Halitosis: prevalence and association with oral etiological factors in children and adolescents

Halitosis is a condition that can have negative social impacts. Although common, its prevalence and associated etiological factors have been studied little in the child/adolescent population. The aim of the present study was to associate the occurrence of halitosis with oral etiological factors in children aged 6-12 years. A cross-sectional study was conducted with 150 male and female children and adolescents. The organoleptic test (OT) was used to determine halitosis. All patients and caregivers answered a questionnaire addressing personal data, general health and oral health, including hygiene habits, and received clarifications regarding the procedures to which the children/adolescents would be submitted in a second session. During the second session, the children were clinically evaluated for halitosis using the OT. The bacterial plaque index, coated tongue index, pH, salivary flow and the presence of dental caries were also determined. Differences in the proportions of the factors were compared between groups (with and without halitosis) using the chi-squared test and Fisher's exact test for categorical variables and the non-parametric Mann-Whitney U test for continuous variables. Halitosis was diagnosed in 17.3% of the children and was associated with a fair score on the Simplified Oral Hygiene Index (OR: 3.5; p = 0.008), the non-daily use of tooth floss (OR: 8.7; p = 0.017), percentage of coated tongue (p = 0.005), abnormal salivary flow (OR: 4.2; p < 0.001) and dental caries (OR: 3.8; p = 0.002). No associations with brushing performed by a caregiver or salivary pH were found.