Prevalence and Associated Factors of Halitosis Among University Students in Guangxi, Southern China: A...

This study aimed to investigate the prevalence of halitosis and explore associated factors among university students in Guangxi, Southern China.

A cross-sectional study was conducted among university students aged 18-25 from 10 universities in Guangxi using multi-stage stratified random sampling. Face-to-face, paper-based questionnaires were administered to collect participants' general information and data on self-reported halitosis. Organoleptic testing (OLT) was used as the clinical reference standard for diagnosing organoleptic halitosis. Standardised oral examinations were also conducted to evaluate participants' oral health status. A bidirectional stepwise multivariable logistic regression analysis was performed to identify factors associated with self-reported and organoleptic halitosis.

Of the 1,377 participants, 34.9% self-reported halitosis, and 33.9% were diagnosed with organoleptic halitosis by the OLT. The agreement rate between the two methods was 65.4%, with a Cohen's κ coefficient of 0.23, indicating fair concordance. In the final multivariate regression analysis, self-reported halitosis was significantly associated with self-perceived stress, dry mouth, food impaction, gingival bleeding, and respiratory tract diseases. In contrast, organoleptic halitosis was significantly associated with smoking, infrequent water intake, lack of daily tongue cleaning, and poor oral hygiene. The absence of regular dental scaling and a tongue coating score (TCS) ≥5 were common correlates of both self-reported and organoleptic halitosis.

The prevalence of halitosis in this population based on the OLT was 33.9%. Early identification and patient education may help reduce the burden of halitosis and improve overall oral health.