rates of self-reported halitosis may be considered moderate. Accuracy diagnostic estimates were determined to be useful, with good prediction for non-diseased individuals.