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Halitosis and Associated Risk Factors in Children: A Cross-sectional Study

Noura A AlMadhi¹, Ayman M Sulimany², Hamad A Alzoman³

¹Department of Pediatric Dentistry and Orthodontics, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia, Phone: +966 500097447,

The Journal of Contemporary Dental Practice

|May 18, 2021

Insights

Children's caries experience significantly increases the risk of halitosis (bad breath). High levels of specific volatile sulfur compounds (VSCs) like hydrogen sulfide and methyl mercaptan were linked to higher decay rates in a study of young children.

Area of Science:

Pediatric Dentistry
Oral Health
Halitosis Research

Background:

Halitosis, or bad breath, is a common concern in children.
Identifying risk factors is crucial for effective prevention and management.
Volatile sulfur compounds (VSCs) are primary contributors to oral malodor.

Purpose of the Study:

To investigate the risk factors associated with halitosis in children.
To utilize the OralChroma™ device for measuring VSCs (H₂S, CH₃SH, CH₃SCH₃).
To explore the correlation between oral hygiene indices and VSC levels.

Main Methods:

Sixty-seven children (ages 3-8) were assessed.
Data collected included demographics, medical history, and oral hygiene practices.
Clinical examinations recorded caries (dmft/DMFT), debris (DI-S), gingival index (MGI), and tongue coating (WTCI).
OralChroma™ measured VSC concentrations.

Main Results:

87% of children exhibited high VSC measures.
Higher dmft/DMFT scores were significantly associated with increased H₂S and CH₃SH levels.
No significant association was found between VSC levels and DI-S, MGI, or WTCI.

Conclusions:

Children's caries experience (dmft/DMFT) is a significant risk factor for halitosis.
High levels of H₂S and CH₃SH are linked to caries in the studied pediatric population.
Caries management should be considered in addressing halitosis in children.

Read full analysis

Abstract

Aim:

To investigate risk factors associated with halitosis in children using OralChroma™.

Materials And Methods:

Sixty-seven children between the ages of 3 and 8 who attended a pre-general anesthesia assessment at the Dental University Hospital at King Saud University, Riyadh, Saudi Arabia, were enrolled in this study after satisfying the inclusion criteria. Demographic data, medical history, and oral hygiene practices were obtained by a standardized questionnaire completed by the parents of each child. Clinical dental examination was conducted to record the following: caries index (dmft/DMFT), simplified debris index (DI-S), modified gingival index (MGI), and Winkel tongue coating index (WTCI). Clinical halitosis was assessed using the OralChroma™ device that measures the concentration of volatile sulfur compounds (VSCs) including hydrogen sulfide (H₂S), methyl mercaptan (CH₃SH), and dimethyl sulfide (CH₃SCH₃). Statistics were completed using Spearman's correlation coefficient and Mann-Whitney U-test to assess the association with the VSC scores with continuous and binary variables, respectively. Then, multivariate linear regression analysis was performed to detect the degree of association.

Results:

High VSC measures were detected in 58 children (87%). The dmft/DMFT was significantly associated with H₂S level (β = 26.84, p = 0.034) and CH₃SH level (β = 19.96, p = 0.016) after controlling possible confounders. There was no significant association of DI-S, MGI, and WTCI with the VSC measures.

Conclusion:

The result suggested that dmft/DMFT score (children's caries experience) is associated significantly with high levels of H2S and CH₃SH in the sample studied.

Clinical Significance:

Caries experience in children is a significant risk factor for halitosis and should be considered during the management of halitosis.

Keywords:

Children Dental caries Halitosis OralChroma Volatile sulfur compounds.

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