Breath Odors, Prevalence, Gender, and Age

Reference
Subjects population
Malodor parameter
Criteria/cutoff
Prevalence (%)
Sulser et al. (1939)
n  =  200
Age n.d.
Osmoscope (indirect method)
Malodor score of PO2 and above (“objectionable”)
56
Morris and Read (1949)
No. n.d.
Age 18–60 years
Osmoscope (direct method; 2 operators)
Malodor score of PO3 and above (1–6) (“halitosis”)
65
Miyazaki et al. (1995)
n  =  2,672
Age 18–64 years
VSC measured by Halimeter
VSC level  ≥  75 ppb
Less than 2 h following meals
More than 2 h following meals
6–14
16–23
Miyazaki et al. (1997)
n  =  2,601
Age 18–64 years
VSC measured by Halimeter
VSC level  ≥  75 ppb
Less then 2.5 h following meals
More then 2.5 h following meals
8–15
18–25
Loesche et al. (1996)
n  =  270
Age  ≥  60 years
Questionnaire
“Been told you have”
“Think you have”
24
31
Soder et al. (2000)
n  =  1681
Mean age 36 years
Organoleptic
Strong, noticeably unpleasant odor (“Foetor ex ore”)
2.4
Iwanicka-Grzegorek et al. (2005)
n  =  295
Age 18–74 years
Organoleptic
Halimeter
Malodor score  ≥  2 (0–5)
VSC levels  ≥  125 ppb
29.7
24.5
Liu et al. (2006)
n  =  2000
Age 15–64 years
Organoleptic
Halimeter
Malodor score  ≥  2 (0–5)
VSC levels  ≥  75 ppb
≥110 ppb
27.5
35.4
20.3
Nadanovsky et al. (2007)
n  =  344
Age 1–87 years
Informants questionnaire
“Yes” to: “family member with bad breath?”
15
Rosenberg et al. (2007)
n  =  88 (46M)
Age 20–55 years
Organoleptic
Malodor score  ≥  2 (0–5)
29.8
Bornstein et al. (2009)
n  =  419
Age 18–94 years
Organoleptic
Halimeter
Malodor score  ≥  2 (0–5)
≥3 (0–5)
≥4 (0–5)
VSC levels  ≥  75 ppb
≥110 ppb
31.5
11.4
2.14
27.9
It is clear that the lack of standardization in threshold criteria and measuring techniques is the cause for this large variation. For example, a study that was conducted in Sweden (Soder et al. 2000), which used “strong, noticeably unpleasant odor” (i.e., “Foetor ex ore”) as the criterion for breath odors, reported 2.4% prevalence in a population of 1681 subjects. Using such a high threshold that is equivalent to an odor judge score “4” (i.e., “strong malodor”) on a 0–5 scale yielded a similarly low prevalence (2.14%) in a study done in Swaziland (Bornstein et al. 2009). However, in the same study, when an odor judge score of “2” and above was applied as a threshold for malodor (i.e., “mild, clearly noticeable malodor”), prevalence reached 31.5%.
Some of these studies regarded odor judge scores of “2” and above as the threshold value for breath odors (Bornstein et al. 2009; Iwanicka-Grzegorek et al. 2005; Liu et al. 2006; Rosenberg et al. 2007). Using this criterion, they reported that 27.5–31.5% of the subjects were positive for breath odors, concluding that the prevalence of breath odors in the general population is a little over 25%.
A few studies based their breath odor assessment solely on oral VSC levels (Miyazaki et al. 1995; Miyazaki et al. 1997), as measured using a sulfide monitor (i.e., Halimeter), whereas others used VSC measurements adjacent to organoleptic scorings (Bornstein et al. 2009; Iwanicka-Grzegorek et al. 2005; Liu et al. 2006). These studies regarded different VSC concentration values as cutoff points for breath odor conformation (e.g., 75, 110, 125 ppb, respectively). It is important to stress that although VSC readings using Halimeter are in high correlation with organoleptic scores and their value is an important parameter for clinical follow up, the absolute value of a given reading would vary between different instruments depending on the sensor’s freshness. Therefore, setting a universal cutoff value would be impractical.
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Nov 30, 2015 | Posted by in General Dentistry | Comments Off on Breath Odors, Prevalence, Gender, and Age
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